Implantation Antimicrobial Prophylaxis In General and Military Field Surgery
https://doi.org/10.24060/2076-3093-2024-14-4-336-344
Abstract
Introduction. Surgical site infections of the postoperative period are well recognized as one of the most pressing issues in modern surgery. Surgical site infections significantly complicate the postoperative course, necessitates costly treatment, and may require additional surgical interventions, thereby extending hospital stays and adversely impacting quality of life of the patients. The suture material can facilitate the adhesion of microorganisms to its surface; thus, it is considered as one of the important factors contributing to the development of surgical site infections.
Aim. To evaluate and compare the clinical experience of applying the Abaktolat suture material featuring an antimicrobial coating used during surgical interventions.
Materials and methods. A retrospective randomized study was conducted involving 49287 patients who were treated across five various medical institutions primarily for abdominal pathologies. The Abaktolat suture material was applied in 25749 patients, of whom 15626 (60.7%) underwent emergency surgeries, while 10123 (39.3%) underwent elective procedures. The second group included 23538 patients who received standard suture material.
Results and discussion. The study demonstrated a statistically significant reduction in the incidence of postoperative infectious complications during emergency surgeries by more than four times (RR 4.23, 95% CI (4.08–4.96), p < 0.0001), and almost by two times during elective surgeries (RR 1.96, 95% CI (1.62–2.37), p < 0.0001) in the group that received Abaktolat, compared to those receiving standard suture materials. In addition, the average length of hospital stay was reduced by 21.6% (2.6 days).
Conclusion. Thus, the use of the Abaktolat suture material is a justified method for the prevention of surgical site infections, particularly in emergency surgery settings. This approach significantly reduces the incidence of infectious complications during the postoperative period, enhances the overall quality of recovery, and leads to substantial financial savings in the treatment of surgical patients.
About the Authors
V. V. PlechevRussian Federation
Vladimir V. Plechev — Dr. Sci. (Med.), Prof., Academician of the Academy of Sciences of the Republic of Bashkortostan
Ufa
M. V. Timerbulatov
Russian Federation
Makhmud V. Timerbulatov — Dr. Sci. (Med.), Prof., Corresponding member of the Academy of Sciences of the Republic of Bashkortostan, Department of Faculty Surgery
Ufa
I. F. Sufiyarov
Russian Federation
Ildar F. Sufiyarov — Dr. Sci. (Med.), Department of Nursing and Palliative Care, Department of Surgical Diseases
Ufa
References
1. Mengistu D.A., Alemu A., Abdukadir A.A., Mohammed Husen A., Ahmed F., Mohammed B., et al. Global incidence of surgical site infection among patients: systematic review and meta-analysis. Inquiry. 2023;60:469580231162549. DOI: 10.1177/00469580231162549
2. Ivlev V.V. Modern suture materials and their using in abdominal surgery (survey of literature). Orenburg Medical Bulletin. 2014;2(3):62–7 (In Russ.).
3. Griffin L., Garren M.R.S., Maffe P., Ghalei S., Brisbois E.J., Handa H. Preventing Staphylococci surgical site infections with a nitric oxide-releasing poly(lactic acid-co-glycolic acid) suture material. ACS Appl Bio Mater. 2024;7(5):3086–95. DOI: 10.1021/acsabm.4c00128
4. Sergeev A.N., Morozov A.M., Askerov E.M., Sergeev N.A., Armasov A.R., Isaev Yu.A. Methods of local antimicrobic prophylaxis of surgical site infection. Kazan medical journal. 2020;101(2):243–8 (In Russ.). DOI: 10.17816/KMJ2020-243
5. Onesti M.G., Carella S., Scuderi N. Effectiveness of antimicrobial-coated sutures for the prevention of surgical site infection: a review of the literature. Eur Rev Med Pharmacol Sci. 2018;22(17):5729–39. DOI: 10.26355/eurrev_201809_15841
6. Chua R.A.H.W., Lim S.K., Chee C.F., Chin S.P., Kiew L.V., Sim K.S., et al. Surgical site infection and development of antimicrobial sutures: a review. Eur Rev Med Pharmacol Sci. 2022;26(3):828–45. DOI: 10.26355/eurrev_202202_27991
7. Classen D.C., Evans R.S., Pestotnik S.L., Horn S.D., Menlove R.L., Burke J.P. The timing of prophylactic administration of antibiotics and the risk of surgical-wound infection. N Engl J Med. 1992;326(5):281–6. DOI: 10.1056/NEJM199201303260501
8. Vasilyeva L.S., Slivnitsyna N.V., Shevchenko O.I., Gerasimov A.A., Katamanova E.V., Lakhman O.L. Clinical and psychological features of combined trauma in participants of military actions. Polytrauma. 2024;2:55–61 (In Russ.).
9. Mokhov E.M., Sergeev A.N. Implantation antimicrobial prevention of infection in the surgery intervention area. Siberian Medical Review. 2017;3:75–81 (In Russ.). DOI: 10.20333/2500136-2017-3-75-81
10. Arshakyan V.A., Gyunter V.E., Shtofin S.G., Fedorov P.G., Samartsev V.A., Morozov D.V. Ways of improvement of surgical sutural material. Acta Biomedica Scientifica. 2017;2(6):193–7 (In Russ.). DOI: 10.12737/article_5a0a910977eca1.04637486
11. La Rosa G.R.M., Scapellato S., Cicciù M., Pedullà E. Antimicrobial activity of antibacterial sutures in oral surgery: a scoping review. Int Dent J. 2024;74(4):688–95. DOI: 10.1016/j.identj.2024.01.029
12. Miyoshi N., Fujino S., Clinical study group of Osaka University, Colorectal cancer treatment group (CSGOCG). Triclosan-coated sutures to reduce surgical site infection in abdominal gastrointestinal surgery: a meta-analysis and systematic review. Surg Open Sci. 202;16:73–6. DOI: 10.1016/j.sopen.2023.09.009
13. Shlepotina N.M., Timakova V.A. Application of suture material and development of surgical site infections: opinion of N.I. Pirogov and modern state of this problem. 2016;3(4):159–61 (In Russ.).
14. Ghosh S., Patra D., Mukherjee R., Biswas S., Haldar J. Multifunctional suture coating for combating surgical site infections and mitigating associated complications. ACS Appl Bio Mater. 2024;7(2):1158–68. DOI: 10.1021/acsabm.3c01060
15. Yang Y., Zhou Z., Ma R., Ren J., Wu X. Antimicrobial-coated sutures versus non-coated sutures in reducing surgical site infection: an updated systematic review and meta-analysis. J Hosp Infect. 2024;150:40–50. DOI: 10.1016/j.jhin.2024.04.027
16. Kniaziuk A.S., Bontsevich D.N., Shevchenko N.I. The comparative description of antibacterial activity of new biologically active surgical suture material. Health and Ecology Issues. 2017;4:106–10 (In Russ.). DOI: 10.51523/2708-6011.2017-14-4-22
17. Pulat G., Muganlı Z., Ercan U.K., Karaman O. Effect of antimicrobial peptide conjugated surgical sutures on multiple drug-resistant microorganisms. J Biomater Appl. 2023;37(7):1182–94. DOI: 10.1177/08853282221145872
18. World Health Organization. Global guidelines for the prevention of surgical site infection. World Health Organization; 2018.
19. Ban K.A., Minei J.P., Laronga C., Harbrecht B.G., Jensen E.H., Fry D.E., et al. American College of Surgeons and Surgical Infection Society: surgical site infection guidelines, 2016 update. J Am Coll Surg. 2017;224:59–74. DOI: 10.1016/j.jamcollsurg.2016.10.029
20. He P., Liu Z., Chen H., Huang G., Mao W., Li A. The role of triclosan-coated suture in preventing surgical infection: a meta-analysis. J Dis Relat Surg. 2023;34(1):42–9. DOI: 10.52312/jdrs.2023.842
21. Vieira D., Angel S.N., Honjol Y., Masse M., Gruenheid S., Harvey E.J., et al. Engineering surgical stitches to prevent bacterial infection. Sci Rep. 2022;12(1):834. DOI: 10.1038/s41598-022-04925-5
22. Anderson D.J., Podgorny K., Berríos-Torres S.I., Bratzler D.W., Dellinger E.P., Greene L., et al. Strategies to prevent surgical site infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol. 2014;35:605–27. DOI: 10.1086/676022
23. National Institute of Health Research Unit on Global Surgery. Alcoholic chlorhexidine skin preparation or triclosan-coated sutures to reduce surgical site infection: a systematic review and meta-analysis of high-quality randomised controlled trials. Lancet Infect Dis. 2022;22(8):1242–51. DOI: 10.1016/S1473-3099(22)00133-5. Erratum in: Lancet Infect Dis. 2022;22(8):e207. DOI: 10.1016/S1473-3099(22)00371-1
24. Chen S., Ge L., Mueller A., Carlson M.A., Teusink M.J., Shuler F.D., et al. Twisting electrospunnanofber fne strips into functional sutures forsustained co-delivery of gentamicin and silver. Nanomedicine. 2017;13:1435–45. DOI: 10.1016/j.nano.2017.01.016
25. Zhang J., Li X., Cheng M., Wan K., Yan S., Peng W., et al. MoO3-X nanodots coated suture for combating surgical site infection via antibacterial and anti-inflammatory properties. Nanomedicine. 2024;60:102757. DOI: 10.1016/j.nano.2024.102757
26. Fedorov P.G., Arshakyan V.A., Gyunter V.E., Shtofin S.G., Samartsev V.A. Modern sutural materials (review of literature). Acta Biomedica Scientifica. 2017;2(6):157–62 (In Russ.). DOI: 10.12737/article_5a0a8e626adf33.46655939
27. Kouzu K., Kabata D., Shinkawa H., Shinji S., Ishinuki T., Tamura K., et al. Association between skin suture devices and incidence of incisional surgical site infection after gastrointestinal surgery: systematic review and network meta-analysis. J Hosp Infect. 2024;150:134–44. DOI: 10.1016/j.jhin.2024.04.029
Review
For citations:
Plechev V.V., Timerbulatov M.V., Sufiyarov I.F. Implantation Antimicrobial Prophylaxis In General and Military Field Surgery. Creative surgery and oncology. 2024;14(4):336-344. (In Russ.) https://doi.org/10.24060/2076-3093-2024-14-4-336-344