Impact of Triclosan-Impregnated Suture on in vitro Adherence of Nosocomial Surgical Pathogens

BACKGROUND/OBJECTIVE: Superficial incisional site infections (SIS) account for 40% to 60% of all surgical site infections. Traditional efforts to reduce SIS infections focus on skin antisepsis, timely and appropriate surgical prophylaxis, and meticulous wound care. Selective predicated antiseptic-impregnated biomedical devices have demonstrated microbiological and clinical efficacy by reducing microbial surface colonization and lowering the risk of nosocomial infection in medical/surgical patient populations. A triclosan-impregnated (TI) vicryl suture was studied under in vitro conditions to evaluate its effectiveness at preventing microbial adherence. METHODS: 1-cm segments (5X) of triclosan-impregnated (3–0) vicryl suture material were exposed to MRSA, glycocalyx-producing S. epidermidis, VRE, E. coli, and Pseudomonas aeruginosa, acquired from surgical site infections. The TI segments were exposed to one of two standardized inoculum, 2.0 and 5.0 log10 CFU/mL at 5- and 120-second exposure times. The TI segments were sonicate, serial diluted, and quantitative cultures performed to determine CFU per cm suture segment. Control studies were performed using non-impregnated vicryl (3–0). RESULTS: The TI-impregnated device compared to non-impregnated controls was effective at reducing or preventing microbial adherence against all gram-positive and gram-negative clinical isolates (p<0.01), including Pseudomonas aeruginosa and an exopolysaccharide-producing strain of S. epidermidis, regardless of inoculum challenge or exposure time. CONCLUSION: These findings suggest that TI sutures are effective at preventing microbial adherence of selected nosocomial pathogens and by extension may reduce the risk of SIS infection in at-risk surgical populations. Additional studies are warranted validating the antimicrobial and clinical efficacy of this innovative device in surgical patients.