medigraphic.com
ISSN 2992-8559 (Electronic)
ISSN 1405-0625 (Print)

2017, Number 2

<< Back Next >>

Cir Plast 2017; 27 (2)

Clinical evolution of surgical wound with uncoated polydioxanone and with chlorhexidine coated suture in postoperative body contour patients after massive loss weight. Comparative clinical study

Portes-Castro A, Morales-Olivera JM, López-Montero M, Albores-De la Riva NX, Ponce-Del Carmen JA

Language: Spanish
References: 24
Page: 61-66
PDF size: 258.87 Kb.


ABSTRACT

Surgical wound infections are a health problem that increases morbidity and hospital costs. The surgical wound infection rate in patients with massive weight loss is 13-16%. In order to reduce infection rates, suture materials with antiseptic coating have been produced to inhibit the proliferation and development of commonly isolated bacteria. We performed a comparative prospective clinical study in which we included 12 patients as a control group and 12 as an experimental group, both undergoing abdominoplasty using uncoated polydioxanone suture and suture with chlorhexidine coating respectively. We performed a post-surgical follow-up with clinical evaluation of the surgical wound of both groups. One patient in the control group presented fat necrosis and epidermolysis with favorable evolution of the surgical wound. The evolution of the surgical wound in both groups was favorable, with an adequate aesthetic result. There were no infections, no wound dehiscence. The size of the sample from this study was insufficient to determine the efficacy of chlorhexidine-coated sutures to prevent infection in patients with massive weight loss who underwent abdominoplasty. However, we do not rule out the routine use of this type of suture as part of the technological advancement in wound closure in post massive weight loss surgery as a tool to decrease the risk of surgical infections.


REFERENCES

  1. D’Ettorre M, Gniuli D, Iaconelli A, Massi G, Mingrone G, Bracaglia R. Wound healing process in post-bariatric patients: An experimental evaluation. Obes Surg 2010; 20: 1552-1558.

  2. Gusenoff JA, Coon D, Nayar H, Kling RE, Rubin JP. Medial thigh lift in the massive weight loss population: outcomes and complications. Plast Reconstr Surg 2015; 135(1): 98-106.

  3. Hasanbegovic E, Sorensen JA. Complications following body contouring surgery after massive weight loss: a meta-analysis. J Plast Reconstr Aesthet Surg 2014; 67(3): 295-301.

  4. García-García ML, Martín-Lorenzo JG, Campillo-Soto A, Torralba-Martínez JA, Lirón-Ruiz R, Miguel-Perelló J et al. Complications and level of satisfaction after dermolipectomy and abdominoplasty post-bariatric surgery. Cir Esp 2014; 92(4): 254-260.

  5. Sanders D, Lambie J, Bond P, Moate R, Steer JA. An in vitro study assessing the effect of mesh morphology and suture fixation on bacterial adherence. Hernia 2013; 17(6): 779-789.

  6. Fowler JR, Perkins TA, Buttaro BA, Truant AL. Bacteria adhere less to barbed monofilament than braided sutures in a contaminated wound model. Clin Orthop Relat Res 2013; 471(2): 665-671.

  7. Alexander JW, Kaplan JZ, Altemeier WA. Role of suture materials in the development of wound infection. Ann Surg 1967; 165: 192-199.

  8. Einarsson JI, Vellinga TT, Twijnstra AR, Chavan NR, Suzuki Y, Greenberg JA. Bidirectional barbed suture: an evaluation of safety and clinical outcomes. JSLS 2010; 14: 381-385.

  9. Fishman M. Microbial adherence and infection-clinical relevance. Infect Control 1986; 7(3): 181-184.

  10. Lissovoy G, Fraeman K, Hutchins V, Murphy D, Song D, Vaughn BB. Surgical site infection: incidence and impact on hospital utilization and treatment costs. Am J Infect Control 2009; 37(5): 387-397.

  11. Katz S, Izhar M, Mirelman D. Bacterial adherence to surgical sutures a possible factor in suture induced infection. Ann Surg 1981; 194(1): 35-41.

  12. McDonnell G, Russell AD. Antiseptics and disinfectants: activity, action, and resistance. Clin Microbiol Rev 1999; 12(1): 147-179.

  13. Ming X, Rothenburger S, Nichols MM. In vivo and in vitro antibacterial efficacy of PDS plus (polydioxanone with triclosan) suture. Surg Infect (Larchmt) 2008; 9(4): 451-457.

  14. Mattavelli I, Rebora P, Doglietto G, Dionigi P, Dominioni L, Luperto M et al. Multi-center randomized controlled trial on the effect of triclosan-coated sutures on surgical site infection after colorectal surgery. Surg Infect (Larchmt) 2015; 16(3): 226-235.

  15. Hoshino S, Yoshida Y, Tanimura S, Yamauchi Y, Noritomi T, Yamashita Y. A study of the efficacy of antibacterial sutures for surgical site infection: a retrospective controlled trial. Int Surg 2013; 98(2): 129-132.

  16. Edmiston CE, Seabrook GR, Goheen MP, Krepel CJ, Johnson CP, Lewis BD et al. Bacterial adherence to surgical sutures: can antibacterial-coated sutures reduce the risk of microbial contamination? J Am Coll Surg 2006; 203: 481-489.

  17. Bedoux G1, Roig B, Thomas O, Dupont V, Le Bot B. Occurrence and toxicity of antimicrobial triclosan and by-products in the environment. Environ Sci Pollut Res Int 2012; 19(4): 1044-1065.

  18. Witorsch RJ. Critical analysis of endocrine disruptive activity of triclosan and its relevance to human exposure through the use of personal care products. Crit Rev Toxicol 2014; 44(6): 535-555.

  19. Glotzbecker MP, Riedel MD, Vitale MG, Matsumoto H, Roye DP, Erickson M et al. What’s the evidence? Systematic literature review of risk factors and preventive strategies for surgical site infection following pediatric spine surgery. Pediatr Orthop 2013; 33(5): 479-487.

  20. Wilson J. How to reduce the risk of surgical site infection. Nurs Times 2015; 111(38): 12-16.

  21. Mangram AJ1, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for Prevention of Surgical Site Infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee. Am J Infect Control 1999; 27(2): 97-132.

  22. Umscheid CA, Mitchell MD, Doshi JA, Agarwal R, Williams K, Brennan PJ. Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs. Infect Control Hosp Epidemiol 2011; 32(2): 101-114.

  23. Greco J, Castaldo E, Nanney L, Wendel JJ, Summitt JB, Kelly KJ et al. The effect of weight loss surgery on complications after abdominal operations. Ann Plast Surg 2008; 61(3): 235-242.

  24. Rolando Jr, Bush A, Mentz H, Newall G, Patronella C, Fortes P. Low molecular weight heparin versus rivaroxaban for thromboprophylaxis in body contouring procedures. Plast Reconstr Surg 2014; 134(4S-1): 121.




2020     |     www.medigraphic.com