Triclosan sutures do not reduce infection after dog knee surgery

Abstract

OBJECTIVE: To compare surgical site infection and inflammation rates between the use of nonimpregnated (polydioxanone and poliglecaprone 25) versus triclosan-impregnated (polydioxanone and poliglecaprone 25) suture for incisional closure in dogs undergoing a standardized orthopedic procedure (tibial plateau leveling osteotomy [TPLO]). DESIGN: Retrospective cohort study. ANIMALS: 283 dogs that underwent TPLO between November 2005 and December 2009. PROCEDURES: Medical records were reviewed for age; body weight; body condition score; use of propofol; perioperative and postoperative administration of antimicrobials; presence of a preoperative infection; use of a jig; technique of joint exploration; type of suture material (triclosan impregnated vs nonimpregnated) used to close the pes anserinus, subcutaneous layer, and subcuticular layer; use of staples or suture to close the skin; and surgery and anesthesia durations. The outcome variables were surgical site inflammation and infection. RESULTS: Rates of infection and inflammation did not differ between surgeries for which triclosan-impregnated suture was used (n = 159 [8.8%, and 18.8%, respectively]) and those for which nonimpregnated suture was used (112 [10.7% and 15.2%, respectively]). The use of staples, compared with suture, to close the skin significantly decreased the inflammation rate. CONCLUSIONS AND CLINICAL RELEVANCE: Compared with in vitro conditions, in vivo conditions (where the environment is not controlled and triclosan may elute more quickly from the suture) may decrease the antibacterial effectiveness of triclosan-impregnated suture. On the basis of our findings, triclosan-impregnated sutures did not seem to provide an additional benefit for clinical use and cannot be strongly recommended for elective orthopedic procedures in veterinary medicine.