Abstract
ObjectiveTo evaluate the efficacy of triclosan-coated suture for the reduction of infection in saphenectomy wounds of patients undergoing coronary artery bypass graft (CABG) surgery.MethodsA total of 508 patients who underwent saphenectomy in CABG surgery were included in a prospective, randomized, double-blind trial from February/2011 to June/2014. Patients were randomized into the triclosan-coated suture group (n= 251) and the conventional non-antibiotic suture group (n=257). Demographic (gender and age), clinical (body mass index, diabetes, and use of analgesics), and intraoperative (cardiopulmonary bypass and cross-clamp times) variables and those related to the saphenectomy wound (pain, dehiscence, erythema, infection, necrosis, and hyperthermia) were measured and analyzed.ResultsOf the 508 patients who underwent saphenectomy, 69.9% were males and 40.2% were diabetic. Thirty-three (6.5%) patients presented infection: 13 (5.3%) with triclosan and 20 (7.9%) with conventional suture (P=0.281). Among diabetic patients (n=204), triclosan suture was used in 45.1% with four cases of infection; conventional suture was used in 54.9% of them, with 11 cases of infection. Most patients (94.3%) underwent on-pump CABG. Wound pain was observed in 9.9% of patients with triclosan-coated suture and in 17.9% with conventional suture (P=0.011). Wound hyperthermia was found in 1.6% of patients with triclosan-coated suture and in 5.4% of those with conventional suture (P=0.028).ConclusionTriclosan-coated suture shows lower infection rate in saphenectomy of patients undergoing CABG, although the differences were not statistically significant. Pain and wound hyperthermia were less frequent in patients with triclosan-coated sutures compared with conventional sutures.
Highlights
Cardiovascular disease is the world's leading cause of mortality, morbidity, and disability[1,2]
Among diabetic patients (n=204), triclosan was used in 45.1% of them, with four cases of infection, and conventional suture was used in 54.9%, with 11 cases of infection (P=0.284)
The results of this study show that the triclosan-coated suture presented the lowest rate of infection in saphenectomy of patients undergoing coronary artery bypass graft (CABG)
Summary
Cardiovascular disease is the world's leading cause of mortality, morbidity, and disability[1,2]. The coronary artery bypass graft (CABG) surgery has been effective in relieving these patients’ symptoms and increasing survival rates[3]. Such surgery requires highly specialized hospitals and trained staff, generating high costs for health systems. CABG is the most practiced cardiac surgery in our country, most of which is performed by the Sistema Único de Saúde (SUS), the Brazilian public health system, both in public and in philanthropic or private hospitals[4]. CABG is the most appropriate treatment for coronary artery disease, currently, the major challenge is to.
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