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Xu L, Liu Y, Zhou W, Yu D. Electrospun Medical Sutures for Wound Healing: A Review. Polymers (Basel) 2022; 14:polym14091637. [PMID: 35566807 PMCID: PMC9105379 DOI: 10.3390/polym14091637] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/16/2022] [Accepted: 04/17/2022] [Indexed: 02/01/2023] Open
Abstract
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.
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Affiliation(s)
- Lin Xu
- School of Materials and Chemistry, University of Shanghai for Science and Technology, Shanghai 200093, China; (L.X.); (W.Z.)
| | - Yanan Liu
- School of Materials and Chemistry, University of Shanghai for Science and Technology, Shanghai 200093, China; (L.X.); (W.Z.)
- Correspondence: (Y.L.); (D.Y.)
| | - Wenhui Zhou
- School of Materials and Chemistry, University of Shanghai for Science and Technology, Shanghai 200093, China; (L.X.); (W.Z.)
| | - Dengguang Yu
- School of Materials and Chemistry, University of Shanghai for Science and Technology, Shanghai 200093, China; (L.X.); (W.Z.)
- Shanghai Engineering Technology Research Center for High-Performance Medical Device Materials, Shanghai 200093, China
- Correspondence: (Y.L.); (D.Y.)
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Sriyai M, Tasati J, Molloy R, Meepowpan P, Somsunan R, Worajittiphon P, Daranarong D, Meerak J, Punyodom W. Development of an Antimicrobial-Coated Absorbable Monofilament Suture from a Medical-Grade Poly(l-lactide- co-ε-caprolactone) Copolymer. ACS OMEGA 2021; 6:28788-28803. [PMID: 34746572 PMCID: PMC8567407 DOI: 10.1021/acsomega.1c03569] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 10/07/2021] [Indexed: 06/12/2023]
Abstract
In this study, a medical-grade poly(l-lactide-co-ε-caprolactone) (PLC) copolymer with a monomer ratio of l-lactide (L) to ε-caprolactone (C) of 70:30 mol % for use as an absorbable surgical suture was synthesized via ring-opening polymerization (ROP) using a novel soluble liquid tin(II) n-butoxide (Sn(OnC4H9)2) as an initiator. In fiber fabrication, the process included copolymer melt extrusion with a minimal draw followed by sequential controlled hot-drawing and fixed-annealing steps to obtain oriented semicrystalline fibers with improved mechanical strength. For healing enhancement, the fiber was dip-coated with "levofloxacin" by adding the drug into a solution mixture of acetone, poly(ε-caprolactone) (PCL), and calcium stearate (CaSt) in the ratio of acetone/PCL/CaSt = 100:1% w/v:0.1% w/v. The tensile strength of the coated fiber was found to be increased to ∼400 MPa, which is comparable with that of commercial polydioxanone (PDS II) of a similar size. Finally, the efficiency of the drug-coated fiber regarding its controlled drug release and antimicrobial activity was investigated, and the results showed that the coated fiber was able to release the drug continuously for as long as 30 days. For fiber antimicrobial activity, it was found that a concentration of 1 mg/mL was sufficient to inhibit the growth of Staphylococcus aureus (MRSA), Escherichia coli O157:H7, and Pseudomonas aeruginosa, giving a clear inhibition zone range of 20-24 mm for 90 days. Cytotoxicity testing of the drug-coated fibers showed a %viability of more than 70%, indicating that they were nontoxic.
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Affiliation(s)
- Montira Sriyai
- Bioplastics
Production Laboratory for Medical Applications, Faculty of Science, Chiang Mai University, Chiang Mai 50200, Thailand
- Center
of Excellence in Materials Science and Technology, Chiang Mai University, Chiang
Mai 50200, Thailand
| | - Jagkrit Tasati
- Department
of Chemistry, Faculty of Science, Chiang
Mai University, Chiang Mai 50200, Thailand
| | - Robert Molloy
- Center
of Excellence in Materials Science and Technology, Chiang Mai University, Chiang
Mai 50200, Thailand
| | - Puttinan Meepowpan
- Department
of Chemistry, Faculty of Science, Chiang
Mai University, Chiang Mai 50200, Thailand
- Center
of Excellence in Materials Science and Technology, Chiang Mai University, Chiang
Mai 50200, Thailand
| | - Runglawan Somsunan
- Department
of Chemistry, Faculty of Science, Chiang
Mai University, Chiang Mai 50200, Thailand
- Center
of Excellence in Materials Science and Technology, Chiang Mai University, Chiang
Mai 50200, Thailand
| | - Patnarin Worajittiphon
- Department
of Chemistry, Faculty of Science, Chiang
Mai University, Chiang Mai 50200, Thailand
- Center
of Excellence in Materials Science and Technology, Chiang Mai University, Chiang
Mai 50200, Thailand
| | - Donraporn Daranarong
- Center
of Excellence in Materials Science and Technology, Chiang Mai University, Chiang
Mai 50200, Thailand
- Science
and Technology Research Institute, Chiang
Mai University, Chiang Mai 50200, Thailand
| | - Jomkwan Meerak
- Center
of Excellence in Materials Science and Technology, Chiang Mai University, Chiang
Mai 50200, Thailand
- Department
of Biology, Faculty of Science, Chiang Mai
University, Chiang Mai 50200, Thailand
| | - Winita Punyodom
- Department
of Chemistry, Faculty of Science, Chiang
Mai University, Chiang Mai 50200, Thailand
- Center
of Excellence in Materials Science and Technology, Chiang Mai University, Chiang
Mai 50200, Thailand
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3
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Josyula A, Parikh KS, Pitha I, Ensign LM. Engineering biomaterials to prevent post-operative infection and fibrosis. Drug Deliv Transl Res 2021; 11:1675-1688. [PMID: 33710589 PMCID: PMC8238864 DOI: 10.1007/s13346-021-00955-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2021] [Indexed: 12/19/2022]
Abstract
Implantable biomaterials are essential surgical devices, extending and improving the quality of life of millions of people globally. Advances in materials science, manufacturing, and in our understanding of the biological response to medical device implantation over several decades have resulted in improved safety and functionality of biomaterials. However, post-operative infection and immune responses remain significant challenges that interfere with biomaterial functionality and host healing processes. The objectives of this review is to provide an overview of the biology of post-operative infection and the physiological response to implanted biomaterials and to discuss emerging strategies utilizing local drug delivery and surface modification to improve the long-term safety and efficacy of biomaterials.
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Affiliation(s)
- Aditya Josyula
- Center for Nanomedicine at the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, 21231, USA
- Department of Chemical & Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Kunal S Parikh
- Center for Nanomedicine at the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, 21231, USA
- Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA
- Center for Bioengineering Innovation and Design, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Ian Pitha
- Center for Nanomedicine at the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, 21231, USA
- Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Laura M Ensign
- Center for Nanomedicine at the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, 21231, USA.
- Department of Chemical & Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA.
- Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA.
- Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD, 21287, USA.
- Departments Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
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Parikh KS, Omiadze R, Josyula A, Shi R, Anders NM, He P, Yazdi Y, McDonnell PJ, Ensign LM, Hanes J. Ultra-thin, high strength, antibiotic-eluting sutures for prevention of ophthalmic infection. Bioeng Transl Med 2021; 6:e10204. [PMID: 34027091 PMCID: PMC8126818 DOI: 10.1002/btm2.10204] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/25/2020] [Accepted: 11/26/2020] [Indexed: 11/17/2022] Open
Abstract
Sutures are applied almost universally at the site of trauma or surgery, making them an ideal platform to modulate the local, postoperative biological response, and improve surgical outcomes. To date, the only globally marketed drug-eluting sutures are coated with triclosan for antibacterial application in general surgery. Loading drug directly into the suture rather than coating the surface offers the potential to provide drug delivery functionality to microsurgical sutures and achieve sustained drug delivery without increasing suture thickness. However, conventional methods for drug incorporation directly into the suture adversely affect breaking strength. Thus, there are no market offerings for drug-eluting sutures, drug-coated, or otherwise, in ophthalmology, where very thin sutures are required. Sutures themselves help facilitate bacterial infection, and antibiotic eye drops are commonly prescribed to prevent infection after ocular surgeries. An antibiotic-eluting suture may prevent bacterial colonization of sutures and preclude patient compliance issues with eye drops. We report twisting of hundreds of individual drug-loaded, electrospun nanofibers into a single, ultra-thin, multifilament suture capable of meeting both size and strength requirements for microsurgical ocular procedures. Nanofiber-based polycaprolactone sutures demonstrated no loss in strength with loading of 8% levofloxacin, unlike monofilament sutures which lost more than 50% strength. Moreover, nanofiber-based sutures retained strength with loading of a broad range of drugs, provided antibiotic delivery for 30 days in rat eyes, and prevented ocular infection in a rat model of bacterial keratitis.
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Affiliation(s)
- Kunal S. Parikh
- Center for NanomedicineThe Wilmer Eye Institute, Johns Hopkins University School of MedicineBaltimoreMarylandUSA
- Department of OphthalmologyThe Wilmer Eye Institute, Johns Hopkins University School of MedicineBaltimoreMarylandUSA
- Center for Bioengineering Innovation & DesignJohns Hopkins UniversityBaltimoreMarylandUSA
- Department of Biomedical EngineeringJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Revaz Omiadze
- Center for NanomedicineThe Wilmer Eye Institute, Johns Hopkins University School of MedicineBaltimoreMarylandUSA
- Department of OphthalmologyThe Wilmer Eye Institute, Johns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Aditya Josyula
- Center for NanomedicineThe Wilmer Eye Institute, Johns Hopkins University School of MedicineBaltimoreMarylandUSA
- Department of Chemical and Biomolecular EngineeringJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Richard Shi
- Center for NanomedicineThe Wilmer Eye Institute, Johns Hopkins University School of MedicineBaltimoreMarylandUSA
- Department of Biomedical EngineeringJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Nicole M. Anders
- Department of OncologySidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Ping He
- Department of OncologySidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Youseph Yazdi
- Center for Bioengineering Innovation & DesignJohns Hopkins UniversityBaltimoreMarylandUSA
- Department of Biomedical EngineeringJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Peter J. McDonnell
- Department of OphthalmologyThe Wilmer Eye Institute, Johns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Laura M. Ensign
- Center for NanomedicineThe Wilmer Eye Institute, Johns Hopkins University School of MedicineBaltimoreMarylandUSA
- Department of OphthalmologyThe Wilmer Eye Institute, Johns Hopkins University School of MedicineBaltimoreMarylandUSA
- Department of Biomedical EngineeringJohns Hopkins University School of MedicineBaltimoreMarylandUSA
- Department of Chemical and Biomolecular EngineeringJohns Hopkins UniversityBaltimoreMarylandUSA
- Department of OncologySidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Justin Hanes
- Center for NanomedicineThe Wilmer Eye Institute, Johns Hopkins University School of MedicineBaltimoreMarylandUSA
- Department of OphthalmologyThe Wilmer Eye Institute, Johns Hopkins University School of MedicineBaltimoreMarylandUSA
- Department of Biomedical EngineeringJohns Hopkins University School of MedicineBaltimoreMarylandUSA
- Department of Chemical and Biomolecular EngineeringJohns Hopkins UniversityBaltimoreMarylandUSA
- Department of OncologySidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of MedicineBaltimoreMarylandUSA
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Khalil IA, Saleh B, Ibrahim DM, Jumelle C, Yung A, Dana R, Annabi N. Ciprofloxacin-loaded bioadhesive hydrogels for ocular applications. Biomater Sci 2020; 8:5196-5209. [PMID: 32840522 PMCID: PMC7594650 DOI: 10.1039/d0bm00935k] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The management of corneal infections often requires complex therapeutic regimens involving the prolonged and high-frequency application of antibiotics that provide many challenges to patients and impact compliance with the therapeutic regimens. In the context of severe injuries that lead to tissue defects (e.g. corneal lacerations) topical drug regimens are inadequate and suturing is often indicated. There is thus an unmet need for interventions that can provide tissue closure while concurrently preventing or treating infection. In this study, we describe the development of an antibacterial bioadhesive hydrogel loaded with micelles containing ciprofloxacin (CPX) for the management of corneal injuries at risk of infection. The in vitro release profile showed that the hydrogel system can release CPX, a broad-spectrum antibacterial drug, for up to 24 h. Moreover, the developed CPX-loaded hydrogels exhibited excellent antibacterial properties against Staphylococcus aureus and Pseudomonas aeruginosa, two bacterial strains responsible for the most ocular infections. Physical characterization, as well as adhesion and cytocompatibility tests, were performed to assess the effect of CPX loading in the developed hydrogel. Results showed that CPX loading did not affect stiffness, adhesive properties, or cytocompatibility of hydrogels. The efficiency of the antibacterial hydrogel was assessed using an ex vivo model of infectious pig corneal injury. Corneal tissues treated with the antibacterial hydrogel showed a significant decrease in bacterial colony-forming units (CFU) and a higher corneal epithelial viability after 24 h as compared to non-treated corneas and corneas treated with hydrogel without CPX. These results suggest that the developed adhesive hydrogel system presents a promising suture-free solution to seal corneal wounds while preventing infection.
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Affiliation(s)
- Islam A Khalil
- Department of Chemical Engineering, Northeastern University, Boston, MA, USA and Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA and Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, USA and Department of Pharmaceutics, Misr University of Science and Technology, 6th of October City 12566, Giza, Egypt
| | - Bahram Saleh
- Department of Chemical Engineering, Northeastern University, Boston, MA, USA
| | - Dina M Ibrahim
- Department of Chemical Engineering, Northeastern University, Boston, MA, USA and Energy Materials Laboratory, School of Sciences and Engineering, The American University in Cairo, New Cairo 11835, Egypt
| | - Clotilde Jumelle
- Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Ann Yung
- Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Reza Dana
- Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Nasim Annabi
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA and Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, USA and Department of Chemical and Biomolecular Engineering, University of California, Los Angeles, Los Angeles, CA 90095, USA.
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6
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Ghosh D, Godeshala S, Nitiyanandan R, Islam MS, Yaron JR, DiCaudo D, Kilbourne J, Rege K. Copper-Eluting Fibers for Enhanced Tissue Sealing and Repair. ACS APPLIED MATERIALS & INTERFACES 2020; 12:27951-27960. [PMID: 32459949 PMCID: PMC9617570 DOI: 10.1021/acsami.0c04755] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Copper ions play an important role in several physiological processes, including angiogenesis, growth factor induction and extracellular matrix remodeling, that modulate wound healing and tissue repair. In this work, copper-loaded alginate fibers were generated and used as surgical sutures for repair of incisional wounds in live mice. Approximately 95% of initially loaded copper ions were released from the sutures within the first 24 h following an initial burst release. This localized delivery of copper at the incision site resulted in significantly higher recovery in tissue biomechanical strengths compared to conventional nylon and calcium alginate sutures at early times following surgery. Irradiation of copper alginate sutures with near-infrared light resulted in a robust photothermal response and led to efficacies similar to those seen with nonirradiated sutures. Histopathology and immunohistological analyses indicated significantly reduced epithelial gap and higher number of CD31+ cells, which is indicative of increased angiogenesis around the incision site. Delivery of copper ions did not result in toxicity under the conditions employed. Our findings demonstrate that delivery of ionic copper from sutures resulted in efficacious approximation and healing of incisional wounds, and copper-eluting fibers may have translational potential for accelerating repair in surgical and trauma wounds.
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Affiliation(s)
- Deepanjan Ghosh
- Biological Design, Arizona State University, Tempe, AZ 85287, USA
| | | | | | - Md Saiful Islam
- Chemical Engineering, Arizona State University, Tempe, AZ 85287, USA
| | - Jordan R. Yaron
- Center for Personalized Diagnostics, The Biodesign Institute, Arizona State University, Tempe, AZ 85287, USA
| | - David DiCaudo
- Division of Dermatopathology, Mayo Clinic College of Medicine, Mayo Clinic, Scottsdale, AZ 85259, USA
| | - Jacquelyn Kilbourne
- Department of Animal Care and Technologies (DACT), Arizona State University, Tempe, AZ 85287, USA
| | - Kaushal Rege
- Biological Design, Arizona State University, Tempe, AZ 85287, USA
- Chemical Engineering, Arizona State University, Tempe, AZ 85287, USA
- To whom the correspondence must be addressed: Prof. Kaushal Rege, Chemical Engineering, 501 E. Tyler Mall, ECG 303, Arizona State University, Tempe, AZ 85287-6106 USA, , Phone: (480)-727-8616, Fax: 480-727-9321
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Kaiser NJ, Bellows JA, Kant RJ, Coulombe KLK. Digital Design and Automated Fabrication of Bespoke Collagen Microfiber Scaffolds. Tissue Eng Part C Methods 2019; 25:687-700. [PMID: 31017039 PMCID: PMC6859695 DOI: 10.1089/ten.tec.2018.0379] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 04/01/2019] [Indexed: 01/06/2023] Open
Abstract
A great variety of natural and synthetic polymer materials have been utilized in soft tissue engineering as extracellular matrix (ECM) materials. Natural polymers, such as collagen and fibrin hydrogels, have experienced especially broad adoption due to the high density of cell adhesion sites compared to their synthetic counterparts, ready availability, and ease of use. However, these and other hydrogels lack the structural and mechanical anisotropy that define the ECM in many tissues, such as skeletal and cardiac muscle, tendon, and cartilage. Herein, we present a facile, low-cost, and automated method of preparing collagen microfibers, organizing these fibers into precisely controlled mesh designs, and embedding these meshes in a bulk hydrogel, creating a composite biomaterial suitable for a wide variety of tissue engineering and regenerative medicine applications. With the assistance of custom software tools described herein, mesh patterns are designed by a digital graphical user interface and translated into protocols that are executed by a custom mesh collection and organization device. We demonstrate a high degree of precision and reproducibility in both fiber and mesh fabrication, evaluate single fiber mechanical properties, and provide evidence of collagen self-assembly in the microfibers under standard cell culture conditions. This work offers a powerful, flexible platform for the study of tissue engineering and cell material interactions, as well as the development of therapeutic biomaterials in the form of custom collagen microfiber patterns that will be accessible to all through the methods and techniques described here. Impact Statement Collagen microfiber meshes have immediate and broad applications in tissue engineering research and show high potential for later use in clinical therapeutics due to their compositional similarities to native extracellular matrix and tunable structural and mechanical characteristics. Physical and biological characterizations of these meshes demonstrate physiologically relevant mechanical properties, native-like collagen structure, and cytocompatibility. The methods presented herein not only describe a process through which custom collagen microfiber meshes can be fabricated but also provide the reader with detailed device plans and software tools to produce their own bespoke meshes through a precise, consistent, and automated process.
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Affiliation(s)
- Nicholas J Kaiser
- Center for Biomedical Engineering, Brown University, Providence, Rhode Island
| | - Jessica A Bellows
- Center for Biomedical Engineering, Brown University, Providence, Rhode Island
| | - Rajeev J Kant
- Center for Biomedical Engineering, Brown University, Providence, Rhode Island
| | - Kareen L K Coulombe
- Center for Biomedical Engineering, Brown University, Providence, Rhode Island
- Department of Molecular Pharmacology, Physiology, and Biotechnology, Brown University, Providence, Rhode Island
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8
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Prevention of bacterial colonization on non-thermal atmospheric plasma treated surgical sutures for control and prevention of surgical site infections. PLoS One 2018; 13:e0202703. [PMID: 30183745 PMCID: PMC6124751 DOI: 10.1371/journal.pone.0202703] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 08/07/2018] [Indexed: 11/19/2022] Open
Abstract
Surgical site infections have a remarkable impact on morbidity, extended hospitalization and mortality. Sutures strongly contribute to development of surgical site infections as they are considered foreign material in the human body. Sutures serve as excellent surfaces for microbial adherence and subsequent colonization, biofilm formation and infection on the site of a surgery. Various antimicrobial sutures have been developed to prevent suture-mediated surgical site infection. However, depending on the site of surgery, antimicrobial sutures may remain ineffective, and antimicrobial agents on them might have drawbacks. Plasma, defined as the fourth state of matter, composed of ionized gas, reactive oxygen and nitrogen species, free radical and neutrals, draws attention for the control and prevention of hospital-acquired infections due to its excellent antimicrobial activities. In the present study, the efficacy of non-thermal atmospheric plasma treatment for prevention of surgical site infections was investigated. First, contaminated poly (glycolic-co-lactic acid), polyglycolic acid, polydioxanone and poly (glycolic acid-co-caprolactone) sutures were treated with non-thermal atmospheric plasma to eradicate contaminating bacteria like Staphylococcus aureus and Escherichia coli. Moreover, sutures were pre-treated with non-thermal atmospheric plasma and then exposed to S. aureus and E. coli. Our results revealed that non-thermal atmospheric plasma treatment effectively eradicates contaminating bacteria on sutures, and non-thermal atmospheric plasma pre-treatment effectively prevents bacterial colonization on sutures without altering their mechanical properties. Chemical characterization of sutures was performed with FT-IR and XPS and results showed that non-thermal atmospheric plasma treatment substantially increased the hydrophilicity of sutures which might be the primary mechanism for the prevention of bacterial colonization. In conclusion, plasma-treated sutures could be considered as novel alternative materials for the control and prevention of surgical site infections.
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Chen S, Ge L, Gombart AF, Shuler FD, Carlson MA, Reilly DA, Xie J. Nanofiber-based sutures induce endogenous antimicrobial peptide. Nanomedicine (Lond) 2017; 12:2597-2609. [PMID: 28960168 DOI: 10.2217/nnm-2017-0161] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM The aim of this study was to develop nanofiber-based sutures capable of inducing endogenous antimicrobial peptide production. METHODS We used co-axial electrospinning deposition and rolling to fabricate sutures containing pam3CSK4 peptide and 25-hydroxyvitamin D3 (25D3). RESULTS The diameters and mechanical properties of the sutures were adjustable to meet the criteria of United States Pharmacopeia designation. 25D3 exhibited a sustained release from nanofiber sutures over 4 weeks. Pam3CSK4 peptide also showed an initial burst followed by a sustained release over 4 weeks. The co-delivery of 25D3 and pam3CSK4 peptide enhanced cathelicidin antimicrobial peptide production from U937 cells and keratinocytes compared with 25D3 delivery alone. In addition, the 25D3/pam3CSK4 peptide co-loaded nanofiber sutures did not significantly influence proliferation of keratinocytes, fibroblasts, or the monocytic cell lines U937 and HL-60. CONCLUSION The use of 25D3/pam3CSK4 peptide co-loaded nanofiber sutures could potentially induce endogenous antimicrobial peptide production and reduce surgical site infections.
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Affiliation(s)
- Shixuan Chen
- Department of Surgery-Transplant & Mary & Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Liangpeng Ge
- Chongqing Academy of Animal Sciences & Key Laboratory of Pig Industry Sciences, Ministry of Agriculture, Chongqing, China
| | - Adrian F Gombart
- Department of Biochemistry & Biophysics & Linus Pauling Institute, Oregon State University, Corvallis, OR 97331, USA
| | - Franklin D Shuler
- Department of Orthopedic Surgery, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV 25755, USA
| | - Mark A Carlson
- Department of Surgery-General Surgery, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Debra A Reilly
- Department of Surgery-Plastic Surgery, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Jingwei Xie
- Department of Surgery-Transplant & Mary & Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, NE 68198, USA
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