Wound closure with triclosan-containing sutures reduce risk of surgical site infection: JAMA

A new study published in the Journal of American Medical Association found a decreased incidence of surgical site infections being linked to wound closure with sutures containing triclosan.

To prevent colonization on the suture surface and reduce the risk of surgical site infection, triclosan, a bactericide chemical, has been put to sutures. Sutures containing triclosan are advised by international standards as a means of preventing surgical site infections. The use of triclosan-containing sutures in clinical practice is still controversial, nevertheless, as a number of recent randomized clinical studies (RCTs) have shown conflicting findings.

The Cochrane CENTRAL, PubMed, and Embase databases were searched between January 1, 2015, and March 14, 2023. It was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standard. This evaluation includes published RCTs that compared sutures containing triclosan with identical sutures without triclosan for the prevention of surgical site infections in any kind of surgery.

The data was separately retrieved and combined by two authors using a random-effects (Mantel-Haenszel) model. When compared to a review published in 2017, this systematic review produced 15 more RCTs. This meta-analysis was conducted on 31 papers that included 17,968 patients (62% male) having different kinds of surgery. The use of sutures containing triclosan was linked to less surgical site infections when compared to sutures without triclosan.

After adjusting for heterogeneity, the evidence's level of confidence was moderate. The summary effect estimate was shown to be resilient when the cumulative z curve passed the trial sequential monitoring limit for benefit in both the trial sequential analysis of all trials and a sensitivity analysis that excluded studies with a high risk of bias.

Overall, in comparison to sutures without triclosan, this systematic review and meta-analysis of 17,968 patients from 31 RCTs concluded with a reasonable degree of certainty that sutures containing triclosan were linked to a lower incidence of surgical site infections. According to the results, further RCTs might not significantly alter the overall effect estimates. The direction was consistent across the accumulation of a large number of randomized individuals, despite considerable doubt over the size of the impact estimate.

Reference:

Jalalzadeh, H., Timmer, A. S., Buis, D. R., Dreissen, Y. E. M., Goosen, J. H. M., Graveland, H., Griekspoor, M., IJpma, F. F. A., van der Laan, M. J., Schaad, R. R., Segers, P., van der Zwet, W. C., de Jonge, S. W., Wolfhagen, N., & Boermeester, M. A. (2025). Triclosan-containing sutures for the prevention of surgical site infection: A systematic review and meta-analysis: A systematic review and meta-analysis. JAMA Network Open, 8(3), e250306. https://doi.org/10.1001/jamanetworkopen.2025.0306