Temporal Change of Interleukin-6, C-Reactive Protein, and Skin Temperature after Total Knee Arthroplasty Using Triclosan-Coated Sutures

Shih-Jie Lin, Fu-Chun Chang, Tsan-Wen Huang, Kuo-Ti Peng, Hsin Nung Shih, Mel S Lee, Shih-Jie Lin, Fu-Chun Chang, Tsan-Wen Huang, Kuo-Ti Peng, Hsin Nung Shih, Mel S Lee

Abstract

The risk of surgical site infections (SSIs) after total knee arthroplasty (TKA) can never be eliminated. Antimicrobial sutures containing triclosan have been used to decrease SSIs, but whether triclosan-coated sutures are effective with TKA is unclear. Between 2011 and 2012, 102 patients randomly assigned to a triclosan or a control group were prospectively assessed. The incidence of SSI within 3 months of surgery, length of hospital stay, pain scale, functional scores, wound condition, and serum inflammatory markers during hospitalization and within 3 months postoperatively were compared. At the final follow-up, there were 2 patients with superficial infections (3.9%) in the control group but none in the triclosan group. Lower serum IL-6 was detected in the triclosan group at 4 weeks and 3 months. The local skin temperature of the knees-recorded at 3 months using infrared thermography-was lower in the triclosan group than in the control group. More precise analytical measurements are needed to investigate local and systemic complications, especially in the early subclinical stage. This prospective, randomized, open-label clinical trial is in the public registry: ClinicalTrials.gov (NCT02533492).

Figures

Figure 1
Figure 1
Overview of study design in CONSORT 2010 flow diagram.
Figure 2
Figure 2
Follow-up protocol.
Figure 3
Figure 3
Serum erythrocyte sedimentation rate (ESR) levels. Plot graph showing the mean ESR levels of patients after total knee replacement with triclosan-coated polyglactin sutures (triclosan group) or with plain polyglactin sutures (control group) from preoperative period to 3-month follow-up (error bars represent SDs).
Figure 4
Figure 4
Serum C-reactive protein (CRP) levels. Plot graph showing the mean CRP levels of patients following total knee replacement with triclosan-coated polyglactin sutures (triclosan group) or with plain polyglactin sutures (control group) from preoperative period to 3-month follow-up (error bars represent SDs).
Figure 5
Figure 5
Serum IL-6 levels. Plot graph showing the mean IL-6 levels of patients following total knee replacement with triclosan-coated polyglactin sutures (triclosan group) or with plain polyglactin sutures (control group) from preoperative period to 3-month follow-up (error bars represent SDs).
Figure 6
Figure 6
Skin surface temperature. Plot graph showing the mean skin surface temperature levels of patients following total knee replacement with triclosan-coated polyglactin sutures (triclosan group) or with plain polyglactin sutures (control group) from preoperative period to 6-month follow-up (error bars represent SDs).

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