Meta-analysis proves that SSI risk is significantly reduced with the use of triclosan-coated sutures.1 Plus sutures are a simple, proven and cost-effective way to help address a known risk factor associated with surgical site infection.2-4 Plus Antibacterial Sutures have been shown in vitro to inhibit bacterial colonisation of the suture for 7 days or more, for protection against the most common organisms associated with SSI.2-5
Features & Benefits
You Can’t Tell the Difference, but Bacteria Can.
Sutures, like any foreign material, lower the number of bacteria required to cause an infection; and the biofilm formed on the suture can actually protect bacteria against infection fighting cells and antibiotic therapy. Ethicon responded by creating Plus Antibacterial Sutures. Shown in vitro to inhibit bacterial colonisation of the suture for 7 days or more, Plus Sutures are a simple way to address a known risk factor for SSI.2-4,6
Shown to reduce SSI risk, supported by Level 1A evidence7-17
Meta-analysis – considered Level 1A evidence7-17 – demonstrated a 28% reduction in surgical site infection (SSI) risk with the use of triclosan-coated sutures.1*†‡. In the same study, meta-regression analysis demonstrated that the effect of triclosan-coated sutures in reducing the risk of SSI did not vary by CDC wound classification or suture type.1*†‡
A cost-effective part of an SSI- prevention bundle.
A single hospitalisation involving a SSI can cost up to
$43,830 NZD in extra costs18. Plus Sutures are an affordable part of the SSI-prevention care bundle recommended by the WHO.7,20,25¶
Recommendations you can trust
Triclosan-coated sutures are supported by evidence- based recommendations from a growing number of global health authorities as part of the
Now recognised by NHMRC (National Health and Medical Research Council - Australia) and other global recognised healthcare authorities including :
- WHO (World Health Organisation)
- CDC (Centre for Disease Control) USA
- NICE (National Institute for Health and Care Excellence) UK
- ACS,SIS (American College of Surgeons and the Surgical Infection Society) USA
VICRYL® Plus Antibacterial Suture (polyglactin 910) Coated
MONOCRYL® Plus Antibacterial Suture (poliglecaprone 25)
PDS® Plus Antibacterial Suture (Polydioxanone)
STRATAFIX™ Knotless Tissue Control Devices with Plus Antibacterial Technology
*21 RCTs, 6,462 patients, 95% CI: (14, 40%), P<0.001.
†All triclosan-coated sutures in these RCTs were Ethicon Plus Antibacterial Sutures (Monocryl Plus, Vicryl Plus and PDS Plus).
‡Clean wounds 10 RCT, 2842 patients, 95% CI (1143%), P=0.003; non-clean wounds 14 RCT, 3620 patients, 95% CI (7-42%).
¶ Assuming 10 or fewer strands used per surgical case.
**CDC, NHMRC, WHO, ACS/SIS, NICE, and RKI guidelines on reducing the risk of surgical site infections are general to triclosan-coated sutures and are not specific to any one brand.
- de Jonge SW, Atema , Solomkin JS, Boermeester MA. Meta-analysis and trial sequential analysis of triclosan-coated sutures for the prevention of surgical site infection. Brit J Surg. 2017;ePub-DOI: 10.1002/bjs.104-45.
- Rothenburger S, Pangler D, Bhende S, Burkley D. In vitro antimicrobial evaluation of coated Vicryl Plus Antibacterial Suture (coated polyglactin 910 with triclosan) using zone of inhibition assays. Surg Infect (Larchmt). 2002;3(suppl):S79-S87.
- Ming X, Rothenburger S, Yang D. In vitro antibacterial efficacy of Monocryl Plus Antibacterial Suture (poligelcaprone 25 with triclosan). Surg Infect (Larchmt). 2007;8(2):201-207.
- Ming X, Rothenburg S, Nichols MM. In vivo and in vitro antibacterial efficacy of PDS Plus (polidioxanone with triclosan) suture. Surg Infect (Larchmt). 2008;9(4):451-457.
- Leaper DJ, Edmiston CE, Holy CE. Meta-analysis of the potential economic impact following introduction of absorbable antimicrobial sutures. Br J Surg. 2016;DOI: 10.1002/bjs.10443.
- Edmiston CE, Seabrook GR, Goheen MP, et al. Bacterial adherence to surgical sutures: can antibacterial-coated sutures reduce the risk of microbial contamination? J Am Coll Surg. 2006; 203:481-489.
- Edmiston CE, Daoud FC, Leaper D. Is there an evidence-based argument for embracing an antimicrobial (triclosan)-coated suture technology to reduce the risk for surgical-site infections? A meta-analysis. Surgery. 2013;154:89-100.
- Apisarnthanarak A, Singh N, Bandong AN, et al. Triclosan-coated sutures reduce the risk of surgical site infections: a systematic review and meta-analysis. Infect Control Hosp Epidemic. 2015;36:169-179.
- Chang WK, Srinivasa S, Morton R, et al. Triclosan-impregnated sutures to decrease surgical site infections: systematic review and meta-analysis of randomized trials. Ann Surg. 2012;255(5):854-859.
- Daoud FC, Edmiston CE Jr, Leaper D. Meta-analysis of prevention of surgical site infections following incision closure with triclosan-coated sutures: robustness to new evidence. Surg Infect (Larchmt). 2014;15(3):165-181.
- Daoud FC. Systematic literature review update of the PRO Trial: potential usefulness of a collaborative database. Surg Infect (Larchmt). 2014;15(6):857-858.
- Guo J, Pan LH, L X, et al. Efficacy of triclosan- coated sutures for reducing risk of surgical site infection in adults: a meta-analysis of randomized clinical trials. J Surg Res. 2016; 201(1):105-117.
- Sajid MS, Craciunas L, Sains P, et al. Use of antibacterial sutures for skin closure in controlling surgical site infections: a systematic review of published randomized, controlled trials. Gastroenterol Rep (Oxf). 2013;1(1):42-50.
- Sandini M, Mattavelli I, Nespoli L, Uggeri F, Gianotti L. Systematic review and meta-analysis of sutures coated with triclosan for the prevention of surgical site infection after elective colorectal surgery according to the PRISMA statement. Medicine (Baltimore). 2014;95(35):e4057. doi:10.1097/MD.0000000000004057.
- Wang ZX, Jiang , Cao Y, Ding YT. Systematic review and meta-analysis of triclosan-coated sutures for the prevention of surgical-site infection. Br J Surg. 2013;100(4):465-473.
- Wu X, Kubilay NZ, Ren J, et al. Antimicrobial-coated sutures to decrease surgical site infections: a systematic review and meta-analysis. Eur J Clin Microbiol Infect Dis. 2017;36(1):19-32.
- Ahmed I, Boulton AJ, Rizvi S, et al. The use of triclosan-coated sutures to prevent surgical site infections: a systematic review and meta-analysis of the literature. BMJ Open. 2019;9:e029727. doi:10.1136/bmjopen-2019-029727.
- Australian Commission on Safety and Quality in Health Care (2018). Selected best practices and suggestions for improvement for clinicians and health system managers. Hospital-Acquired Complication. Available online. Accessed on 9th July 2019.
- Berríos-Torres SI, Umscheid CA, Bratzler DW, et al. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection. JAMA Surg. 2017;152(8):784_791. doi:10.1001/jamasurg. 2017.0904.
- World Health Organization. Global Guidelines for the Prevention of Surgical Site Infection. https://apps.who.int/iris/bitstream/handle/10665/250680/9789241549882-eng.pdf?sequence=8. Published November 2016. Accessed February 10, 2020.
- Ban KA, Minei JP, Laronga C, et al. American College of Surgeons and Surgical Infection Society: Surgical Site Infection Guidelines, 2016 Update. J Am Coll Surg. 2016;224(1):59_74.
- National Institute for Health and Care Excellence (NICE) Guideline. Surgical site infections: prevention and treatment. NICE website. https://www.nice.org.uk/guidance/ng125/chapter/Recommendations#closuremethods. Accessed October 17, 2019.
- Prevention of postoperative wound infections. Recommendation of the Committee for Hospital Hygiene and Infection Prevention (KRINKO) at the Robert Koch Institute. Bundesgesundheitsbl. 2018; 61(4):448_473
- Australian Guidelines for the Prevention and Control of Infection in Healthcare, Canberra: National Health and Medical Research Council (2019).
- Plus Suture Cost Analysis. 2019. Ethicon, Inc.
©2022 Johnson & Johnson (New Zealand) Ltd. This site is published by Johnson & Johnson (New Zealand) Ltd which is solely responsible for its contents.
This site is intended for Healthcare Professionals from New Zealand only. Ethicon is a business unit of Johnson & Johnson (New Zealand) Ltd. 507 Mount Wellington Highway, Mount Wellington, Auckland, 1060, New Zealand.