Antimicrobial-coated sutures to decrease surgical site infections: a systematic review and meta-analysis.

To investigate the effectiveness of antimicrobial-coated sutures compared with non-coated sutures in reducing surgical site infection (SSI) and develop recommendations for World Health Organization (WHO) SSI prevention guidelines. We searched Medline, Embase, Cinahl, Cochrane Central Register of Controlled Trials, and WHO Global Health from 1990-16/02/2015 with language restricted to English, Spanish, and French. Meta-analysis was performed with a random-effects model. Meta-regression analysis assessed whether the effect of antimicrobial coating changed according to the type of suture and surgery. Subgroup analyses were based on types of sutures. Quality of the retrieved evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation. Thirteen randomized controlled trials (RCTs) and five observational studies (OBSs) met the inclusion criteria. Antimicrobial sutures significantly reduced SSI risk (for RCTs: OR 0.72, 95 % CI 0.59-0.88, p = 0.001, I