Talk track

Key Messages

  • STRATAFIX™ Symmetric PDS™ Plus Knotless Tissue Control Device is designed specifically for high-tension closures like fascia.
  • The STRATAFIX™ Knotless Tissue Control Devices has self anchoring technology which provides multiple points of fixation along the suture line, combining the strength and security of interrupted closure, with the efficiency of continuous closure - with no knot-related complications such as increased risk of infection from bacterial attachment.4-7
  • STRATAFIX™ Symmetric PDS™ Plus incorporates Plus Antibacterial Technology with triclosan coating, which has been shown in vitro to inhibit E.coli colonization of the suture for 11 days or more.8
  • A meta-analysis of 21 randomized controlled trials showed a 28% reduction in SSI risk with the use of triclosan-coated sutures​.14¶#**

Detailed Talk Track

I understand you don’t currently use a barbed or knotless suture technique. You mentioned consistent tension and control with your sutures is important when closing the fascia. That’s where STRATAFIX™ Symmetric PDS™ Plus Knotless Tissue Control Device can make a real difference. It’s designed specifically for high-tension closures like fascia. Many surgeons have told me about the trade offs that can come with traditional suture techniques. For example, interrupted closure can lead to inconsistent distribution of tension, knot related complications and can be time consuming, while the continuous closure technique can lead to a compromise in strength and security and a potential break in the suture.1,2,3 The STRATAFIX™ Knotless Tissue Control Devices overcomes these trade offs with self anchoring technology which provides multiple points of fixation along the suture line, combining the strength and security of interrupted closure, with the efficiency of continuous closure – with no knot-related complications such as increased risk of infection from bacterial attachment.4-7 STRATAFIX™ Symmetric PDS™ Plus also incorporates antibacterial technology with triclosan coating, which has been shown to inhibit bacterial colonization of the suture for 11 days or more.8 Using STRATAFIX™ Symmetric PDS™ Plus sutures aligns with recommendations by the CDC, ACS/Surgical Infection Society, and NICE guidelines, which all advise that triclosan-coated sutures should be used to reduce the risk of SSIs​.*†,9-13 In fact, a meta-analysis of 21 randomized controlled trials showed a 28% reduction in SSI risk with the use of triclosan-coated sutures​.14¶#**

References

*These guidelines on reducing the risk of surgical site infections are general to triclosan-coated sutures and are not speci‹c to any one brand.

† 2021 NICE MedTech guidelines recommend the use of Ethicon Plus Antibacterial Sutures as part of a bundle of care for preventing surgical site infection.33

¶ In a meta-analysis that included 21 RCTs, 6462 patients, 95% CI: (14, 40%), P<0.001.

#All triclosan-coated sutures in these RCTs were Ethicon Plus Antibacterial Sutures (MONOCRYL™ Plus Antibacterial [poliglecaprone 25] Suture, Coated VICRYL™ Plus Antibacterial [polyglactin 910] Suture, and PDS™ Plus Antibacterial [polydioxanone] Suture).

**Meta-analysis only included traditional (non-barbed) sutures.

1. Sissener T. Suture patterns. Comp Anim. 2006;11:14-19.

2. Boutros S, Weinfeld AB, Friedman JD. Continuous versus interrupted suturing of traumatic lacerations: a time, cost, and complication rate comparison. J Trauma Injury Infect Crit Care. 2000;48(3):495-497.

3. Seiler CM, Bruckner T, Diener MK, et al. Interrupted or continuous slowly absorbable sutures for closure of primary elective midline abdominal incisions: a multicenter randomized trial (INSECT: ISRCTN24023541). Ann Surg. 2009;249(3):576- 582. 4a barbed suture like STRATAFIX™, which is the only barbed suture appropriate for high-tension areas such as fascia and offers antibacterial protection?​​

4. Nonnenman H. 100326296: Time zero tissue holding – Competitive claims comparisons for STRATAFIX Knotless Tissue Control Devices vs various products. 2015. Ethicon, Inc.

5. Moran ME, Marsh C, Perrotti M. Bidirectional-barbed sutured knotless running anastomosis v classic Van Velthoven suturing in a model system. J Endourol. 2007;21(10):1175-1178.

6. Vakil JJ, O’Reilly MP, Sutter EG, Mears SC, Belkoff SM, Khanuja HS. Knee arthrotomy repair with a continuous barbed suture: a biomechanical study. J Arthroplasty. 2011;26(5):710-713.

7. Levine BR, Ting N, Della Valle CJ. Use of a barbed suture in the closure of hip and knee arthroplasty wounds. Orthopedics. 2011;34(9):e473-e475. doi: 10.3928/01477447-20110714-35.
8. Ming X, Rothenburger S, Nichols MM. In vivo and in vitro antibacterial efficacy of PDS Plus (polidioxanone with triclosan) suture. Surg Infect (Larchmt). 2008;9(4):451-457.

9. Berríos-Torres SI, Umscheid CA, Bratzler DW, et al. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017. JAMA Surg. doi:10.1001/jamasurg.2017.0904.

10. Global guidelines on the prevention of surgical site infection. World Health Organization website. http://www.who.int/gpsc/ssi-prevention-guidelines/en/. Accessed October 5, 2018.

11. Ban KA, Minei JP, Laronga C, et al. American College of Surgeons and Surgical Infection Society: Surgical Site Infection Guidelines, 2016 Update. J Am Coll Surg. 2016;224:59-74.

12. National Institute for Health and Care Excellence (NICE) Guideline. Surgical site infections: prevention and treatment. NICE website. https://www.nice.org.uk/guidance/ng125/chapter/Recommendations#closuremethods. Accessed February 14, 2022.
Prevention of postoperative wound infections. Recommendation of the Committee for Hospital Hygiene and Infection

13. Prevention (KRINKO) at the Robert Koch Institute. Bundesgesundheitsbl. 2018; 61(4):448-473.

14. de Jonge SW, Atema JJ, Solomkin JS, Boermeester MA. Meta-analysis andtrial sequential analysis of triclosan-coated sutures for the prevention of surgical-site infection. Br J Surg. 2017;104(2):e118-e133.

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