Antimicrobial-impregnated Sutures Reduce Surgical Site Infections in Plastic Surgery: A Systematic Review and Meta-analysis.

BACKGROUND

Surgical site infections (SSIs) are a common complication in plastic surgery, contributing to increased morbidity, prolonged recovery, and increased healthcare costs. Antimicrobial-impregnated sutures (AISs) have shown promise in reducing SSI rates across surgical disciplines. However, their efficacy in plastic surgery remains unclear.

METHODS

This review followed PRISMA (Preferred Reporting Items of Systematic Reviews and Meta-Analysis) 2020 guidelines. PubMed and Web of Science were searched for comparative studies assessing AIS use. Seven studies were identified. Data extracted included patient demographics, study variables, and postoperative outcomes. SSI rates were pooled using a random-effects model and reported as a risk ratio (RR) with 95% confidence intervals (CIs). Analyses of wound healing/outcomes were performed using Fisher exact tests.

RESULTS

In a pool of 1553 patients (807 intervention, 746 control), AIS use was associated with a significant reduction in SSIs (RR 0.68, 95% CI [0.51-0.90], P = 0.0066). This effect was pronounced in abdominal surgery (RR 0.51, 95% CI [0.35-0.74], P = 0.0004) but not significant in breast surgery (RR 0.71, 95% CI [0.44-1.15], P = 0.1657). AISs significantly improved cosmetic outcomes (RR 0, 95% CI [0-0.2058], P < 0.0001).

CONCLUSIONS

AISs are associated with improved postoperative outcomes, particularly in reducing incidence of SSIs and improving cosmetic outcomes. Although these findings support the use of AISs in plastic surgery procedures, randomized controlled trials comparing antimicrobial agents and their use in different anatomical areas are warranted to establish definitive clinical guidelines.