Background: Coated polyglactin 910 suture with triclosan was developed recently in order to
imbue the parent suture, coated polyglactin 910, with antibacterial activity against the most
common organisms that cause surgical site infections (SSI). Because such alterations could alter
the physical properties of the suture, this study sought to compare the intraoperative handling
and wound healing characteristics of coated polyglactin 910 suture with triclosan and
traditional coated polyglactin 910 suture in pediatric patients undergoing various general surgical
procedures.
Methods: This was a prospective, randomized, controlled, open-label, comparative, single-center
study. Pediatric patients (age 1–18 years) undergoing various surgical procedures were
randomized in a 2:1 ratio to treatment with either coated polyglactin 910 suture with triclosan
or coated polyglactin 910 suture. The primary endpoint was the surgeon's assessment of the
overall intraoperative handling of coated polyglactin 910 suture with triclosan and traditional
coated polyglactin 910 suture without triclosan. The secondary endpoints included specific
intraoperative suture handling measures and wound healing assessments. The suture handling
measures were (1) ease of passage through tissue; (2) first-throw knot holding; (3) knot
tie-down smoothness; (4) knot security; (5) surgical handling; (6) surgical hand; (7) memory;
and (8) suture fraying. Assessment of wound healing included the following: Healing
progress, infection, edema, erythema, skin temperature, seroma, suture sinus, and pain. Adverse
events were recorded.
Results: Scores for intraoperative handling were favorable and not significantly different
for both sutures, although coated polyglactin 910 suture with triclosan received more "excellent"
scores (71% vs. 59%). Wound healing characteristics were comparable for both sutures
except for pain on postoperative day 1. Significantly fewer patients treated with polyglactin 910 suture with triclosan reported pain on day 1 than patients who received the other suture
(68% vs. 89%, p = 0.01). The overall incidence of adverse events was 18%; none was devicerelated.
Conclusions: Coated polyglactin 910 suture with triclosan performed as well or better than
traditional coated polyglactin 910 suture in pediatric patients undergoing general surgical procedures.
The incidence of postoperative pain was significantly less in patients treated with
coated polyglactin 910 suture with triclosan than the traditional suture. We speculate that
polyglactin 910 suture with triclosan, by inhibiting bacterial colonization of the suture, reduced
pain that can be an indicator of "subclinical" infection. Coated polyglactin 910 suture
with triclosan may be a useful alternative in patients at increased risk of developing SSI.
