Sukeik M, George D, Gabr A, Kallala R, Wilson P, Haddad FS. Randomised controlled trial of triclosan coated vs uncoated sutures in primary hip and knee arthroplasty. World J Orthop 2019; 10(7): 268-277 [PMID: 31363457 DOI: 10.5312/wjo.v10.i7.268]
Corresponding Author of This Article
Mohamed Sukeik, MD (Hons), FRCSEd (Tr&Orth), PGA, MD (Res), Consultant Hip and Knee Surgeon, Dr. Sulaiman Al-Habib Hospital – Al Khobar, King Salman Bin Abdulaziz Rd, Al Bandariyah, Al Khobar 34423, Saudi Arabia. m.sukeik@nhs.net
Research Domain of This Article
Orthopedics
Article-Type of This Article
Randomized Controlled Trial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Jul 18, 2019; 10(7): 268-277 Published online Jul 18, 2019. doi: 10.5312/wjo.v10.i7.268
Table 1 Criteria and points allocation used in calculating the ASEPSIS score
ASEPSIS Score calculation
Points
Criterion
Additional treatment
10
Antibiotics
5
Drainage of pus under local anaesthetic
10
Debridement of wound under general anaesthetic
0-5
Serous discharge
0-5
Erythema
0-10
Purulent exudate
0-10
Separation of deep tissues
10
Isolation of bacteria
5
Stay in hospital over 14 d
Breakdown of ASEPSIS score
0-10
No infection, normal healing
11-20
Disturbance of healing
21-30
Minor infection
31-40
Moderate infection
> 40
Severe infection
Table 2 Patient demographics between the two groups
Trial group
P value
Controls (n = 69)
Cases (n = 81)
Age
mean (SD)
67.85 (9.85)
68.65
0.44
(10.90)
Diagnosis
OA
68
77
0.33
SUFE
0
2
AVN
1
0
Hip dysplasia
0
1
Perthes
0
1
Gender
Male
24
25
0.73
Female
45
56
BMI
mean (SD)
28.70 (5.13)
29.14 (4.97)
0.54
Smoker
Yes
6
6
0.64
Never
42
57
Ex-smoker
13
12
Diabetic
Yes
4
10
0.26
No
57
64
ASA Grade
1
9
9
0.68
2
47
52
3
13
20
Table 3 Comparison of operative data between the two groups
Trial group
P value
Controls (n = 69)
Cases (n = 81)
Site
Hip
42
54
0.5
Knee
27
27
Surgeon
Consultant
25
29
0.63
Registrar
38
41
Fellow
6
11
Anaesthetic
General
45
50
0.56
Regional
17
26
Both
3
2
Local anaesthetic
Yes
67
77
0.38
No
1
4
Length of operation
mean (SD)
88.44 (23.84)
91.24 (26.5)
0.67
mean (SD)
3.75 (0.87)
3.53 (0.81)
0.12
Number of sutures used
2
1
7
0.26
3
23
29
4
30
30
5
6
8
> 5
1
0
Prosthesis hip
Synergy – R3
37
48
0.30
Trifit – Trinity
3
3
Exeter
0
3
Knee
Triathalon
21
23
0.70
Saiph knee
5
3
Wound closure (min)
mean (SD)
14.64 (5.51)
13.89 (5.13)
0.47
VAS score (mean, SD)
Day 1
6.47 (2.62)
6.20 (2.35)
0.34
Day 3
4.75 (2.33)
4.18 (2.33)
0.15
Day 5
4.67 (1.75)
2.92 (2.87)
0.18
Length of stay (d)
mean (SD)
6.13 (4.23)
6.23 (4.11)
0.95
Table 4 Outcomes at follow-up
Trial group
P value
Controls (n = 69)
Cases (n = 81)
ASEPSIS scores
0-10
65
75
0.75
> 10
4
6
mean (SD range)
1.41
2.54
0.036
(0.38-2.43)
(1.41-3.68)
Follow-up outcomes (2-wk)
Site of follow-up
Hospital
35
37
0.21
Community
27
28
Inpatient
2
10
Did not attend
5
6
Wound complications
Yes
1
6
0.22
No
63
69
Superficial SSI
1
2
Erythema
0
3
Serous discharge
0
1
Follow-up outcomes (6-wk)
Attended hospital
Yes
61
65
0.189
No
8
16
Wound complications
Yes
1
8
0.03
No
60
57
Superficial SSI
1
3
Wound dehiscence
0
1
Irritation from suture
0
2
Serous discharge
0
1
Deep SSI
0
1
Systemic complications
Nausea and vomiting
0
2
0.12
Dizziness
0
0
1.00
Bleeding(not from wound)
1
2
0.26
Stiffness
4
5
0.30
Neurovascular injury
0
0
1.00
DVT
1
0
0.18
PE
0
1
0.19
Chest infection
1
2
0.26
MI
0
0
1.00
CVA
0
0
1.00
Fracture
0
2
0.12
Dislocation
0
0
1.00
Loosening
0
0
1.00
Mortality
0
0
1.00
Missing data
8
16
Citation: Sukeik M, George D, Gabr A, Kallala R, Wilson P, Haddad FS. Randomised controlled trial of triclosan coated vs uncoated sutures in primary hip and knee arthroplasty. World J Orthop 2019; 10(7): 268-277