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Why risk an SSI in veterinary procedures?
SSIs have been described as a complication in 3 to 5.5% of all small animal surgical procedures. Plus Sutures have been shown in vitro to inhibit bacterial colonization of the suture, for protection against the most common organisms associated with SSI. And, they require no technique change since they handle like the sutures you know and love.1-4*
Sutures can be a nidus for infection5,6
Like all implants, sutures can lower the infective threshold.5,6 Once bacteria colonize on the surface, biolm can form–a known risk factor for SSI.7 Plus Sutures are shown in vitro to inhibit bacterial colonization of the suture for 7 days or more against the most common organisms associated with SSI.2-4*
Shown to reduce SSI risk8†‡
Meta-analysis demonstrated a 28% reduction in SSI risk with the use of triclosan-coated sutures.8†‡ Meta-regression analysis demonstrated that the effect of Plus Sutures in reducing the risk of SSI did not vary by Centers for Disease Control and Prevention (CDC) wound classification or suture type.8†‡§
Recommended by 6 independent authorities 9-13||
Triclosan-coated sutures are included in SSI-prevention bundles recommended by a number of evidence-based organizations, including the WHO, CDC, ACS/SIS, NICE, and RKI.
CDC, WHO, ACS/AIS, 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.
*Staphylococcus aureus, Staphylococcus epidermidis, Methicillin-resistant Staphylococcus aureus (MRSA), Methicillin-resistant Staphylococcus epidermidis (MRSE), Escherichia coli, and Klebsiella pneumoniae.
†In a meta-analysis of 21 RCTs, 6462 patients, 95% CI: (14, 40%), P<0.001.
‡All triclosan-coated sutures in these RCTs were Ethicon Plus Antibacterial Sutures (MONOCRYL® Plus Antibacterial [poliglecaprone 25] Suture, Coated VICRYL® Plus Antibacterial [polyglactin 910] Suture, and PDS® Plus Antibacterial [polydioxanone] Suture). STRATAFIX™ are the only barbed sutures with Plus Antibacterial Technology.
§Clean wounds 10 RCT, 2842 patients 95% CI (11-43%). P= 0.003; non-clean wounds 14 RCT, 3620 patients. 95% CI (7 – 42%).||CDC, WHO, ACS/SIS, NICE, and KRINKO guidelines on reducing the risk of surgical site infections are general to triclosan-coated sutures and are not speci_c to any one brand.
¶Market share data based upon sales compiled Animalytix 2018-2020 time period for veterinary market.
- Verwilghen D, Singh A. Fighting surgical site infections in small animals: are we getting anywhere? Vet Clin NA Small Anim. 2015;45:243-276.
- Rothenburger S, Spangler 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 1:S79-87.
- Ming X, Rothenburger S, Nichols MM. In vivo and in vitro antibacterial e_cacy of PDS Plus (Polidioxanone with Triclosan) Suture. Surg Infect (Larchmt). 2008;9(4):451-457.
- Ming X, Rothenburger S, Yang D. In vitro antibacterial e_cacy of MONOCRYL plus antibacterial suture (Poliglecaprone 25 with triclosan). Surg Infect (Larchmt). 2007 Apr;8(2):201-8.
- Mangram AJ, Horan TC, Pearson ML, et al. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol. 1999;20(4):247-278.
- 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(4):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.
- De Jonge SW, Atema JJ, 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.10445.
- Berríos-Torres SI, Umscheid CA, Bratzler DW, et al. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017. JAMA Surg. 2017;152(8):784-791.
- WHO Global Guidelines for the Prevention of Surgical Site Infection. Geneva: World Health Organization; 2016.
- 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.
- NICE Guideline Updates Team (UK). Surgical site infection: prevention and treatment. NICE website. https://www.nice.org.uk/guidance/ng125/chapter/Recommendations#closuremethods. Accessed April 3, 2020.
- 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.
- Animalytix Veterinary Market for Suture. United States: Animalytix; 2021. Accessed: February 28, 2021.
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