• 1. Fitzpatrick N, Solano M. Predictive variables for complication after TPLO with stifle inspection by arthrotomy in 1000 consecutive dogs. Vet Surg 2010; 39:460474.

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

  • 3. Schulz K. Stifle. In: Fossum TW, ed. Small animal surgery textbook. 3rd ed. St Louis: Mosby, 2007; 12541275.

  • 4. Cockshutt J. Principles of surgical asepsis. In: Slatter DH, ed. Textbook of small animal surgery. 3rd ed. Philadelphia: WB Saunders Co, 2003; 149154.

    • Search Google Scholar
    • Export Citation
  • 5. Frey TN, Hoelzler MG, Scavelli TD, et al. Risk factors for surgical site infection-inflammation in dogs undergoing surgery for rupture of the cranial cruciate ligament: 902 cases (2005–2006). J Am Vet Med Assoc 2010; 236:8894.

    • Search Google Scholar
    • Export Citation
  • 6. Pacchiana PD, Morris E, Gillings SL, et al. Surgical and postoperative complications associated with tibial plateau leveling osteotomy in dogs with cranial cruciate ligament rupture: 397 cases (1998–2001). J Am Vet Med Assoc 2003; 222:184193.

    • Search Google Scholar
    • Export Citation
  • 7. Priddy NH II, Tomlinson JL, Dodam JR, et al. Complications with and owner assessment of the outcome of tibial plateau leveling osteotomy for treatment of cranial cruciate ligament rupture in dogs: 193 cases (1997–2001). J Am Vet Med Assoc 2003; 222:17261732.

    • Search Google Scholar
    • Export Citation
  • 8. Stauffer KD, Tuttle TA, Elkins AD, et al. Complications associated with 696 tibial plateau leveling osteotomies (2001–2003). J Am Anim Hosp Assoc 2006; 42:4450.

    • Search Google Scholar
    • Export Citation
  • 9. Vasseur PB, Levy J, Dowd E, et al. Surgical wound infection rates in dogs and cats. Data from a teaching hospital. Vet Surg 1988; 17:6064.

    • Search Google Scholar
    • Export Citation
  • 10. Kim SE, Pozzi A, Kowaleski MP, et al. Tibial osteotomies for cranial cruciate ligament insufficiency in dogs. Vet Surg 2008; 37:111125.

    • Search Google Scholar
    • Export Citation
  • 11. Ford HR, Jones P, Gaives B. Intraoperative handling and wound healing: controlled clinical trial comparing coated VICRYL plus antibacterial suture (coated polyglactin 910 suture with triclosan) with coated VICRYL suture (coated polyglactin 910 suture). Surg Infect (Larchmt) 2005; 6:313321.

    • Search Google Scholar
    • Export Citation
  • 12. Storch M, Pery LC, Davidson JM. A 28-day study of the effect of coated VICRYL*plus antibacterial suture (coated polyglactin 910 suture with triclosan) on wound healing in guinea pig linear incisional skin wounds. Surg Infect (Larchmt) 2002; 3(suppl 1):S89S98.

    • Search Google Scholar
    • Export Citation
  • 13. Edmiston CE, Goheen MP, Seabrook GR, 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
  • 14. 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
  • 15. Slocum B, Slocum TD. Tibial plateau leveling osteotomy for repair of cranial cruciate ligament rupture in the canine. Vet Clin North Am Small Anim Pract 1993; 23:777795.

    • Search Google Scholar
    • Export Citation
  • 16. Bischofberger AS, Brauer T, Gugelchuk G, et al. Difference in incisional complications following exploratory celiotomies using antibacterial-coated suture material for subcutaneous closure: prospective randomised study in 100 horses. Equine Vet J 2010; 42:304309.

    • Search Google Scholar
    • Export Citation
  • 17. US Environmental Protection Agency. Triclosan facts. Available at: www.epa.gov/oppsrrd1/REDs/factsheets/triclosan_fs.htm. Accessed May 5, 2011.

    • Search Google Scholar
    • Export Citation
  • 18. Cutter CN. The effectiveness of triclosan-incorporated plastic against bacteria on beef surfaces. J Food Prot 1999; 62:474479.

  • 19. Roth JH, Windle BH. Staple versus suture closure of skin in a pig model. Can J Surg 1988; 31:1920.

  • 20. Torfs S, Levet T, Delesalle C, et al. Risk factors for incisional complications after exploratory celiotomy in horses: do skin staples increase the risk? Vet Surg 2010; 39:616620.

    • Search Google Scholar
    • Export Citation
  • 21. Bennett RA, Yaeger MJ, Trapp A, et al. Histologic evaluation of the tissue reaction to five suture materials in the body wall of rock doves (Columba livid). J Avian Med Surg 1997; 11:175182.

    • Search Google Scholar
    • Export Citation
  • 22. Woods DS, Collins JE, Walshaw R. Tissue reaction to nonabsorbable suture materials in the canine linea alba: a histology evaluation. J Am Anim Hosp Assoc 1984; 20:3994.

    • Search Google Scholar
    • Export Citation
  • 23. Singhal AK, Hussain A. Skin closure with automatic stapling in total hip and knee arthroplasty. JK Pract 2006; 13:142143.

  • 24. McFadden MS, Bennett RA, Kinsel MJ, et al. Evaluation of the histologic reactions to commonly used suture materials in the skin and musculature of ball pythons (Python regius). Am J Vet Res 2011; 72:13971406.

    • Search Google Scholar
    • Export Citation
  • 25. Kirpensteijn J, Fingland RB, Boyer JE Jr, et al. Comparison of stainless steel fascial staples and polypropylene suture material for closure of the linea alba in dogs. Vet Surg 1993; 22:464472.

    • Search Google Scholar
    • Export Citation
  • 26. Murphy M, Prendergast P, Rice J. Comparison of clips versus sutures in orthopaedic wound closure. Eur J Orthop Surg Traumatol 2004; 14:1618.

    • Search Google Scholar
    • Export Citation

Advertisement

Effect of using triclosan-impregnated suture for incisional closure on surgical site infection and inflammation following tibial plateau leveling osteotomy in dogs

Sean W. Etter BS1, Guillaume R. Ragetly DVM, PhD, DACVS2, R. Avery Bennett DVM, MS, DACVS3, and David J. Schaeffer PhD4
View More View Less
  • 1 Department of Veterinary Clinical Medicine, University of Illinois, Urbana, IL 61802.
  • | 2 Department of Veterinary Clinical Medicine, University of Illinois, Urbana, IL 61802.
  • | 3 Department of Veterinary Clinical Medicine, University of Illinois, Urbana, IL 61802.
  • | 4 Department of Comparative Biosciences, University of Illinois, Urbana, IL 61802.

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.

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.

Contributor Notes

Dr. Ragetly's present address is Centre Hospitalier Vétérinaire Frégis, 43 avenue Aristide Briand, 94110 Arceuil, France.

Dr. Bennett's present address is Lauderdale Veterinary Specialists, 3217 NW 10th Terrace, Fort Lauderdale, Florida 33309.

Presented in abstract form at the American College of Veterinary Surgeons Symposium, Chicago, November 2011.

Address correspondence to Dr. Ragetly (gragetly@yahoo.fr).