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Antiseptic measures reduce bacterial contamination of sutures in strabismus surgery
J Pediatr Ophthalmol Strabismus. 2011;doi:10.3928/01913913-20110920-01.
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Bacterial contamination of sutures used in strabismus surgery is high, but the risk of postoperative endophthalmitis can be reduced with proper prophylaxis, a study found.
"We propose that the cause of contamination is suture contact with eyelid margins and eyelashes and that the route of the infection is via scleral suture tract," the study authors said. "Although rare, endophthalmitis can occur with potential dismal potential visual outcomes. We therefore recommend that strabismus surgeons consider soaking sutures in povidone iodine prior to routine use."
The prospective, randomized study involved an analysis of muscle sutures from strabismus procedures. A control group included 61 untreated sutures. The second group included 200 antibiotic/steroid-coated sutures. The third group included 141 antiseptic-soaked and antibiotic/steroid-coated sutures. All samples were used in sterile conditions and analyzed for contamination.
Study results showed bacterial growth occurring in 28% of sutures in the first group, 22% of sutures in the second group and 9% of sutures in the third group. Reduction of bacterial growth in antiseptic-soaked and antibiotic/steroid-coated sutures was statistically significant (P = .006).
No complications from the use of antibiotic-coated sutures or povidone iodine solution were identified at 1 month after surgery. Coagulase-negative Staphylococcus epidermidis endophthalmitis was identified in one patient at 1 week but was treated successfully, the authors said.