One Year Randomized Controlled Trial To Compare The Effectiveness Of Triclosan Coated Pds Plus Versus Uncoated Pds Sutures In Prevention Of Surgical Site Infections After Monolayer Closure In Open Abdominal Surgeries

Abstract

Background and objectives Surgical site infections remain one of the most frequent complications in open abdominal surgery. This study compared the effectiveness of Triclosan coated PDS Plus and non coated PDS II after monolayer abdominal fascia closure in preventing SSI in open abdominal surgeries. Methodology The randomized controlled trial was conducted in the Department of General Surgery, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum for the period of one year from January 2014 to December 2014 were studied. A total of 60 patients undergoing open abdominal surgeries (Clean contaminated) were enrolled. These patients were divided into two groups of 30 each based on suture material used to close the abdominal fascia in monolayer as Group A (PDS II sutures) and Group B (PDS plus sutures). Results Most of the patients were males in group A and B (63.33%) with males to female ratio of 1.72:1 (p=1.000). Nearly half of the study population (50%) was aged ≤ 30 years in group A compared to 33.33% in group B (p=0.262). The mean age in group A and group B was comparable (39.90±11.67 vs 41.67±16.08 years; p=0.687). Other pre-intervention characteristics including fever, vomiting, tenderness, vitals and type of surgery were comparable (p>0.050). On post operative day two, discharge was noted in 19 (63.33%) patients in group A and culture was positive in 9 (81.82%) of the patients with commonest organism being Escherichia coli and pseudomonas aeruginosa (3 patients each [27.27%]). In group B, discharged was noted in 21 (70%) patients of which culture was positive in 7 (77.78%) patients with pseudomonas aeruginosa and commonest organism (22.22%). However these findings were comparable in group A and B (p>0.050). Similar trend was noted on day six as well as day ten. The other wound characteristics including pain, local tenderness, redness, raised local temperature, fever were comparable in group A and group B on day two as well as day six and ten (p=0.050). The surgical site infections were present in 43.33% of the patients in group A compared to 30% of the patients in group B (p=0.284). Conclusion and interpretation Abdominal fascia closure with Triclosan coated PDS Plus sutures is as effective as non-coated PDS sutures after monolayer closure in clean contaminated open abdominal surgeries in the prevention of surgical site infections.