Comparison between antimicrobial-coated sutures and uncoated sutures for the prevention of surgical site infections in plastic surgery: a double blind control trial
Authors: S Carella
N Scuderi
P Fioramonti
M G Onesti
Journal: European review for medical and pharmacological sciences (2019)
Discipline: PHARMACOLOGY & TOXICOLOGY
Keywords: Surgical site infection; antimicrobial-impregnated sutures; chlorhexidine; elective plastic surgery; randomized trial
Affiliations: Department of General Surgery, Plastic Surgery "P. Valdoni", Policlinico Umberto I, Sapienza University of Rome, Rome, Italy. .

Abstract:  Objective: Surgical site infection (SSI) produces considerable morbidity and increases health care costs. One of its causes is microbial adherence to the surgical sutures surface. A strategy to avoid microbial colonization is the use of antimicrobial-impregnated sutures. Recently absorbable sutures treated with chlorhexidine (CHX) have been developed. Our study purpose was to compare CHX-coated and uncoated suture in elective plastic surgery. Patients and methods: We conducted a randomized, double-blind, single-centre controlled trial of 18 patients undergoing elective bilateral mammary surgery and 18 patients undergoing skin lesions removals. Patients were divided into 2 groups receiving antibacterial-coated (study group) and uncoated (controlled group) sutures for wound closure. Patients were evaluated for scar results and signs of SSIs were monitored over a period of 30 days (or 1 year in case of prosthetic surgery). Statistical comparison was performed using dependent t-tests for paired samples. Results: For patients undergoing mammary surgery, based on Vancouver Scale, there were no significant differences between the two groups. We noticed that in 8 patients the vertical scars belonging to the control group were larger than the contralateral 8 vertical sutures belonging to the study group. For patients undergoing skin surgery, surgical wounds treated with uncoated sutures were significantly more erythematous than the ones belonging to the study group (Media: 0,8333% vs. 1,5556%, respectively; standard deviation: 9,235 vs. 0,6157; 95%; p=0.0092). Conclusions: No wounds infection was reported between the two groups. Based on our experience, we conclude that the use of CHX-coated sutures should be considered in case of inflamed lesions removal. Further studies are needed to validate our results. 

Retracted: No

PubPeer comments:
  Obvious image repeat: 1) Fig 3f: ctrl cells treated with shVEGF-442 SARI cells treated with shVEGF-901 2) Fig 3h: ctrl cells treated with shVEGF-442 SARI cells treated with shVEGF-442 , 
 Dear Dr. Cassines, Thank you very much for pointing out the mistakes of Figure 3 in our published work. We apologize for such unconscious error during the figure preparation and will contact the journal editorial office as soon as possible to correct the error Thank you again for helping us find and correct the mistake. Lei Dai , 
 Dear Dr. Diaporthe Cassines, Thank you very much for pointing out these errors of Fig 3f and Fig 3h in our published work. We have checked our original data and found we used wrong figures by mistake. We will contact the editorial department of the journal as soon as possible to submit the right picture and ask for a corrigendum. We will more carefully process our data in our future work. Thank you again for helping us find and correct the mistake. Sincerely yours Hongxin Deng , 
 Figure 5E. Panel ctrl, PX-478 are same as figure 3F above. , 
 #3 Supplemental Figure 1 contains unidentified splices between some of the bands, but not in the same location. Could the authors provide the raw data? Shown below is the inverse image. , 
 #3 Supplementary Figure 6, GAPDH in b and d look the same.  , 
 another splice found in fig4f on GAPDH  , 
 Dear Dr. Aphis Poacyni and Sweltsa Mediana, Thank you very much for pointing out the mistakes in our published manuscript. We apologize for such unconscious error during the figure preparation. After carefully investigate our raw data, we will contact the editor to apply for correction immediately. Thank you again for helping us find and correct the mistake. Sincerely yours Hongxin Deng , 
 #8 Dear Dr. Deng: Thank you for your reply. It would be appreciated if you were to also post the raw data here. , 
 Another duplicate found in Fig 3H.  , 
 Dear Dr. Christella Subelata, Thank you very much for pointing out these errors in our published work. We have noticed the unconscious errors during the figure preparation and apologize for it. We will contact the editorial department of the journal as soon as possible to submit the right picture and ask for a corrigendum. We will more carefully process our data in our future work. Thank you again for helping us find and correct the mistake. Sincerely yours Hongxin Deng , 
 #4 Figure 5E; SARI DMSO panel and SARI PX-478 panel are the same. Just rotate and flip. , 
 ****Duplication of pictures In figure 3h, see the pictures in red boxes, repeat usage of the same picture.  , 
 #12 Amazing! You are correct. I summarized the current findings in Fig 5E and 3F from you, #1 Diaporthe Cassines and #4 Aphis Poacyni. And I find another duplicate with supplementary Fig 5B. , 
  , 
 Another 3 duplicates.  , 
 Another duplicate, see below.  , 
 Follow #7, left 3 lanes of GAPDH are similar between Supp. fig 6a and fig 4f. They are different experiments. Why the band looks similar? If duplicate by mistake, why there is a splice? Could the author make comments? It would be appreciated if the author post the raw data here. Thanks!  , 
 Dear Dr Karubar, we have supplied the raw data for investigating by editors from NC and asked for a corrigendum. Hongxin Deng ,