Triclosan-coated sutures for the reduction of sternal wound infections: Economic considerations

Background. Sternal wound infections are a major complication after cardiac surgery in terms of morbidity and cost increase. To decrease the incidence of infection, we evaluated triclosan-coated sutures for the closure of the sternal incision, as it is known that most of the surgical site infections are related to the incision site. Methods. From May to December 2005, a total of 479 patients underwent a cardiac surgical procedure. From those, 103 patients were closed with triclosan-coated suture material ( cost per patient $30 [ in United States dollars]), whereas the remaining 376 patients had their incision closed with noncoated sutures ( cost per patient $21). Results. During the study period, 24 patients had superficial ( n = 10) or deep ( n = 14) sternal wound infections ( cost per patient $11,200). All those patients were closed with conventional suture material. In the triclosan group, no wound infection or dehiscence was observed during hospital stay and follow-up visits. Conclusions. Triclosan-coated sutures might be valuable in the reduction of sternal wound infections and avoid the suture being a risk factor for surgical site infections. The increased cost of the coated suture material has to be weighed against the enormous cost of sternal wound infections caused directly by the cost of care as well as indirectly through the loss of economic productivity.