• 1. Riou JP, Cohen JR, Johnson H Jr. Factors influencing wound dehiscence. Am J Surg 1992;163:324330.

  • 2. Nelson LL. Surgical site infections in small animal surgery. Vet Clin North Am Small Anim Pract 2011;41:10411056.

  • 3. van Duijkeren E, Catry B, Greko C, et al. Review on methicillin-resistant Staphylococcus pseudintermedius. J Antimicrob Chemother 2011;66:27052714.

    • Search Google Scholar
    • Export Citation
  • 4. Weese JS. A review of post-operative infections in veterinary orthopaedic surgery. Vet Comp Orthop Traumatol 2008;21:99105.

  • 5. Perreten V, Kadlec K, Schwarz S, et al. Clonal spread of methicillin-resistant Staphylococcus pseudintermedius in Europe and North America: an international multicentre study. J Antimicrob Chemother 2010;65:11451154.

    • Search Google Scholar
    • Export Citation
  • 6. Nicoll C, Singh A, Weese JS. Economic impact of tibial plateau leveling osteotomy surgical site infection in dogs. Vet Surg 2014;43:899902.

    • Search Google Scholar
    • Export Citation
  • 7. Nazarali A, Singh A, Weese JS. Perioperative administration of antimicrobials during tibial plateau leveling osteotomy. Vet Surg 2014;43:966971.

    • Search Google Scholar
    • Export Citation
  • 8. Turk R, Singh A, Weese JS. Prospective surgical site infection surveillance in dogs. Vet Surg 2015;44:28.

  • 9. Edmiston CE, Seabrook GR, Goheen MP, et al. Bacterial adherence to surgical sutures: can antibacterial-coated sutures reduce the risk of microbial contamination? J Am Coll Surg 2006;203:481489.

    • Search Google Scholar
    • Export Citation
  • 10. Masini BD, Stinner DJ, Waterman SM, et al. Bacterial adherence to suture materials. J Surg Educ 2011;68:101104.

  • 11. Singh A, Walker M, Rosseau J, et al. Characterization of the biofilm forming ability of Staphylococcus pseudintermedius from dogs. BMC Vet Res 2013;9:93.

    • Search Google Scholar
    • Export Citation
  • 12. Morrison S, Singh A, Rousseau J, et al. Adherence of methicillin-resistant Staphylococcus pseudintermedius to suture materials commonly used in small animal surgery. Am J Vet Res 2016;77:194198.

    • Search Google Scholar
    • Export Citation
  • 13. Rothenburger S, Spangler D, Bhende S, et al. In vitro antimicrobial evaluation of coated VICRYL* Plus Antibacterial suture (coated polyglactin 910 with triclosan) using zone of inhibition assays. Surg Infect (Larchmt) 2002;3(suppl 1):S79S87.

    • Search Google Scholar
    • Export Citation
  • 14. Ming X, Rothenburger S, Nichols MM. In vivo and in vitro antibacterial efficacy of PDS Plus (polidioxanone with triclosan) suture. Surg Infect (Larchmt) 2008;9:451457.

    • Search Google Scholar
    • Export Citation
  • 15. Delliaert AE, Van der Kerckhove E, Tuinder S, et al. The effect of triclosan-coated sutures in wound healing. A double blind randomised prospective pilot study. J Plast Reconstr Aesthet Surg 2009;62:771773.

    • Search Google Scholar
    • Export Citation
  • 16. Leaper D, Assadian O, Hubner NO, et al. Antimicrobial sutures and prevention of surgical site infection: assessment of the safety of the antiseptic triclosan. Int Wound J 2011;8:556566.

    • Search Google Scholar
    • Export Citation
  • 17. Sprowson AP, Jensen C, Parsons N, et al. The effect of triclosan-coated sutures on the rate of surgical site infection after hip and knee arthroplasty: a double-blind randomized controlled trial of 2546 patients. Bone Joint J 2018;100-B:296302.

    • Search Google Scholar
    • Export Citation
  • 18. Etter SW, Ragetly GR, Bennett RA, et al. Effect of using triclosan-impregnated suture for incisional closure on surgical site infection and inflammation following tibial plateau leveling osteotomy in dogs. J Am Vet Med Assoc 2013;242:355358.

    • Search Google Scholar
    • Export Citation
  • 19. Ming X, Rothenburger S, Yang D. In vitro antibacterial efficacy of Monocryl Plus Antibacterial suture (poliglecaprone 25 with triclosan). Surg Infect (Larchmt) 2007;8:201208.

    • Search Google Scholar
    • Export Citation
  • 20. Storch ML, Rothenburger SJ, Jacinto G. Experimental efficacy study of coated Vicryl Plus Antibacterial suture in guinea pigs challenged with Staphylococcus aureus. Surg Infect (Larchmt) 2004;5:281288.

    • Search Google Scholar
    • Export Citation
  • 21. Stine SL, Odum SM, Mertens WD. Protocol changes to reduce implant-associated infection rate after tibial plateau leveling osteotomy: 703 dogs, 811 TPLO (2006–2014). Vet Surg 2018;47:481489.

    • Search Google Scholar
    • Export Citation
  • 22. World Health Organization. Preventing surgical site infections: implementation approaches for evidence-based recommendations: Available at: apps.who.int/iris/bitstream/handle/10665/273154/9789241514385-eng.pdf?ua=1. Accessed Jun 28, 2019.

    • Search Google Scholar
    • Export Citation
  • 23. European Committee of Antimicrobial Susceptibility Testing guidelines: available at www.eucast.org/ast_of_bacteria/disk_diffusion_methodology/. Accessed Jul 3, 2019.

    • Search Google Scholar
    • Export Citation
  • 24. Monocryl Plus Antibacterial [package insert] 389680.R02. Livingston, Scotland: Ethicon Inc, 2005.

  • 25. PDS Plus Antibacterial [package insert] 389688.R02. Livingston, Scotland: Ethicon Inc, 2006.

  • 26. Coated Vicryl Plus Antibacterial [package insert] 389767. R02. Livingston, Scotland: Ethicon Inc, 2011.

  • 27. Barbolt TA. Chemistry and safety of triclosan, and its use as an antimicrobial coating on coated Vicryl*Plus antibacterial suture (coated polyglactin 910 suture with triclosan). Surg Infect (Larchmt) 2002;3:S45S53.

    • Search Google Scholar
    • Export Citation

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Investigation of the in vitro antimicrobial activity of triclosan-coated suture material on bacteria commonly isolated from wounds in dogs

Joanna McCagherty BVMS1, Donald A. Yool BVMS, PhD4, Gavin K. Paterson BSc, PhD2, Stephen R. Mitchell BSc, MSc3, Samantha Woods BSc, MA, VetMB1, Ana I. Marques DVM1, Jon L. Hall MA, VetMB1, John R. Mosley BVMS, PhD1, and Tim J. Nuttall BVSc, PhD1
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  • 1 1Hospital for Small Animals, Royal (Dick) School of Veterinary Studies and the Roslin Institute, University of Edinburgh, Midlothian EH25 9RG, Scotland.
  • | 2 2Easter Bush Pathology, Royal (Dick) School of Veterinary Studies and the Roslin Institute, University of Edinburgh, Midlothian EH25 9RG, Scotland.
  • | 3 3Department of Biological Sciences, Royal (Dick) School of Veterinary Studies and the Roslin Institute, University of Edinburgh, Midlothian EH25 9RG, Scotland.
  • | 4 4School of Veterinary Medicine, University of Glasgow, Glasgow G61 1BD, Scotland.

Abstract

OBJECTIVE

To investigate in vitro effects of triclosan coating of suture materials on the growth of clinically relevant bacteria isolated from wounds in dogs.

SAMPLE

6 types of suture material and 10 isolates each of methicillin-susceptible Staphylococcus pseudintermedius, methicillin-resistant S pseudintermedius, Escherichia coli, and AmpC β-lactamase and extended-spectrum β-lactamase–producing E coli from clinical wound infections.

PROCEDURES

Isolates were cultured on Mueller-Hinton agar with 3 types of triclosan-coated suture, uncoated counterparts of the same suture types, and positive and negative controls. Zones of inhibition (ZOIs) were measured after overnight incubation. Sustained antimicrobial activity assays were performed with susceptible isolates. The ZOI measurements and durations of sustained antimicrobial activity were compared among suture types and isolates by statistical methods. Suture surface characteristics and bacterial adherence were evaluated qualitatively with scanning electron microscopy.

RESULTS

ZOIs were generated only by triclosan-coated materials; triclosan-coated suture had sustained antimicrobial activity (inhibition) for 3 to 29 days against all tested pathogens. The ZOIs around triclosan-coated suture were significantly greater for S pseudintermedius isolates than for E coli isolates. Bacterial adherence to uncoated polyglactin-910 was greatest, followed by triclosan-coated polyglactin-910, and then uncoated monofilament sutures, with least adherence to coated monofilament sutures.

CONCLUSIONS AND CLINICAL RELEVANCE

Surface characteristics of suture materials may be as important or more important than triclosan coating for microbial inhibition; however, triclosan coating appeared to affect bacterial adherence for multifilament sutures. Triclosan-coated, particularly monofilament, sutures inhibited pathogens commonly isolated from wounds of dogs, including multidrug-resistant bacteria. Further studies are required to assess clinical efficacy of triclosan-coated suture materials in vivo.

Abstract

OBJECTIVE

To investigate in vitro effects of triclosan coating of suture materials on the growth of clinically relevant bacteria isolated from wounds in dogs.

SAMPLE

6 types of suture material and 10 isolates each of methicillin-susceptible Staphylococcus pseudintermedius, methicillin-resistant S pseudintermedius, Escherichia coli, and AmpC β-lactamase and extended-spectrum β-lactamase–producing E coli from clinical wound infections.

PROCEDURES

Isolates were cultured on Mueller-Hinton agar with 3 types of triclosan-coated suture, uncoated counterparts of the same suture types, and positive and negative controls. Zones of inhibition (ZOIs) were measured after overnight incubation. Sustained antimicrobial activity assays were performed with susceptible isolates. The ZOI measurements and durations of sustained antimicrobial activity were compared among suture types and isolates by statistical methods. Suture surface characteristics and bacterial adherence were evaluated qualitatively with scanning electron microscopy.

RESULTS

ZOIs were generated only by triclosan-coated materials; triclosan-coated suture had sustained antimicrobial activity (inhibition) for 3 to 29 days against all tested pathogens. The ZOIs around triclosan-coated suture were significantly greater for S pseudintermedius isolates than for E coli isolates. Bacterial adherence to uncoated polyglactin-910 was greatest, followed by triclosan-coated polyglactin-910, and then uncoated monofilament sutures, with least adherence to coated monofilament sutures.

CONCLUSIONS AND CLINICAL RELEVANCE

Surface characteristics of suture materials may be as important or more important than triclosan coating for microbial inhibition; however, triclosan coating appeared to affect bacterial adherence for multifilament sutures. Triclosan-coated, particularly monofilament, sutures inhibited pathogens commonly isolated from wounds of dogs, including multidrug-resistant bacteria. Further studies are required to assess clinical efficacy of triclosan-coated suture materials in vivo.

Contributor Notes

Dr. Marques’ present address is Vets Now Hospital, 123–145 North St, Glasgow G3 7DA, Scotland.

Address correspondence to Dr. McCagherty (jmccaghe@exseed.ed.ac.uk).