Expanded use of triclosan-coated sutures for surgical site infection prevention in oesophageal cancer surgery

Surgical site infection (SSI) remains one of the most common and serious complications following oesophageal cancer surgery, contributing to prolonged hospitalisation, increased healthcare costs, and reduced postoperative quality of life. Although triclosan-coated antimicrobial sutures have been shown to reduce SSIs in various surgical fields by inhibiting bacterial adhesion and biofilm formation, their use in oesophageal cancer surgery has not been adequately evaluated. This study aimed to assess the efficacy of triclosan-coated sutures in preventing SSIs when applied broadly during oesophageal cancer surgery. This retrospective cohort study enrolled 182 patients who underwent oesophageal cancer surgery between January 2021 and December 2024. Patients were divided into the conventional (n = 135) and triclosan-coated sutures groups (n = 47). In the triclosan group, antimicrobial sutures were used for skin and fascial closure, as well as in intra-abdominal applications—reinforcement of the gastric conduit staple line and anastomoses. SSI incidence was classified per the Centres for Disease Control and Prevention guidelines. Risk factors were identified using univariate and multivariate logistic regression analyses. Microbiological cultures of the infected sites were analysed. The overall SSI rate was significantly lower in the triclosan group than that in the conventional group (10.6% vs. 25.9%, P = 0.0211). The incidence of superficial, deep, and organ/space infections was lower in the triclosan group than that in the conventional group, albeit without statistical significance. In this exploratory multivariable logistic regression analysis, conventional suture use remained statistically associated with SSI [odds ratio (OR) 3.09, 95% confidence interval (CI) 1.08–8.82, P = 0.0350]. Triclosan-coated sutures were associated with a reduced incidence of SSIs after oesophageal cancer surgery. Given the retrospective design and the limited number of events, these findings should be interpreted cautiously. Further prospective multicentre studies are warranted to validate these results.