FAQs
Quick answers to commonly asked questions
(Click on a question to view the answer)
Plus SUTURES
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Does Ethicon have data on MONOCRYL* Plus Antibacterial (poliglecaprone 25) Suture?
In addition, Ethicon studies concluded that MONOCRYL* Plus Suture is equivalent to MONOCRYL* Suture in performance, safety and handling.
Supporting published data:
Ming X, Nichols M, Rothenburger S. In Vivo Antibacterial Efficacy of MONOCRYL* Plus Antibacterial Suture (Poliglecaprone 25 with Triclosan). Surg Infect J. 2007:8(2): 209-213.
Ming X, Rothenburger S, Yang D. In Vitro Antibacterial Efficacy of MONOCRYL* Plus Antibacterial Suture (Poliglecaprone 25 with Triclosan). Surg Infect J. 2007:8(2):201-207.
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Does Coated VICRYL* Plus Antibacterial (polyglactin 910) Suture affect wound healing?
Supporting published data:
Ford HR, Jones P, Reblock K, Simpkins DL. Intra-operative handling and wound healing characteristics of coated polyglactin 910 antibacterial suture and coated polyglactin 910 suture. Surg Infect. 2005:6:313-321.
“We speculate that polyglactin 910 suture with Triclosan by inhibiting bacterial colonization of the suture, reduced pain that can be an indicator of “subclinical” infection.”
-Dr. Henri Ford
Storch M, Perry LC, Davidson JM,Ward JJ. A 28-Day Study of the Effect of Coated VICRYL* Plus Antibacterial Suture (Coated Polyglactin 910 Suture) with Triclosan) on Wound Healing in Guinea Pig Linear Incisional Skin Wounds. Surg Infect. 2002;3:S89-S98.
Gomez-Alonso A, Garcia-Criado FJ, Parreno-Manchado FC, Garcia-Sanchez JE, Garcia-Sanchez E, Parreno-Manchado A Zambrano-Cuadrado Y. Study of the efficacy of Coated VICRYL* Plus Antibacterial suture (coated Polyglactin 910 suture with Triclosan) in two animal models of general surgery. Journal of Infection. 2007:54(1): 82-88.
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Supporting published data:
Ford HR, Jones P, Reblock K, Simpkins DL. Intra-operative handling and wound healing characteristics of coated polyglactin 910 antibacterial suture and coated polyglactin 910 suture. Surg Infect.2005:6:313-321.
Storch M, Scalzo H, Van Lue S, Jacinto G. Physical and functional comparison of coated VICRYL* Plus Antibacterial suture (coated polyglactin 910 with Triclosan) with Coated VICRYL* suture (coated polyglactin 910). Surg Infect J. 2002,3 (suppl 1):S65-S77.
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Does Ethicon have data on PDS Plus Suture?
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Why can Ethicon say “kills” bacteria on the suture?
An independent in vitro study concluded, “Antibacterial-coated sutures exhibit an inhibitory or bactericidal activity against bacteria commonly cultured from surgical wounds.”
Supporting published data:
Storch ML, Rothenburger SJ, Jacinto G Experimental Efficacy Study of Coated VICRYL* plus Antibacterial Suture in Guinea Pigs Challenged with Staphylococcus aureus. Surg Infect J. 2004;5 ;281-288.
Charles E Edmiston, Gary R Seabrook, Michael P Goheen, Candace J Krepel, Christopher P Johnson, Brian D Lewis, Kellie R Brown, Jonathan B Towne. Bacterial Adherence to Surgical Sutures: Can Antibacterial-Coated Sutures Reduce the Risk of Microbial Contamination? J Am Coll Surg. 2006; Vol 203, 4; 481- 489.
Ming X, Nichols M, Rothenburger S. In Vivo Antibacterial Efficacy of MONOCRYL* Plus Antibacterial Suture (Poliglecaprone 25 with Triclosan). Surg Infect J. 2007:8(2): 209-213.
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What is the chance of developing an allergic reaction from Plus SUTURES?
It is possible for the occasional patient who is sensitive to foreign bodies (suture) to develop a heightened foreign body reaction. This may be perceived as an allergic reaction.
Supporting published data:
Barbolt TA.Chemistry and safety of Triclosan, and its use as an antibacterial coating on VICRYL* Plus Antibacterial suture (coated polyglactin 910 with Triclosan). Surg Infect J. 2002;3 (suppl 1):S45-S54.
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Are Plus SUTURES bactericidal?
Independent and company performed studies showed an “inhibitory or bactericidal activity” against S aureus (methicillin-resistant S aureus [MRSA]), S epidermidis (biofilm-positive) and E coli by inhibiting colonization on the suture.
Supporting published data:
Storch ML, Rothenburger SJ, Jacinto G Experimental Efficacy Study of Coated VICRYL* Plus Antibacterial Suture in Guinea Pigs Challenged with Staphylococcus aureus. Surg Infect J. 2004;5 ;281-288
Ming X, Nichols M, Rothenburger S. In Vivo Antibacterial Efficacy of MONOCRYL* Plus Antibacterial Suture (Poliglecaprone 25 with Triclosan). Surg Infect J. 2007:8
Charles E Edmiston, Gary R Seabrook, Michael P Goheen, Candace J Krepel, Christopher P Johnson, Brian D Lewis, Kellie R Brown, Jonathan B Towne. Bacterial Adherence to Surgical Sutures: Can Antibacterial-Coated Sutures Reduce the Risk of Microbial Contamination? J Am Coll Surg 2006; Vol 203, 4;481- 489
Gomez-Alonso A, Garcia-Criado FJ, Parreno-Manchado FC, Garcia-Sanchez JE, Garcia-Sanchez E, Parreno-Manchado A Zambrano-Cuadrado Y. Study of the efficacy of Coated VICRYL* Plus Antibacterial suture (coated Polyglactin 910 suture with Triclosan) in two animal models of general surgery. Journal of Infection. 2007:54(1): 82-88.
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Does Ethicon have data on Coated VICRYL* Plus Sutures?
Supporting published data:
Barbolt TA. Chemistry and Safety of Triclosan, and Its Use as an Antimicrobial Coating on Coated VICRYL*® Plus Antibacterial Suture (Coated Polyglactin 910 Suture with Triclosan). Surgical Infections. 2002;3:S45-S53.
Ford HR, Jones P, Gaines B, Reblock K, Simpkins DL. Intraoperative handling and wound healing: controlled clinical trial comparing coated VICRYL* plus antibacterial suture (coated polyglactin 910 suture with triclosan) with coated VICRYL* suture (coated polyglactin 910 suture). Surgical Infections. 2005;6:313-321.
Rothenburger A, Spangler D, Bhende S, Burkley D. In vitro antimicrobial evaluation of Coated VICRYL* Plus Antibacterial Suture (coated polyglactin 910 with triclosan) using zone of inhibition assays. Surgical Infections. 2002;3:S79-S87.
IRGACARE®† MP
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Does triclosan promote antibiotic resistance?
IRGACARE®† MP is the medical grade triclosan used in Plus SUTURES and is a chlorinated phenolic biocide – a “phenol” with multi-targeted biocidal mechanisms:
- Non-specific effects on cell membrane activities and cell membrane integrity
- Blocks the active site of the enoyl-acyl carrier protein reductase (ENR)–essential enzyme in fatty acid synthesis–building cellular components and reproduction
Supporting published data:
Gilbert P, and McBain AJ. Literature-Based Evaluation of the Potential Risks Associated With Impregnation of Medical Devices and Implants With Triclosan. Surg Infect J. 2002;3(suppl 1):S55-S64.
Barbolt TA. Chemistry and Safety of Triclosan, and Its Use as an Antimicrobial Coating on Coated VICRYL*® Plus Antibacterial Suture (Coated Polyglactin 910 Suture with Triclosan). Surgical Infections. 2002;3:S45-S53
Links to additional supporting published data:
Allison, Levy, Larson et al. Antimicrob Agents Chemother. 2004; 48: 2973-2979.
Gilbert, P, McBain, AJ. Potential impact of increased use of biocides in consumer products on prevalence of antibiotic resistance. Clin Microbiol Rev. 2003 Apr;16 (2):189-208.
http://cmr.asm.org/content/vol16/issue2/>
Weber, David J; Rutala, William A; Use of Germicides in the Home and the Healthcare Setting: Is there a Relationship Between Germicide Use and Antibiotic Resistance? Infect Control Hosp Epidemiol. 2006;27:1107 – 1119
http://www.journals.uchicago.edu/cgi-bin/resolve?id=doi:10.1086/507964>
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Triclosan is broken down and metabolized in the body. Triclosan is excreted in a neutralized, inactive form via the kidneys, posing no threat to the patient or the environment.
Supporting published data:
Barbolt TA. Chemistry and safety of Triclosan, and its use as an antibacterial coating on VICRYL* Plus Antibacterial suture (coated polyglactin 910 with Triclosan). Surg Infect J. 2002;3 (suppl 1):S45-S54.p>
Gilbert P, and McBain AJ. Literature-Based Evaluation of the Potential Risks Associated With Impregnation of Medical Devices and Implants With Triclosan. Surg Infect J. 2002;3 (suppl 1):S55-S64.
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Why do I need an antibacterial agent on a monofilament suture?
It is also important to understand that the presence of a foreign material (such as suture) in a wound lowers the number of bacteria required to produce an infection.
Supporting published data:
Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR, the Hospital Infection Control Practices Advisory Committee. Guideline for the prevention of surgical site infection, 1999. Infect Control Hosp Epidemiol. 1999;20:247-280.
- Foreign body
“Quantitatively, it has been shown that if a surgical site is contaminated with >105 microorganisms per gram of tissue, the risk of SSI is markedly increased. However, the dose of contaminating microorganisms required to produce infection may be much lower when foreign material is present at the site (ie, 102 staphylococci per gram of tissue introduced on silk sutures).2
http://www.cdc.gov/ncidod/dhqp/gl_surgicalsite.html>
Ford HR, Jones P, Reblock K, Simpkins DL. Intra-operative handling and wound healing characteristics of coated polyglactin 910 antibacterial suture and coated polyglactin 910 suture. Surg Infect. 2002;3:S89-S98.
Evidence suggests that the suture knot may be the repository for bacteria that contaminate the wound. As such, it provides a nidus or scaffold for bacterial colonization and replication that can ultimately result in SSI. The most common organisms responsible for SSI include Staphylococcus aureus, Staphylococcus epidermidis, methicillin-resistant S aureus (MRSA), and methicillin-resistant S epidermidis (MRSE).”1
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How long does the zone of inhibition last?
Testing has demonstrated the zone of inhibition lasts in vitro for a minimum of 7 days for S aureus. MONOCRYL* Plus Suture
Testing has demonstrated the zone of inhibition lasts in vitro for 31 days for S aureus and 21 days for E. coli.
PDS Plus Suture
Testing has demonstrated the zone of inhibition lasts in vitro for 23 days for S aureus and 17 days for E. coli.
Supporting published data:
Coated VICRYL* Plus Suture
Rothenburger S, Spangler D, Bhende S, Burkley D. In Vitro Antimicrobial Evaluation of Coated VICRYL* Plus Antibacterial Suture (Coated Polyglactin 910 with Triclosan) using Zone of Inhibition Assays. Surg Infect J. 2002;3 : S79-S87.
MONOCRYL* Plus Suture
Ming X, Rothenburger S, Yang D. In Vitro Antibacterial Efficacy of MONOCRYL* Plus Antibacterial Suture (Poliglecaprone 25 with Triclosan). Surg Infect J. 2007:8(2): 201-207.
PDS Plus Suture
Testing has demonstrated the zone of inhibition lasts in vitro for 23 days for S aureus and 17 days for E. coli.
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Is triclosan being overused and/or misused?
Supporting published data:
Weber, David J; Rutala, William A; Use of Germicides in the Home and the Healthcare Setting: Is there a Relationship Between Germicide Use and Antibiotic Resistance? Infect Control Hosp Epidemiol. 2006;27:1107 – 1119.
http://www.journals.uchicago.edu/cgi-bin/resolve?id=doi:10.1086/507964>
Levy. SB Emerg Infect Dis. 2001:7 512-515.
http://www.cdc.gov/ncidod/EID/vol7no3_supp/contents.htm>
Allison, Levy, Larson et al. Antimicrob Agents Chemother. 2004;48:2973-2979.
Gilbert, P, McBain, AJ Potential impact of increased use of biocides in consumer products on prevalence of antibiotic resistance. Clin Microbiol Rev. 2003 Apr;16(2):189-208.
Surgical Site Infection
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Background information related to surgical site infections (SSIs)
Supporting published data: Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR, the Hospital Infection Control Practices Advisory Committee. Guideline for the prevention of surgical site infection, 1999. Infect Control Hosp Epidemiol. 1999;20:247-280.p>
http://www.cdc.gov/ncidod/dhqp/gl_surgicalsite.html>
Fry DE The Economic Costs of Surgical Site Infection. Surg Infect J. 2002;3 (suppl 1):S37-S43.
Barie PS. Surgical Site Infections: Epidemiology and Prevention. Surg Infect J. 2002;3 (suppl 1):S9-S21.
Murphy D, Whiting J, Hollenbeak CS APIC white paper Dispelling the Myths: The True Cost of Healthcare-Associated Infections. APIC Briefing. 2007/
http://www.apic.org/Content/NavigationMenu/PracticeGuidance/Reports/hai_whitepaper.pdf>
† Ciba Corporation, Inc.
