**The Clinical and Economic Value of Triclosan-Coated Surgical Sutures in Abdominal Surgery**

#### **Marco Ceresoli 1, Francesca Carissimi 1, Alessandra Piemontese 2, Vito Paragò 2, Thibaut Galvain 3, Giovanni A. Tommaselli 2 and Luca Gianotti 1,\***

1 School of Medicine and Surgery, Milano-Bicocca University and Department of Surgery, San Gerardo Hospital, 20900 Monza, Italy; m.ceresoli4@campus.unimib.it (M.C.); f.carissimi@campus.unimib.it (F.C.)


Received: 11 December 2019; Accepted: 30 January 2020; Published: 6 February 2020

**Abstract:** Surgical site infection (SSI) is a frequent complication of surgical procedures. The aim of this study was to analyze the clinical evidence for SSI prevention with triclosan-coated sutures (TCS) in abdominal surgery and to investigate the economic impact of TCS in this type of procedure compared with conventional absorbable sutures (CS). A literature review was carried out to identify meta-analyses that were published between 1990 and 2019 that assessed the use of TCS in abdominal surgery. A budget impact analysis was performed from an Italian hospital perspective based on the most recently published evidence to simulate the financial impact of TCS in a general surgery unit. Uncertainty was explored through scenario analysis, as well as deterministic and probabilistic sensitivity analyses. Nine meta-analyses and two additional randomized clinical trials were retrieved. All meta-analyses described a reduction (range 19%–44%) in the risk of SSI when TCS were used. The use of TCS was associated with an overall annual net saving for the general surgery unit of €14,785 and a reduction of 3.2 SSIs compared with CS. Sensitivity analyses resulted in a positive annual saving associated with TCS in 98% of scenarios. TCS are a valuable, cost-saving SSI prevention strategy. TCS additional costs would be o ffset by the reduction in SSIs.

**Keywords:** triclosan; surgical site infection; suture; abdominal surgery; cost-analysis; budget impact analysis
