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Triclosan in Single Use Medical Devices for Preventing Infections: A Review of Clinical Effectiveness, Safety and Guidelines

Last updated: July 11, 2019
Project Number: RC1143-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness and safety of using triclosan on single use medical devices and/or consumables for infection prevention in hospitalized patients?
  2. What are the evidence-based guidelines regarding the use of triclosan in medical devices and/or consumables?

Key Message

One health technology assessment, one systematic review, six randomized controlled trials, and one non-randomized study were identified regarding the clinical effectiveness of triclosan on single use medical devices or consumables. All the relevant evidence examined triclosan-coated sutures compared to uncoated sutures. The evidence mostly consisted of low to moderate quality studies in adult patients, with one high quality study conducted in pediatric patients. There was evidence from one low-quality systematic review, as well as low-, moderate-, and high-quality randomized controlled trials that triclosan-coated sutures were associated with a lower risk of surgical site infections in hospitalized patients compared with patients treated with uncoated sutures. There was limited evidence of variable quality to suggest that triclosan-coated sutures were associated with reduced risk of wound dehiscence, a lower use of antimicrobials post-operatively, fewer instances of wound revision, fewer outpatient visits, lower readmission rate, lower surface temperature, and fewer instances of evisceration. Limited evidence of variable quality also suggested that triclosan-coated sutures made no difference compared to uncoated sutures with regards to quality of life, the incidence of incisional hernia. post-operative mortality, critical care admission, clostridium difficile infections, pain, functional score, and complications. Three evidence-based guidelines were identified. All three guidelines suggest considering the use of triclosan-coated sutures for the prevention of surgical site infections. Overall, patients treated with triclosan-coated sutures had outcomes that were better or not different than patients treated with uncoated sutures.