Combining in the melt physical and biological properties of poly(caprolactone) and chlorhexidine to obtain antimicrobial surgical monofilaments

Antimicrobial Activity of Antibacterial Sutures in Oral Surgery: A Scoping Review

OBJECTIVE

The aim of this scoping review was to explore and synthesise the current evidence on the antimicrobial activity of antibacterial suture materials used in oral surgery.

METHODS

The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews. A bibliographic search was carried out in the PubMed and Scopus databases to retrieve all human clinical studies that investigated the antimicrobial efficacy of antibacterial-coated sutures used in oral surgery. Included studies were screened and extracted independently by 2 examiners. Data were tabulated and qualitatively described.

RESULTS

The search initially returned 150 articles and resulted in 5 included studies after the duplicates' removal and the full-text screening. Selected studies were published from 2014 to 2019. Three studies (60%) were randomised clinical trials, whilst the remaining studies did not report information on randomisation. The antimicrobial agents for coated sutures included triclosan and chlorhexidine. In almost all the studies, antibacterial-coated sutures exhibited lower bacterial retention compared to those without coating.

CONCLUSIONS

Within limitations, the antimicrobial-coated sutures employed in oral surgery exhibited good results in terms of their microbicidal activity when compared with sutures that were not coated. Considering the high variability and confounding factors identified in the included studies, more high-quality research is needed to confirm these results. Antimicrobial-coated sutures could represent a promising and clinically valid strategy to reduce microbial colonisation in oral surgery. The reduced bacterial adherence is likely to improve the clinical success of the surgical procedures. Yet, the cost-benefit ratio of antimicrobial-coated sutures should be assessed in larger clinical trials to confirm their efficacy over conventional noncoated sutures.

Drug-Eluting Sutures by Hot-Melt Extrusion: Current Trends and Future Potentials

Surgical site infections (SSIs) may result from surgical procedures requiring a secondary administration of drugs at site or systemically in treating the infection. Drug-eluting sutures containing antimicrobial agents symbolise a latent strategy that precludes a secondary drug administration. It also offers the possibility of delivering a myriad of therapeutic agents to a localised wound site to effect analgesia, anti-inflammation, or the deployment of proteins useful for wound healing. Further, the use of biodegradable drug-eluting sutures eliminates the need for implanting foreign material into the wound, which needs to be removed after healing. In this review, we expound on recent trends in the manufacture of drug-eluting sutures with a focus on the hot-melt extrusion (HME) technique. HME provides a solvent-free, continuous one-step manufacturing conduit for drug-eluting sutures, hence, there is no drying step, which can be detrimental to the drug or suture threads and, thus, environmentally friendly. There is the possibility of combining the technology with additive manufacturing platforms to generate personalised drug-loaded implantable devices through prototyping and scalability. The review also highlights key material requirements for fabricating drug-eluting sutures by HME, as well as quality attributes. Finally, a preview of emerging drug-eluting sutures and advocacy for harmonisation of quality assurance by regulatory authorities that permits quality evaluation of novelty sutures is presented.

Electrospun Medical Sutures for Wound Healing: A Review

With the increasing demand for wound healing around the world, the level of medical equipment is also increasing, but sutures are still the preferred medical equipment for medical personnel to solve wound closures. Compared with the traditional sutures, the nanofiber sutures produced by combining the preparation technology of drug-eluting sutures have greatly improved both mechanical properties and biological properties. Electrospinning technology has attracted more attention as one of the most convenient and simple methods for preparing functional nanofibers and the related sutures. This review firstly discusses the structural classification of sutures and the performance analysis affecting the manufacture and use of sutures, followed by the discussion and classification of electrospinning technology, and then summarizes the relevant research on absorbable and non-absorbable sutures. Finally, several common polymers and biologically active substances used in creating sutures are concluded, the related applications of sutures are discussed, and the future prospects of electrospinning sutures are suggested.

3D Printing of Antibacterial Polymer Devices Based on Nitric Oxide Release from Embedded S-Nitrosothiol Crystals

Controlled release of drugs from medical implants is an effective approach to reducing foreign body reactions and infections. We report here on a one-step 3D printing strategy to create drug-eluting polymer devices with a drug-loaded bulk and a drug-free coating. The spontaneously formed drug-free coating dramatically reduces the surface roughness of the implantable devices and serves as a protective layer to suppress the burst release of drugs. A high viscosity liquid silicone that can be extruded based on its shear-thinning property and quickly vulcanize upon exposure to ambient moisture is used as the ink for 3D printing. S-Nitrosothiol type nitric oxide (NO) donors in their crystalline forms are selected as model drugs because of the potent antimicrobial, antithrombotic, and anti-inflammatory properties of NO. Direct ink writing of the homogenized polymer-drug mixtures generates rough and ill-defined device surfaces because of the exposed S-nitrosothiol microparticles. When a low-viscosity silicone (polydimethylsiloxane) is added into the ink, this silicone diffuses outward upon deposition to form a drug-free outermost layer without compromising the integrity of the printed structures. S-Nitrosoglutathione (GSNO) or S-nitroso-N-acetylpenicillamine (SNAP) embedded in the printed silicone matrix releases NO under physiological conditions from days to about one month. The microsized drug crystals are well-preserved in the ink preparation and printing processes, which is one reason for the sustained NO release. Biofilm and cytotoxicity experiments confirmed the antibacterial property and safety of the printed NO-releasing devices. This additive manufacturing platform does not require dissolution of drugs and involves no thermal or UV processes and, therefore, offers unique opportunities to produce drug-eluting silicone devices in a customized manner.

Health care-associated infections: Controlled delivery of cationic antiseptics from polymeric excipients

Nowadays, the treatment of health care-associated infections represents a serious issue, due to the increasing number of bacterial strains resistant to traditional antibiotics. The use of antiseptics like quaternary ammonium salts and biguanides is a viable alternative to face these life-threatening infections. However, their inherent toxicity as well as the necessity of providing a sustained release to avoid the formation of pathogen biofilms are compelling obstacles towards their assessment in the hospitals. Within this framework, the role of polymeric drug delivery systems is fundamental to overcome the aforementioned problems. Biocompatibility, biodegradability and excipient-drug interactions are crucial properties determining the efficacy of the formulation. In this work, we provide an in-depth analysis of the polymer drug delivery systems that have been developed or are under development for the sustained release of positively charged antiseptics, highlighting the crucial characteristics that allowed to achieve the most relevant therapeutic effects. We reported and compared natural occurring polymers and synthetic carriers to show their pros and cons and applicability in the treatment of health care-associated infections. Then, the discussion is focused on a particularly relevant class of materials adopted for the scope, represented by polyesters, which gave rise, due to their biodegradability, to the field of resorbable drug delivery devices. Finally, a specific analysis on the effect of the polymer functionalization over the formulation performances for the different types of polymeric carriers is presented.

Alleviating the toxicity concerns of antibacterial cinnamon-polycaprolactone biomaterials for healthcare-related biomedical applications

Fibrous constructs with incorporated cinnamon-extract have previously been shown to have potent antifungal abilities. The question remains to whether these constructs are useful in the prevention of bacterial infections in fiber form and what the antimicrobial effects means in terms of toxicity to the native physiological cells. In this work, cinnamon extract containing poly (ε-caprolactone) (PCL) fibers were successfully manufactured by pressurized gyration and had an average size of ∼2 μm. Cinnamon extract containing PCL fibers were tested against Escherichia coli, Staphylococcus aureus, Methicillin resistant staphylococcus aureus, and Enterococcus faecalis bacterial species to assess their antibacterial capacity; it was found that these fibers were able to reduce viable cell numbers of the bacterial species up to two orders of magnitude lower than the control group. The results of the antibacterial tests were assessed by scanning electron microscopy (SEM). The constructs were also tested under indirect MTT tests where they showed little to no toxicity, similar to the control groups. Additionally, cell viability fluorescent imaging displayed no significant toxicity issues with the fibers, even at their highest tested concentration. Here we present a viable method for the production the non-toxic and naturally abundant cinnamon extracted fibers for numerous biomedical applications.

Engineering and polymeric composition of drug-eluting suture: A review

Sutures are the most popular surgical implants in the global surgical equipment market. They are used for holding tissues together to achieve wound closure. However, controlling the body's immune response to these "foreign bodies" at site of infection is challenging. Natural polymers such as collagen, silk, nylon, and cotton, and synthetic polymers such as polycaprolactone, poly(lactic-co-glycolic acid), poly(p-dioxanone) and so forth, contribute the robust foundation for the engineering of drug-eluting sutures. The incorporation of active pharmaceutical ingredients (APIs) with polymeric composition of suture materials is an efficient way to reduce inflammatory reaction in the wound site as well as to control bacterial growth, while allowing wound healing. The incorporation of polymeric composition in surgical sutures has been found to add high flexibility as well as excellent physical and mechanical properties. Fabrication processes and polymer materials allow control over drug-eluting profiles to effectively address wound healing requirements. This review outlines and discusses (a) polymer materials and APIs used in suture applications, including absorbable and nonabsorbable sutures; (b) suture structures, such as monofilament, multifilament, barded and smart sutures; and (c) the existing manufacturing techniques for drug-eluting suture production, including electrospinning, melt-extrusion and coating.

Fabrication and characterisation of melt-extruded chitosan/keratin/PCL/PEG drug-eluting sutures designed for wound healing

Diclofenac potassium loaded sutures based upon PEG/PCL/chitosan-keratin blends were fabricated using the hot-melt extrusion technique. Polymer sutures were evaluated based on their physical, thermal and mechanical properties, while the drug-eluting sutures were evaluated for drug release properties. Lastly, the performance of the drug-loaded sutures in the contact with the human keratinocyte cell line HaCat were assessed. Results showed that the sutures extruded homogeneously at a temperature of 63 ± 1 °C providing a uniform thickness of fibres. Analysis by Differential Scanning Calorimetry (DSC) and Thermogravimetric Analysis (TGA) showed that completely amorphous and miscible solid dispersions were created. Fourier transform infrared (FTIR) spectroscopy indicated that the presence of hydrogen bonds between the polymers improved material miscibility. Tensile properties of the sutures were clearly affected by the PEG, chitosan and keratin additions. The optimal formulation of tensile strength was obtained when PCL/PEG/chitosan-keratin were combined at a ratio of 80/19/1 w/w. Rapid and sustained drug release rates were achieved with the PEG/PCL/chitosan/keratin blends at various combinations. The composite of PCL/PEG/chitosan-keratin with 30 wt% of diclofenac potassium also exhibited high cell viability and wound healing rates in vitro cytotoxicity testing. The anti-inflammatory properties imparted by the PCL/PEG/chitosan/keratin/drug sutures may further the use of composite sutures for wound healing in clinical settings.

Comparative Study on the Efficacy of Postsurgical Oral Prophylactic Antibiotic Versus Antimicrobial Suture Placement Alone in Preventing Surgical Site Infection After Removal of Impacted Mandibular Third Molar

Aim

To evaluate the efficacy of postsurgical oral prophylactic antibiotic versus antimicrobial suture placement in preventing infection after removal of an impacted mandibular third molar.

Materials and methods

This was a prospective, single-blind study including 150 individuals of 18-40 years divided into two groups with 75 patients each. The patients in Group 1 were administered oral amoxicillin tablets 500 mg for 5 days postsurgery with 3-0 polyglactin sutures for closure and in group 2 with (3-0) antimicrobial chlorhexidine diacetate-impregnated polyglactin sutures only. Evaluation was done on 3rd, 7th, 15th days and 1 month.

Results

There was no significant difference in rates of infection between the groups. Abnormal erythema, pain and trismus showed statistically better results in group 2 on 3rd and 7th days. An antibiotic side effect assessment showed 17.65% patients with minor side effects.

Conclusion

Chlorhexidine diacetate-impregnated polyglactin sutures showed reduced erythema, pain and trismus in healthy patients undergoing surgical removal of third molar.

Polyurethane-Based Composites: Effects of Antibacterial Fillers on the Physical-Mechanical Behavior of Thermoplastic Polyurethanes

The challenge to manufacture medical devices with specific antibacterial functions, and the growing demand for systems able to limit bacterial resistance growth, necessitates the development of new technologies which can be easily produced at an industrial level. The object of this work was the study and the development of silver, titanium dioxide, and chitosan composites for the realization and/or implementation of biomedical devices. Thermoplastic elastomeric polyurethane was selected and used as matrix for the various antibacterial functions introduced during the processing phase (melt compounding). This strategy was employed to directly incorporate antimicrobial agents into the main constituent material of the devices themselves. With the exception of the composite filled with titanium dioxide, all of the other tested composites were shown to possess satisfactory mechanical properties. The best antibacterial effects were obtained with all the composites against Staphylococcus aureus: viability was efficiently inhibited by the prepared materials in four different bacterial culture concentrations.

Antimicrobial additives for poly(lactic acid) materials and their applications: current state and perspectives

Poly(lactic acid)-based antimicrobial materials received considerable attention as promising systems to control microbial growth. The remarkable physicochemical properties of PLA such as renewability, biodegradability, and US Food and Drug Administration (FDA) approval for clinical use open up interesting perspectives for application in food packaging and biomedical materials. Nowadays, there is an increasing consumer demands for fresh, high-quality, and natural foods packaged with environmentally friendly materials that prolong the shelf life. The incorporation of antimicrobial agents into PLA-based polymers is likely to lead to the next generation of packaging materials. The development of antimicrobial PLA materials as a delivery system or coating for biomedical devices is also advantageous in order to reduce possible dose-dependent side effects and limit the phenomena of antibiotic resistance. This mini-review summarizes the most recent advances made in antimicrobial PLA-based polymers including their preparation, biocidal action, and applications. It also highlights the potential of PLA systems as efficient stabilizers-carriers of various kinds of antimicrobial additives including essential oils and other natural compounds, active particles and nanoparticles, and conventional and synthetic molecules.

Plasma modified PLA electrospun membranes for actinorhodin production intensification in Streptomyces coelicolor immobilized-cell cultivations

Most of industrially relevant bioproducts are produced by submerged cultivations of actinomycetes. The immobilization of these Gram-positive filamentous bacteria on suitable porous supports may prevent mycelial cell-cell aggregation and pellet formation which usually negatively affect actinomycete submerged cultivations, thus, resulting in an improved biosynthetic capability. In this work, electrospun polylactic acid (PLA) membranes, subjected or not to O₂-plasma treatment (PLA-plasma), were used as support for immobilized-cell submerged cultivations of Streptomyces coelicolor M145. This strain produces different bioactive compounds, including the blue-pigmented actinorhodin (ACT) and red-pigmented undecylprodigiosin (RED), and constitutes a model for the study of antibiotic-producing actinomycetes. Wet contact angles and X-ray photoelectron spectroscopy analysis confirmed the increased wettability of PLA-plasma due to the formation of polar functional groups such as carboxyl and hydroxyl moieties. Scanning electron microscope observations, carried out at different incubation times, revealed that S. coelicolor immobilized-cells created a dense "biofilm-like" mycelial network on both kinds of PLA membranes. Cultures of S. coelicolor immobilized-cells on PLA or PLA-plasma membranes produced higher biomass (between 1.5 and 2 fold) as well as higher levels of RED and ACT than planktonic cultures. In particular, cultures of immobilized-cells on PLA and PLA-plasma produced comparable levels of RED that were approximatively 4 and 5 fold higher than those produced by planktonic cultures, respectively. In contrast, levels of ACT produced by immobilized-cell cultures on PLA and PLA-plasma were different, being 5 and 10 fold higher than those of planktonic cultures, respectively. Therefore, this is study demonstrated the positive influence of PLA membrane on growth and secondary metabolite production in S. coelicolor and also revealed that O₂-plasma treated PLA membranes specifically promoted higher ACT production than not treated membranes.

Development of polymeric functionally graded scaffolds: a brief review

Over recent years, there has been a growing interest in multilayer scaffolds fabrication approaches. In fact, functionally graded scaffolds (FGSs) provide biological and mechanical functions potentially similar to those of native tissues. Based on the final application of the scaffold, there are different properties (physical, mechanical, biochemical, etc.) which need to gradually change in space. Therefore, a number of different technologies have been investigated, and often combined, to customize each region of the scaffolds as much as possible, aiming at achieving the best regenerative performance.In general, FGSs can be categorized as bilayered or multilayered, depending on the number of layers in the whole structure. In other cases, scaffolds are characterized by a continuous gradient of 1 or more specific properties that cannot be related to the presence of clearly distinguished layers. Since each traditional approach presents peculiar advantages and disadvantages, FGSs are good candidates to overcome the limitations of current treatment options. In contrast to the reviews reported in the literature, which usually focus on the application of FGS, this brief review provides an overview of the most common strategies adopted to prepare FGS.

Synthesis, characterization, and antimicrobial properties of novel double layer nanocomposite electrospun fibers for wound dressing applications

Herein, novel hybrid nanomaterials were developed for wound dressing applications with antimicrobial properties. Electrospinning was used to fabricate a double layer nanocomposite nanofibrous mat consisting of an upper layer of poly(vinyl alcohol) and chitosan loaded with silver nanoparticles (AgNPs) and a lower layer of polyethylene oxide (PEO) or polyvinylpyrrolidone (PVP) nanofibers loaded with chlorhexidine (as an antiseptic). The top layer containing AgNPs, whose purpose was to protect the wound site against environmental germ invasion, was prepared by reducing silver nitrate to its nanoparticulate form through interaction with chitosan. The lower layer, which would be in direct contact with the injured site, contained the antibiotic drug needed to avoid wound infections which would otherwise interfere with the healing process. Initially, the upper layer was electrospun, followed sequentially by electrospinning the second layer, creating a bilayer nanofibrous mat. The morphology of the nanofibrous mats was studied by scanning electron microscopy and transmission electron microscopy, showing successful nanofiber production. X-ray diffraction confirmed the reduction of silver nitrate to AgNPs. Fourier transform infrared spectroscopy showed a successful incorporation of the material used in the produced nanofibrous mats. Thermal studies carried out by thermogravimetric analysis indicated that the PVP–drug-loaded layer had the highest thermal stability in comparison to other fabricated nanofibrous mats. Antimicrobial activities of the as-synthesized nanofibrous mats against Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, and Candida albicans were determined using disk diffusion method. The results indicated that the PEO–drug-loaded mat had the highest antibacterial activity, warranting further attention for numerous wound-healing applications.

Antimicrobial Polymers in the Nano-World

Infections are one of the main concerns of our era due to antibiotic-resistant infections and the increasing costs in the health-care sector. Within this context, antimicrobial polymers present a great alternative to combat these problems since their mechanisms of action differ from those of antibiotics. Therefore, the microorganisms' resistance to these polymeric materials is avoided. Antimicrobial polymers are not only applied in the health-care sector, they are also used in many other areas. This review presents different strategies that combine nanoscience and nanotechnology in the polymer world to combat contaminations from bacteria, fungi or algae. It focuses on the most relevant areas of application of these materials, viz. health, food, agriculture, and textiles.

Fabrication and characterization of electrospun poly(e-caprolactone) fibrous membrane with antibacterial functionality

This research study is mainly targeted on fabrication and characterization of antibacterial poly(e-caprolactone) (PCL) based fibrous membrane containing silver chloride particles. Micro/nano fibres were produced by electrospinning and characterized with TGA, DSC, SEM and mechanical analysis. It was found that addition of silver particles slightly reduced onset of thermal degradation and increased crystallization temperature of neat PCL. Silver-loaded samples exhibited higher tensile stress and lower strain revealing that the particles behaved as reinforcing agent. Moreover, addition of silver chloride resulted in beaded surface texture and formation of finer fibres as opposed to the neat. Antibacterial properties were tested against Gram-negative and Gram-positive bacteria and remarkable biocidal functionalities were obtained with about six logs reduction of Staphylococcus aureus and Escherichia coli O157:H7.

A Facile and Eco-friendly Route to Fabricate Poly(Lactic Acid) Scaffolds with Graded Pore Size

Over the recent years, functionally graded scaffolds (FGS) gaineda crucial role for manufacturing of devices for tissue engineering. The importance of this new field of biomaterials research is due to the necessity to develop implants capable of mimicking the complex functionality of the various tissues, including a continuous change from one structure or composition to another. In this latter context, one topic of main interest concerns the design of appropriate scaffolds for bone-cartilage interface tissue. In this study, three-layered scaffolds with graded pore size were achieved by melt mixing poly(lactic acid) (PLA), sodium chloride (NaCl) and polyethylene glycol (PEG). Pore size distributions were controlled by NaCl granulometry and PEG solvation. Scaffolds were characterized from a morphological and mechanical point of view. A correlation between the preparation method, the pore architecture and compressive mechanical behavior was found. The interface adhesion strength was quantitatively evaluated by using a custom-designed interfacial strength test. Furthermore, in order to imitate the human physiology, mechanical tests were also performed in phosphate buffered saline (PBS) solution at 37 °C. The method herein presented provides a high control of porosity, pore size distribution and mechanical performance, thus offering the possibility to fabricate three-layered scaffolds with tailored properties by following a simple and eco-friendly route.

Incorporation of an Antibiotic in Poly(Lactic Acid) and Polypropylene by Melt Processing

Purpose

In this work an antibiotic, ciprofloxacin (CFX), was incorporated into 2 different polymeric matrices, poly(lactic acid) (PLA) and polypropylene (PP), to provide them with antimicrobial properties. The influence of CFX content on release kinetics and on antimicrobial and mechanical properties was evaluated.

Methods

CFX was incorporated into both the polymers by melt mixing.

Results

The effect of CFX incorporation was found to strongly depend on which polymer matrix was used. In particular, the antimicrobial tests revealed that PLA samples containing CFX produced no inhibition zone and only a slight antibacterial activity was observed when the highest concentration of CFX was added to PLA. On the contrary, PP-based materials incorporating CFX, even those containing the smallest concentration of antibiotic, showed antimicrobial activity. These results were found to be in good agreement with the evaluation of the CFX release.

Conclusions

The negative findings of PLA-based systems are attributed to degradation phenomena that occur during the melt processing, involving some interaction between PLA and CFX. A proposed reaction mechanism between CFX and PLA occurring in the melt is presented.

Effect of Graphene Nanoplatelets on the Physical and Antimicrobial Properties of Biopolymer-Based Nanocomposites

In this work, biopolymer-based nanocomposites with antimicrobial properties were prepared via melt-compounding. In particular, graphene nanoplatelets (GnPs) as fillers and an antibiotic, i.e., ciprofloxacin (CFX), as biocide were incorporated in a commercial biodegradable polymer blend of poly(lactic acid) (PLA) and a copolyester (BioFlex^®). The prepared materials were characterized by scanning electron microscopy (SEM), and rheological and mechanical measurements. Moreover, the effect of GnPs on the antimicrobial properties and release kinetics of CFX was evaluated. The results indicated that the incorporation of GnPs increased the stiffness of the biopolymeric matrix and allowed for the tuning of the release of CFX without hindering the antimicrobial activity of the obtained materials.

Optimal bovine collagen concentration to achieve tracheal epithelial coverage of collagen sponges

OBJECTIVES/HYPOTHESIS

Artificial tracheas prepared using a collagen sponge and polypropylene mesh have been implanted in patients who received tracheal resections, but epithelialization in the reconstructed area is slow. We determined the optimal bovine atelocollagen concentration necessary for the rapid and complete tracheal epithelial coverage of collagen sponge implants.

STUDY DESIGN

Preliminary animal experiment.

METHODS

Collagen sponges were prepared using lyophilizing 0.5%, 0.7%, and 1.0% atelocollagen solutions (0.5%, 0.7%, and 1.0% sponges) and were analyzed using scanning electron microscopy. Partial tracheal defects were prepared in rabbits and reconstructed using sponges. Epithelial regeneration in the reconstructed area was evaluated by endoscopic, histological, and scanning electron microscope analyses.

RESULTS

All sponges had a membranous structural framework, and numerous fibrous structures filled the spaces within the framework in the 0.5% sponges. The membranous structure in the 0.7% sponges branched at many points, and intermembrane spaces were frequently observed. Conversely, the membranous structure in the 1.0% sponges was relatively continuous, thick, and closely arranged. Two weeks after implantation, tracheal defects were entirely covered with epithelium in two of the four and three of the four of the 0.5% and 0.7% sponge-implanted rabbits, respectively. The collagen sponges remained exposed to the tracheal lumen in four of the four rabbits in the 1.0% sponge group. Ciliogenesis in the center of the epithelialized region was detected only in the 0.7% sponge group.

CONCLUSION

Collagen sponges prepared from various concentrations of bovine atelocollagen have different structures. Complete epithelial coverage was achieved in more rabbits implanted with sponges prepared using the 0.7% bovine atelocollagen solution than in those implanted with sponges prepared from the 0.5% and 1.0% solutions.

LEVEL OF EVIDENCE

NA Laryngoscope, 126:E396-E403, 2016.

Effect of temperature on the release of carvacrol and cinnamaldehyde incorporated into polymeric systems to control growth and biofilms of Escherichia coli and Staphylococcus aureus

This study assessed the effect of temperature on the release of essential oil components incorporated by melt compounding into polymeric films. Specifically, polyethylene-co-vinylacetate (EVA) films containing carvacrol (CAR) and cinnamaldehyde (ALD), alone and in combination, were prepared and their surface and mechanical properties and antibacterial and anti-biofilm activity against Escherichia coli and Staphylococcus aureus were evaluated. The addition of ALD and CAR did not provoke variation in the surface morphology of EVA and allowed their delivery. At 37°C, films containing CAR, ALD or their combination (25+75%) were found to have the strongest bactericidal effect, whereas at lower temperatures a lower killing rate was observed. There was no clear evidence of the influence of temperature on the anti-biofilm activity of the essential oil component-based polymeric films. The biomass formed on EVA containing ALD, CAR or their combination (25+75) was significantly lower (60-80% reduction) than that formed on the EVA control at both 37° and 22°C.

Silver nanoparticle-coated suture effectively reduces inflammation and improves mechanical strength at intestinal anastomosis in mice

BACKGROUND

Our previous studies have revealed that silver nanoparticles (AgNPs) had anti-inflammatory properties. In this study, we coated AgNPs onto the surface of absorbable suture, to further explore their anti-inflammatory efficacy and potential clinical application using an intestinal anastomosis model.

METHODS

Layer-by-layer deposition was used to coat AgNPs on absorbable sutures. Scanning electron microscopy (SEM) was conducted to observe the morphology and distribution of AgNPs on suture surface. 1cm of either non-coated suture, suture coated with antibiotics or AgNPs-coated suture was placed on E. coli overlay of LB agar plates to test for bacterial inhibition. The respective sutures were then used for ileal anastomosis in mice. The anastomotic sites were harvested to investigate the degree of tissue inflammation and cell proliferation, as well as collagen deposition. Furthermore, burst pressure measurement was employed to test for mechanical properties.

RESULTS

SEM observation indicated AgNPs could be immobilized and distributed on suture surface evenly. AgNPs-coated suture had the best in vitro anti-bacterial efficacy when compared with other groups. Subsequent immunohistochemistry in the intestinal anastomosis model showed significantly less inflammatory cell infiltration (macrophage and neutrophil) and better collagen deposition in the anastomotic tissue in the AgNPs-coated suture group. Burst pressure measurement in healed anastomosis further confirmed that AgNPs-coated suture had better mechanical properties.

CONCLUSION

Our study suggests that AgNPs-coated sutures can improve anastomosis healing due to better mechanical properties from reduced inflammation.

Synthesis, characterization and antimicrobial activity of conjugates based on fluoroquinolon-type antibiotics and gelatin

Different fluoroquinolon-type antibiotics were conjugated to gelatin with the aim to synthesize biomacromolecules with antimicrobial properties. The covalent linkage of the antibiotic was performed by a radical process involving the residues in the side chains of gelatin able to undergo oxidative modifications. The conjugation of antibiotic moieties onto the protein structure was confirmed by FT-IR, UV-Vis, fluorescence, and calorimetric analyses. Biocompatibility tests were performed on human bone marrow mesenchymal stromal cells and the antibacterial properties of bioactive polymers were investigated by appropriate tests against Klebsiella pneumoniae and Escherichia coli. With regard to the tests conducted in the presence of E. coli, a minimum inhibitory concentration (MIC) ranging from 0.05 to 0.40 μg mL(-1) was recorded, while in the presence of K. pneumoniae this concentration varies from 0.10 to 1.60 μg mL(-1). In all the conjugates, the drug moieties retain their biological activity and the MIC values are lower than the resistance parameters of fluoroquinolon-type antibiotics versus Enterobacteriacae. The collected data suggest a broad range of applications, from biomedical to pharmaceutical and food science for all conjugates.

Development and characterization of essential oil component-based polymer films: a potential approach to reduce bacterial biofilm

The development of new polymeric materials aimed to control the bacterial biofilm appears to be an important practical approach. The goal of the present study was to prepare and characterize poly(ethylene-co-vinyl acetate) copolymer (EVA) films containing citronellol, eugenol, and linalool and evaluate their efficiency on growth and biofilm formation of Listeria monocytogenes, Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, and Pseudomonas aeruginosa in monospecies and dual species. The results showed that the addition of oil components influenced the elastic modulus (15 % decrease), the tensile stress (30 % decrease), the elongation at break (10 % increase), and the contact angle values (10-20° decrease) while leaving the homogeneity of the surface unaltered. Among the polymeric films, EVA + citronellol and EVA + eugenol at 7 wt% had the best inhibitory effect. After 24-48 h of incubation, EVA + citronellol was more effective against the growth (30-60 % reduction) than EVA + eugenol (15-30 % inhibition). However, this inhibition decreased after 240 h of incubation. On the contrary, the biofilm evaluation revealed a strong inhibition trend also after prolonged incubation time: the amount of biomass per square centimeter formed on copolymer with oil components was significantly less (40-70 % decrease) than that on pure copolymer control for L. monocytogenes, S. aureus, and E. coli. When polymeric materials were simultaneously inoculated with combinations of S. aureus and E. coli, the biomass accumulated was higher for EVA + citronellol and lower for EVA + eugenol than that in monoculture biofilm. The findings were similar to the results obtained by 2,3-bis[2-methyloxy-4-nitro-5-sulfophenyl]-2H-tetrazolium-5-carboxanilide assay that measures the metabolic activity of viable cells.