Association between skin suture devices and incidence of incisional surgical site infection after gastrointestinal surgery: systematic review and network meta-analysis.

Kouzu, K; Kabata, D; Shinkawa, H; Shinji, S; Ishinuki, T; Tamura, K; Uchino, M; Ohge, H; Shimizu, J; Haji, S; Mohri, Y; Yamashita, C; Kitagawa, Y; Suzuki, K; Kobayashi, M; Kobayashi, M; Hanai, Y; Nobuhara, H; Imaoka, H; Yoshida, M; Mizuguchi, T; Mayumi, T; Kitagawa, Y

Kouzu, K; Kabata, D; Shinkawa, H; Shinji, S; Ishinuki, T; Tamura, K; Uchino, M; Ohge, H; Shimizu, J; Haji, S; Mohri, Y; Yamashita, C; Kitagawa, Y; Suzuki, K; Kobayashi, M; Kobayashi, M; Hanai, Y; Nobuhara, H; Imaoka, H; Yoshida, M; Mizuguchi, T; Mayumi, T; Kitagawa, Y.

Afiliação

Kouzu K; Department of Surgery, National Defence Medical College, Saitama, Japan. Electronic address: dj27qd.t01312kk@gmail.com.
Kabata D; Department of Medical Statistics, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
Shinkawa H; Department of Hepatobiliary-Pancreatic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
Shinji S; Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan.
Ishinuki T; Department of Nursing, Division of Surgical Science, Sapporo Medical University, Hokkaido, Japan.
Tamura K; Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Uchino M; Department of Gastroenterological Surgery, Division of Inflammatory Bowel Disease, Hyogo Medical University, Hyogo, Japan.
Ohge H; Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan.
Shimizu J; Department of Surgery, Toyonaka Municipal Hospital, Osaka, Japan.
Haji S; Department of Surgery, Soseikai General Hospital, Kyoto, Japan.
Mohri Y; Department of Surgery, Mie Prefectural General Medical Center, Mie, Japan.
Yamashita C; Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, Aichi, Japan.
Kitagawa Y; Department of Infection Control, National Center for Geriatrics and Gerontology, Aichi, Japan.
Suzuki K; Department of Infectious Disease Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka, Japan.
Kobayashi M; Department of Anesthesiology, Hokushinkai Megumino Hospital, Hokkaido, Japan.
Kobayashi M; Laboratory of Clinical Pharmacokinetics, School of Pharmacy, Kitasato University, Tokyo, Japan.
Hanai Y; Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Toho University, Tokyo, Japan.
Nobuhara H; Department of Dentistry, Hiroshima Prefectural Hospital, Hiroshima, Japan.
Imaoka H; Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Mie, Japan.
Yoshida M; Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, International University of Health and Welfare, School of Medicine, Chiba, Japan.
Mizuguchi T; Department of Nursing, Division of Surgical Science, Sapporo Medical University, Hokkaido, Japan.
Mayumi T; Department of Intensive Care Unit, Japan Community Healthcare Organization Chukyo Hospital, Aichi, Japan.
Kitagawa Y; Keio University, School of Medicine, Tokyo, Japan.

J Hosp Infect ; 150: 134-144, 2024 Jun 19.

Article em En | MEDLINE | ID: mdl-38901769

ABSTRACT

ABSTRACT

BACKGROUND:

Surgical site infections (SSIs) are common complications after abdominal surgery.

AIM:

To compare which suture devices could reduce the incidence of incisional surgical site infections (SSIs) after gastrointestinal surgery using a systematic review and network meta-analysis.

METHODS:

The CENTRAL, PubMed, and ICHUSHI-Web databases were searched from January 1st, 2000, to December 31st, 2022, for randomized clinical trials (RCTs) comparing the incidence of incisional SSI after gastrointestinal surgery among patients treated with different surgical suture devices, including non-absorbable sutures, absorbable sutures, skin staplers, and tissue adhesives (last searched in August 23th, 2023). The risk of bias was assessed using the criteria of the Cochrane Handbook for Systematic Reviews of Interventions. To estimate the pooled odds ratios (ORs) for each comparison, a fixed-effect inverse-variance model based on the Mantel-Haenszel approach was employed.

FINDINGS:

A total of 18 RCTs with 5496 patients were included in this study. The overall SSIs in absorbable sutures were significantly lower than those in skin staplers (OR 0.77; 95% confidence intervals (CI) 0.63-0.95) and non-absorbable sutures (OR 0.62; 95% CI 0.39-0.99), whereas SSIs in absorbable sutures were not significantly different from the SSIs in tissue adhesive. The highest P-score was 0.91 for absorbable sutures. A funnel plot for estimating the heterogeneity of the studies revealed that a publication bias would be minimal (Egger test, P = 0.271).