{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:25:26Z","timestamp":1790749526300,"version":"4.1.0"},"reference-count":67,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n International guidelines recommend the use of triclosan-containing sutures for the prevention of surgical site infections. However, controversy still remains about triclosan-containing suture use in clinical practice since several new randomized clinical trials (RCTs) have shown contradicting results.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To update a previous systematic review and meta-analysis of the association of triclosan-containing sutures with surgical site infections and explore the potential added value of new RCTs.<\/jats:p>\n <\/jats:sec>\n \n Data Sources<\/jats:title>\n PubMed, Embase, and Cochrane CENTRAL databases were searched from January 1, 2015, to March 14, 2023. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed.<\/jats:p>\n <\/jats:sec>\n \n Study Selection<\/jats:title>\n Published RCTs comparing triclosan-containing sutures with similar sutures without triclosan for the prevention of surgical site infections in any type of surgery were included.<\/jats:p>\n <\/jats:sec>\n \n Data Extraction and Synthesis<\/jats:title>\n Two authors (H.J. and A.S.T.) independently extracted and pooled data in a random-effects (Mantel-Haenszel) model. The certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation approach, and trial sequential analysis was used to estimate whether further studies would reveal different outcomes.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcome was the incidence of surgical site infections, expressed as relative risk (RRs) and corresponding 95% CIs. Secondary outcomes were the incidence of surgical site infections according to depth (superficial incisional, deep incisional, and organ\/space) and adverse events related to triclosan-containing sutures.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The systematic review yielded 15 additional RCTs compared with a previous published review in 2017. A meta-analysis of 31 studies including 17\u202f968 participants (62% male) undergoing various types of surgery was performed. Use of triclosan-containing sutures was associated with fewer surgical site infections compared with sutures without triclosan (RR, 0.75; 95% CI, 0.65-0.86). The certainty of evidence was moderate after downgrading for heterogeneity (\u03c4\n 2<\/jats:sup>\n \u2009=\u20090.04;\n \n I\n 2<\/jats:sup>\n <\/jats:italic>\n \u2009=\u200943%). In the trial sequential analysis of all trials and a sensitivity analysis excluding studies with a high risk of bias, the cumulative\n z<\/jats:italic>\n curve crossed the trial sequential monitoring boundary for benefit, confirming the robustness of the summary effect estimate.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n This updated meta-analysis found moderate-certainty evidence that wound closure with triclosan-containing sutures was associated with a lower risk of surgical site infections. The trial sequential analysis suggests that future trials that would change these findings are improbable.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.0306","type":"journal-article","created":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T11:31:30Z","timestamp":1741347090000},"page":"e250306","source":"Crossref","is-referenced-by-count":14,"title":["Triclosan-Containing Sutures for the Prevention of Surgical Site Infection"],"prefix":"10.1001","volume":"8","author":[{"given":"Hasti","family":"Jalalzadeh","sequence":"first","affiliation":[{"name":"Department of Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands"},{"name":"Amsterdam Gastroenterology Endocrinology and Metabolism, Amsterdam, the Netherlands"},{"name":"Dutch National Guideline Group for Prevention of Postoperative Surgical Site Infections, Dutch Association of Medical Specialists, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allard S.","family":"Timmer","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands"},{"name":"Amsterdam Gastroenterology Endocrinology and Metabolism, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis R.","family":"Buis","sequence":"additional","affiliation":[{"name":"Dutch National Guideline Group for Prevention of Postoperative Surgical Site Infections, Dutch Association of Medical Specialists, Utrecht, the Netherlands"},{"name":"Department of Neurosurgery, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasmine E. M.","family":"Dreissen","sequence":"additional","affiliation":[{"name":"Dutch National Guideline Group for Prevention of Postoperative Surgical Site Infections, Dutch Association of Medical Specialists, Utrecht, the Netherlands"},{"name":"Department of Neurosurgery, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon H. M.","family":"Goosen","sequence":"additional","affiliation":[{"name":"Dutch National Guideline Group for Prevention of Postoperative Surgical Site Infections, Dutch Association of Medical Specialists, Utrecht, the Netherlands"},{"name":"Department of Orthopedic Surgery, Sint Maartenskliniek, Ubbergen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haitske","family":"Graveland","sequence":"additional","affiliation":[{"name":"Dutch National Guideline Group for Prevention of Postoperative Surgical Site Infections, Dutch Association of Medical Specialists, Utrecht, the Netherlands"},{"name":"Dutch Association of Medical Specialists, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchel","family":"Griekspoor","sequence":"additional","affiliation":[{"name":"Dutch National Guideline Group for Prevention of Postoperative Surgical Site Infections, Dutch Association of Medical Specialists, Utrecht, the Netherlands"},{"name":"Dutch Association of Medical Specialists, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank F. A.","family":"IJpma","sequence":"additional","affiliation":[{"name":"Dutch National Guideline Group for Prevention of Postoperative Surgical Site Infections, Dutch Association of Medical Specialists, Utrecht, the Netherlands"},{"name":"Division of Trauma Surgery, Department of Surgery, University Medical Center Groningen, Groningen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten J.","family":"van der Laan","sequence":"additional","affiliation":[{"name":"Dutch National Guideline Group for Prevention of Postoperative Surgical Site Infections, Dutch Association of Medical Specialists, Utrecht, the Netherlands"},{"name":"Division of Trauma Surgery, Department of Surgery, University Medical Center Groningen, Groningen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roald R.","family":"Schaad","sequence":"additional","affiliation":[{"name":"Dutch National Guideline Group for Prevention of Postoperative Surgical Site Infections, Dutch Association of Medical Specialists, Utrecht, the Netherlands"},{"name":"Department of Anesthesiology, Leiden University Medical Centre, Leiden, the Netherlands"},{"name":"Dutch Association of Anesthesiology, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrique","family":"Segers","sequence":"additional","affiliation":[{"name":"Dutch National Guideline Group for Prevention of Postoperative Surgical Site Infections, Dutch Association of Medical Specialists, Utrecht, the Netherlands"},{"name":"Department of Cardiothoracic Surgery, Maastricht University Medical Center+, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wil C.","family":"van der Zwet","sequence":"additional","affiliation":[{"name":"Dutch National Guideline Group for Prevention of Postoperative Surgical Site Infections, Dutch Association of Medical Specialists, Utrecht, the Netherlands"},{"name":"Department of Medical Microbiology, Infectious Diseases and Infection Prevention, Maastricht University Medical Center, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stijn W.","family":"de Jonge","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands"},{"name":"Amsterdam Gastroenterology Endocrinology and Metabolism, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels","family":"Wolfhagen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands"},{"name":"Amsterdam Gastroenterology Endocrinology and Metabolism, Amsterdam, the Netherlands"},{"name":"Dutch National Guideline Group for Prevention of Postoperative Surgical Site Infections, Dutch Association of Medical Specialists, Utrecht, the 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