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Altun E, Bayram C, Gultekinoglu M, Matharu R, Delbusso A, Homer-Vanniasinkam S, Edirisinghe M. Pressure-Spun Fibrous Surgical Sutures for Localized Antibacterial Delivery: Development, Characterization, and In Vitro Evaluation. ACS APPLIED MATERIALS & INTERFACES 2023; 15:45561-45573. [PMID: 37729472 PMCID: PMC10561146 DOI: 10.1021/acsami.3c07956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 09/06/2023] [Indexed: 09/22/2023]
Abstract
Surgical sutures designed to prevent infection are critical in addressing antibiotic-resistant pathogens that cause surgical site infections. Instead of antibiotics, alternative materials such as biocides have been assessed for coating commercially used sutures due to emerging antibiotic resistance concerns worldwide. This study has a new approach to the development of fibrous surgical sutures with the ability to deliver localized antibacterial agents. A new manufacturing process based on pressure spinning was used for the first time in the production of fibrous surgical sutures by physically blending antibacterial triclosan (Tri) agent with poly(lactic-co-glycolic acid) (PLGA) and poly(ethylene oxide) (PEO) polymers. Fibrous surgical sutures with virgin PLGA, virgin PEO, different ratios of PLGA-PEO, and different ratios of Tri-loaded PLGA-PEO fibrous sutures were produced to mimic the FDA- and NICE-approved PLGA-based sutures available in the market and compared for their characteristics. They were also tested simultaneously with commercially available sutures to compare their in vitro biodegradation, antibacterial, drug release, and cytotoxicity properties. After in vitro antibacterial testing for 24 h, sutures having 285 ± 12 μg/mg Tri loading were selected as a model for further testing as they exhibited antibacterial activity against all tested bacteria strains. The selected model of antibacterial fibrous sutures exhibited an initial burst of Tri release within 24 h, followed by a sustained release for the remaining time until the sutures completely degraded within 21 days. The cell viability assay showed that these surgical sutures had no cytotoxic effect on mammalian cells.
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Affiliation(s)
- Esra Altun
- Department
of Mechanical Engineering, University College
London (UCL), Torrington Place, London WC1E 7JE, U.K.
| | - Cem Bayram
- Department
of Nanotechnology and Nanomedicine, Graduate School of Science and
Engineering, Hacettepe University, Ankara 06800, Turkey
| | - Merve Gultekinoglu
- Department
of Nanotechnology and Nanomedicine, Graduate School of Science and
Engineering, Hacettepe University, Ankara 06800, Turkey
| | - Rupy Matharu
- Department
of Civil, Environmental and Geomatic Engineering, University College London, Gower Street, London WC1E
6BT, U.K.
| | - Angelo Delbusso
- Department
of Mechanical Engineering, University College
London (UCL), Torrington Place, London WC1E 7JE, U.K.
| | | | - Mohan Edirisinghe
- Department
of Mechanical Engineering, University College
London (UCL), Torrington Place, London WC1E 7JE, U.K.
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Li Y, Meng Q, Chen S, Ling P, Kuss MA, Duan B, Wu S. Advances, challenges, and prospects for surgical suture materials. Acta Biomater 2023; 168:78-112. [PMID: 37516417 DOI: 10.1016/j.actbio.2023.07.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/07/2023] [Accepted: 07/24/2023] [Indexed: 07/31/2023]
Abstract
As one of the long-established and necessary medical devices, surgical sutures play an essentially important role in the closing and healing of damaged tissues and organs postoperatively. The recent advances in multiple disciplines, like materials science, engineering technology, and biomedicine, have facilitated the generation of various innovative surgical sutures with humanization and multi-functionalization. For instance, the application of numerous absorbable materials is assuredly a marvelous progression in terms of surgical sutures. Moreover, some fantastic results from recent laboratory research cannot be ignored either, ranging from the fiber generation to the suture structure, as well as the suture modification, functionalization, and even intellectualization. In this review, the suture materials, including natural or synthetic polymers, absorbable or non-absorbable polymers, and metal materials, were first introduced, and then their advantages and disadvantages were summarized. Then we introduced and discussed various fiber fabrication strategies for the production of surgical sutures. Noticeably, advanced nanofiber generation strategies were highlighted. This review further summarized a wide and diverse variety of suture structures and further discussed their different features. After that, we covered the advanced design and development of surgical sutures with multiple functionalizations, which mainly included surface coating technologies and direct drug-loading technologies. Meanwhile, the review highlighted some smart and intelligent sutures that can monitor the wound status in a real-time manner and provide on-demand therapies accordingly. Furthermore, some representative commercial sutures were also introduced and summarized. At the end of this review, we discussed the challenges and future prospects in the field of surgical sutures in depth. This review aims to provide a meaningful reference and guidance for the future design and fabrication of innovative surgical sutures. STATEMENT OF SIGNIFICANCE: This review article introduces the recent advances of surgical sutures, including material selection, fiber morphology, suture structure and construction, as well as suture modification, functionalization, and even intellectualization. Importantly, some innovative strategies for the construction of multifunctional sutures with predetermined biological properties are highlighted. Moreover, some important commercial suture products are systematically summarized and compared. This review also discusses the challenges and future prospects of advanced sutures in a deep manner. In all, this review is expected to arouse great interest from a broad group of readers in the fields of multifunctional biomaterials and regenerative medicine.
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Affiliation(s)
- Yiran Li
- College of Textiles & Clothing, Qingdao University, Qingdao, 266071, China
| | - Qi Meng
- College of Textiles & Clothing, Qingdao University, Qingdao, 266071, China
| | - Shaojuan Chen
- College of Textiles & Clothing, Qingdao University, Qingdao, 266071, China
| | - Peixue Ling
- Shandong Academy of Pharmaceutical Science, Jinan, 250101, China
| | - Mitchell A Kuss
- Mary & Dick Holland Regenerative Medicine Program and Division of Cardiology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Bin Duan
- Mary & Dick Holland Regenerative Medicine Program and Division of Cardiology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Shaohua Wu
- College of Textiles & Clothing, Qingdao University, Qingdao, 266071, China; Shandong Academy of Pharmaceutical Science, Jinan, 250101, China.
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Sanya DRA, Onésime D, Vizzarro G, Jacquier N. Recent advances in therapeutic targets identification and development of treatment strategies towards Pseudomonas aeruginosa infections. BMC Microbiol 2023; 23:86. [PMID: 36991325 PMCID: PMC10060139 DOI: 10.1186/s12866-023-02832-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 03/21/2023] [Indexed: 03/31/2023] Open
Abstract
The opportunistic human pathogen Pseudomonas aeruginosa is the causal agent of a wide variety of infections. This non-fermentative Gram-negative bacillus can colonize zones where the skin barrier is weakened, such as wounds or burns. It also causes infections of the urinary tract, respiratory system or bloodstream. P. aeruginosa infections are common in hospitalized patients for which multidrug-resistant, respectively extensively drug-resistant isolates can be a strong contributor to a high rate of in-hospital mortality. Moreover, chronic respiratory system infections of cystic fibrosis patients are especially concerning, since very tedious to treat. P. aeruginosa exploits diverse cell-associated and secreted virulence factors, which play essential roles in its pathogenesis. Those factors encompass carbohydrate-binding proteins, quorum sensing that monitor the production of extracellular products, genes conferring extensive drug resistance, and a secretion system to deliver effectors to kill competitors or subvert host essential functions. In this article, we highlight recent advances in the understanding of P. aeruginosa pathogenicity and virulence as well as efforts for the identification of new drug targets and the development of new therapeutic strategies against P. aeruginosa infections. These recent advances provide innovative and promising strategies to circumvent infection caused by this important human pathogen.
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Affiliation(s)
| | - Djamila Onésime
- Université Paris-Saclay, INRAE, AgroParisTech, Micalis Institute, Jouy-en-Josas, 78350, France
| | - Grazia Vizzarro
- Institute of Microbiology, University Hospital and University of Lausanne, Lausanne, 1011, Switzerland
- Present Address: Laboratory of Molecular Microbiology, Global Health Institute, School of Life Sciences, Station 19, EPFL-SV-UPBLO, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, 1015, Switzerland
| | - Nicolas Jacquier
- Institute of Microbiology, University Hospital and University of Lausanne, Lausanne, 1011, Switzerland.
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Metallic nanoparticle-coated sutures: a breakthrough in the field of surgery. Ann Med Surg (Lond) 2023; 85:555-556. [PMID: 36923752 PMCID: PMC10010808 DOI: 10.1097/ms9.0000000000000162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 12/24/2022] [Indexed: 03/06/2023] Open
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Sampathi S, Tiriya PK, Dodoala S, Junnuthula V, Dyawanapelly S. Development of Biocompatible Ciprofloxacin-Gold Nanoparticle Coated Sutures for Surgical Site Infections. Pharmaceutics 2022; 14:pharmaceutics14102130. [PMID: 36297565 PMCID: PMC9608442 DOI: 10.3390/pharmaceutics14102130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/26/2022] [Accepted: 09/29/2022] [Indexed: 11/06/2022] Open
Abstract
Surgical site infections (SSIs) are mainly observed after surgeries that use biomaterials. The aim of this present work was to develop ciprofloxacin hydrochloride (CPH)-loaded gold nanoparticles. These ciprofloxacin-gold nanoparticles were coated onto a sterile surgical suture using an adsorption technique, followed by rigidization via ionotropic crosslinking using sodium alginate. Furthermore, UV-visible spectroscopy, infrared spectroscopy, and scanning electron microscopy were used to characterize the samples. The particle size of the nanoparticles was 126.2 ± 13.35 nm with a polydispersity index of 0.134 ± 0.03, indicating nanosize formation with a monodispersed system. As per the International Council for Harmonization of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines, stability studies were performed for 30 days under the following conditions: 2-8 °C, 25 ± 2 °C/60 ± 5% RH, and 40 ± 2 °C/75 ± 5% RH. For both Gram-negative and Gram-positive bacteria, the drug-coupled nanoparticle-laden sutures showed a twofold higher zone of inhibition compared with plain drug-coated sutures. In vitro drug release studies showed a prolonged release of up to 180 h. Hemolysis and histopathology studies displayed these sutures' acceptable biocompatibility with the healing of tissue in Albino Swiss mice. The results depict that the use of antibiotic-coated sutures for preventing surgical site infection for a long duration could be a viable clinical option.
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Affiliation(s)
- Sunitha Sampathi
- GITAM School of Pharmacy, GITAM (Deemed to be University), Hyderabad 502329, India
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Balanagar, Hyderabad 500037, India
- Correspondence: (S.S.); (V.J.); (S.D.)
| | - Pankaj Kumar Tiriya
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER), Balanagar, Hyderabad 500037, India
| | - Sujatha Dodoala
- Institute of Pharmaceutical Technology, Sri Padmavati Mahila Viswavidyalayam, Tirupati 517502, India
| | - Vijayabhaskarreddy Junnuthula
- Drug Research Program, Faculty of Pharmacy, University of Helsinki, Viikinkaari 5 E, 00790 Helsinki, Finland
- Correspondence: (S.S.); (V.J.); (S.D.)
| | - Sathish Dyawanapelly
- Department of Pharmaceutical Science and Technology, Institute of Chemical Technology, Mumbai 400019, India
- Correspondence: (S.S.); (V.J.); (S.D.)
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Surgical Applications of Materials Engineered with Antimicrobial Properties. Bioengineering (Basel) 2022; 9:bioengineering9040138. [PMID: 35447700 PMCID: PMC9030825 DOI: 10.3390/bioengineering9040138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/17/2022] [Accepted: 03/24/2022] [Indexed: 02/06/2023] Open
Abstract
The infection of surgically placed implants is a problem that is both large in magnitude and that broadly affects nearly all surgical specialties. Implant-associated infections deleteriously affect patient quality-of-life and can lead to greater morbidity, mortality, and cost to the health care system. The impact of this problem has prompted extensive pre-clinical and clinical investigation into decreasing implant infection rates. More recently, antimicrobial approaches that modify or treat the implant directly have been of great interest. These approaches include antibacterial implant coatings (antifouling materials, antibiotics, metal ions, and antimicrobial peptides), antibacterial nanostructured implant surfaces, and antibiotic-releasing implants. This review provides a compendium of these approaches and the clinical applications and outcomes. In general, implant-specific modalities for reducing infections have been effective; however, most applications remain in the preclinical or early clinical stages.
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