This prospective, randomized, multicenter, double-blind, parallel group trial by Dr. Turtiainen and her associates in Finland [1] was designed to investigate the potential effect of an antibacterial triclosan-coated suture on the incidence of wound infection in patients undergoing reconstructive vascular surgery. In producing a negative result, the investigators have clarified the role, or lack thereof, of this approach to wound infection. They raise at least two important topics that need to be discussed. The first is the relative dearth of articles in the medical literature reporting negative results, and the other is the matter of wound infections associated with vascular surgery. In general terms, the reluctance of investigators (and journals) to publish negative results contributes significantly to the imbalances that lead to reporting bias. This bias is now assuming more importance than previously because we increasingly depend on meta-analyses to guide medical care via the development and use of guidelines and protocols. The absence of negative studies in the literature inevitably leads to the production of conclusions from such analyses that are biased toward the positive. To reduce such misleading tendencies, the publication of carefully designed and wellconducted studies such as this one should be encouraged even when the results are negative [2]. The problem studied in the article by Turtiainen et al. [1]—infection associated with reconstructive vascular surgery—is a source of particular anxiety because of its potentially disastrous consequences, especially in this age of methicillin-resistant Staphylococcus aureus (MRSA) and health care-associated infections. The consequences of infection can be catastrophic. ‘‘... outcomes often worse than those of the natural history of the condition that led to implantation [of the graft]’’ [3]. Infection of a prosthetic conduit not uncommonly leads to limb loss or death. Add to this mix the propensity of groin wounds disproportionately to be affected and the preponderance of diabetic patients involved and we understand why vascular surgeons should be so concerned about this topic. The incidence of surgical-site infections (SSIs) after vascular surgery varies widely from one publication to another, as does the definition of wound infection. The incidence reported here is not out of keeping with other reports. Vascular surgery is often regarded largely as ‘‘clean’’ surgery in that incisions are made through apparently uncontaminated tissue, and the procedures do not involve opening any hollow viscus. Published audits of wound infection in vascular surgery report wide variations in wound infection rates. Those at the lower end probably involve a certain amount of selection bias as authors strive to demonstrate the excellence of their practice. Studies such as the one published here almost certainly give a more accurate picture of the real world. Clear definition of what constitutes an SSI and impartial, blinded follow-up are important aspects of this accuracy. It seems possible that infection rates outside the confines of a trial (where patients are known to receive more error-free care) are even higher than those discovered here. So what is to be done about the problem of wound infection in vascular surgery? It seems that there is no magic bullet yet, and we therefore must depend upon rigorous application of techniques and policies that are well established. Appropriate prophylactic antibiotics, meticulous maintenance of intraoperative sterility, accurate surgical technique avoiding excessive dissection and cautery, and most importantly careful patient selection have major roles in the minimization of this substantial risk. P. Rogers (&) Western Infirmary, Glasgow G11 6NT, UK e-mail: pn.rogers@btinternet.com