AUTHOR=Timmer Allard S. , Wolfhagen Niels , Pianka Frank , Knebel Phillip , Justinger Christoph , Stravodimos Christos , Ichida Kosuke , Rikiyama Toshiki , Baracs József , Vereczkei András , Gianotti Luca , Sandini Marta , Ruiz-Tovar Jaime , Marc-Hernández Artur , Nakamura Toru , Dijkgraaf Marcel G. W. , Boermeester Marja A. , de Jonge Stijn W. 

TITLE=The Effect of Fascial Closure With Triclosan-Coated Sutures on the Incidence of Abdominal Wall Dehiscence: An Individual Participant Data Meta-Analysis 

JOURNAL=Journal of Abdominal Wall Surgery

VOLUME=Volume 3 - 2024

YEAR=2024

URL=https://www.frontierspartnerships.org/journals/journal-of-abdominal-wall-surgery/articles/10.3389/jaws.2024.13337

DOI=10.3389/jaws.2024.13337

ISSN=2813-2092

ABSTRACT=Introduction
Wound closure with triclosan-coated sutures (TCS) appears to reduce the risk of surgical site infection (SSI). Because there is a strong association between postoperative SSI and the development of acute abdominal wall dehiscence (AWD) after laparotomy, we hypothesised that the use of TCS for wound closure after laparotomy also reduces the risk of AWD.

Methods
The MEDLINE, Embase, and CENTRAL were searched from database inception to November 01, 2022. Randomised trials that compared the use of TCS with identical but uncoated sutures for fascial closure were eligible if they could provide individual participant data (IPD) on AWD. From these trials we only included participants that had undergone open abdominal surgery for analysis. The primary outcome was the incidence of AWD within 30 days postoperatively, requiring emergency reoperation.The certainty of evidence was assessed using GRADE methodology. (PROSPERO: CRD42019121173).

Results
We identified twelve eligible trials. Eight trials shared IPD. The incidence of AWD within 30 days after surgery was 27/1565 (1.7%) in the TCS group versus 40/1430 (2.8%) in the control group (Relative Risk: 0.70 [95% confidence-interval (CI) 0.44-1.11, I²= 0%, ²= 0.00]). The certainty of evidence was moderate after downgrading for imprecision. The incidence of incisional SSI was 163/1576 (10.3%) versus. 198/1439 (13.8%), RR 0.80 (95% CI 0.67-0.97).

Discussion
We found no conclusive evidence to support the use of triclosan-coated sutures for the prevention of acute abdominal wall dehiscence after laparotomy. In these selected trials, a significant reduction in incisional SSI was observed.