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Singhal M, Seaton CC, Surtees A, Katsikogianni MG. Formulation, Characterisation, and Biocompatibility Assessment of Rifampicin-Loaded Poly(d,l-lactide-co-glycolide) Composites for Local Treatment of Orthopaedic and Wound Infections. Pharmaceutics 2024; 16:1467. [PMID: 39598590 PMCID: PMC11597898 DOI: 10.3390/pharmaceutics16111467] [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: 09/20/2024] [Revised: 11/10/2024] [Accepted: 11/12/2024] [Indexed: 11/29/2024] Open
Abstract
Background/Objectives: The escalating challenge of antimicrobial resistance (AMR) necessitates the development of targeted antibiotic delivery platforms, minimising systemic administration. Polymer-based drug delivery emerges as a promising solution, ensuring sustained release and prolonged efficacy of bioactive compounds, ensuring long-term efficacy. Methods: This study focuses on encapsulating rifampicin (RIF), a key antibiotic for orthopaedic and wound-related infections, within Poly(d,l-lactide-co-glycolide) (PLGA), a biodegradable polymer, through solvent casting, to formulate a PLGA-RIF composite membrane. Comprehensive characterisation, employing Fourier-transformed infrared spectroscopy (FT-IR), scanning electron microscopy (SEM), thermal analysis and X-ray Diffraction (XRD), confirmed the integrity of both the starting and produced materials. UV-Vis spectroscopy revealed a controlled drug release profile over 21 days in various media, with the chosen media influencing the drug release, notably the tryptic soya broth (TSB) caused the highest release. The quantitative assessment of the antimicrobial efficacy of the developed PLGA-RIF composite was conducted by measuring the size of the inhibition zones against both Gram-negative and Gram-positive bacteria. Results: The results confirmed the composite's potential as a robust antibacterial biomaterial, demonstrating a rapid and effective antibacterial response. Cytocompatibility tests incorporated human fibroblast and osteoblast-like cell lines and demonstrated that the RIF:PLGA (1:8) formulation maintained eukaryotic cell viability, indicating the composite's potential for targeted medical applications in combating bacterial infections with minimal systemic impact. Conclusions: This study presents the significance of investigating drug release within appropriate and relevant physiological media. A key novelty of this work therefore lies in the exploration of drug release dynamics across different media, allowing for a comprehensive understanding of how varying physiological conditions may influence drug release and its effect on biological responses.
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Affiliation(s)
- Mitali Singhal
- School of Pharmacy and Medical Science, Institute of Cancer Therapeutics, University of Bradford, Bradford BD7 1DP, UK;
| | - Colin C. Seaton
- School of Chemistry and Biosciences, University of Bradford, Bradford BD7 1DP, UK;
| | - Alexander Surtees
- School of Archaeological and Forensic Sciences, University of Bradford, Bradford BD7 1DP, UK;
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Arioli M, Puiggalí J, Franco L. Nylons with Applications in Energy Generators, 3D Printing and Biomedicine. Molecules 2024; 29:2443. [PMID: 38893319 PMCID: PMC11173604 DOI: 10.3390/molecules29112443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/14/2024] [Accepted: 05/17/2024] [Indexed: 06/21/2024] Open
Abstract
Linear polyamides, known as nylons, are a class of synthetic polymers with a wide range of applications due to their outstanding properties, such as chemical and thermal resistance or mechanical strength. These polymers have been used in various fields: from common and domestic applications, such as socks and fishing nets, to industrial gears or water purification membranes. By their durability, flexibility and wear resistance, nylons are now being used in addictive manufacturing technology as a good material choice to produce sophisticated devices with precise and complex geometric shapes. Furthermore, the emergence of triboelectric nanogenerators and the development of biomaterials have highlighted the versatility and utility of these materials. Due to their ability to enhance triboelectric performance and the range of applications, nylons show a potential use as tribo-positive materials. Because of the easy control of their shape, they can be subsequently integrated into nanogenerators. The use of nylons has also extended into the field of biomaterials, where their biocompatibility, mechanical strength and versatility have paved the way for groundbreaking advances in medical devices as dental implants, catheters and non-absorbable surgical sutures. By means of 3D bioprinting, nylons have been used to develop scaffolds, joint implants and drug carriers with tailored properties for various biomedical applications. The present paper aims to collect evidence of these recently specific applications of nylons by reviewing the literature produced in recent decades, with a special focus on the newer technologies in the field of energy harvesting and biomedicine.
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Affiliation(s)
- Matteo Arioli
- Departament d’Enginyeria Química, Escola d’Enginyeria de Barcelona Est-EEBE, Universitat Politècnica de Catalunya, Av. Eduard Maristany 10–14, 08019 Barcelona, Spain; (M.A.); (J.P.)
| | - Jordi Puiggalí
- Departament d’Enginyeria Química, Escola d’Enginyeria de Barcelona Est-EEBE, Universitat Politècnica de Catalunya, Av. Eduard Maristany 10–14, 08019 Barcelona, Spain; (M.A.); (J.P.)
- Barcelona Research Center in Multiscale Science and Engineering, Universitat Politècnica de Catalunya, Campus Diagonal-Besòs, Av. Eduard Maristany 10–14, 08019 Barcelona, Spain
| | - Lourdes Franco
- Departament d’Enginyeria Química, Escola d’Enginyeria de Barcelona Est-EEBE, Universitat Politècnica de Catalunya, Av. Eduard Maristany 10–14, 08019 Barcelona, Spain; (M.A.); (J.P.)
- Barcelona Research Center in Multiscale Science and Engineering, Universitat Politècnica de Catalunya, Campus Diagonal-Besòs, Av. Eduard Maristany 10–14, 08019 Barcelona, Spain
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Yu YM, Lu YP, Zhang T, Zheng YF, Liu YS, Xia DD. Biomaterials science and surface engineering strategies for dental peri-implantitis management. Mil Med Res 2024; 11:29. [PMID: 38741175 DOI: 10.1186/s40779-024-00532-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 04/29/2024] [Indexed: 05/16/2024] Open
Abstract
Peri-implantitis is a bacterial infection that causes soft tissue inflammatory lesions and alveolar bone resorption, ultimately resulting in implant failure. Dental implants for clinical use barely have antibacterial properties, and bacterial colonization and biofilm formation on the dental implants are major causes of peri-implantitis. Treatment strategies such as mechanical debridement and antibiotic therapy have been used to remove dental plaque. However, it is particularly important to prevent the occurrence of peri-implantitis rather than treatment. Therefore, the current research spot has focused on improving the antibacterial properties of dental implants, such as the construction of specific micro-nano surface texture, the introduction of diverse functional coatings, or the application of materials with intrinsic antibacterial properties. The aforementioned antibacterial surfaces can be incorporated with bioactive molecules, metallic nanoparticles, or other functional components to further enhance the osteogenic properties and accelerate the healing process. In this review, we summarize the recent developments in biomaterial science and the modification strategies applied to dental implants to inhibit biofilm formation and facilitate bone-implant integration. Furthermore, we summarized the obstacles existing in the process of laboratory research to reach the clinic products, and propose corresponding directions for future developments and research perspectives, so that to provide insights into the rational design and construction of dental implants with the aim to balance antibacterial efficacy, biological safety, and osteogenic property.
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Affiliation(s)
- Ya-Meng Yu
- Department of Dental Materials, Peking University School and Hospital of Stomatology, Beijing, 100081, China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing, 100081, China
| | - Yu-Pu Lu
- Department of Dental Materials, Peking University School and Hospital of Stomatology, Beijing, 100081, China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing, 100081, China
| | - Ting Zhang
- School of Materials Science and Engineering, Peking University, Beijing, 100871, China
| | - Yu-Feng Zheng
- School of Materials Science and Engineering, Peking University, Beijing, 100871, China.
| | - Yun-Song Liu
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing, 100081, China.
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, 100081, China.
| | - Dan-Dan Xia
- Department of Dental Materials, Peking University School and Hospital of Stomatology, Beijing, 100081, China.
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing, 100081, China.
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Mitra D, Kashid RV, Shetty GP, Patil SP, Shah RA. Evaluation of the antibacterial and wound healing efficacy of Aloe vera-coated 3-0 silk sutures in comparison to uncoated 3-0 silk sutures following flap surgery - A randomized clinical trial. J Indian Soc Periodontol 2024; 28:354-359. [PMID: 39742061 PMCID: PMC11684577 DOI: 10.4103/jisp.jisp_363_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 08/27/2024] [Indexed: 01/03/2025] Open
Abstract
Background The efficacy of surgical interventions relies on appropriate closure of the surgical site, which should also be devoid of bacteria. Plaque accumulation is a constant challenge that hampers the healing outcome. Sutures used to close the wound serve as reservoirs for microbes, increasing the risk of surgical site infections (SSIs). To avoid this, sutures can be coated with antimicrobial agents such as Aloe vera, which could be delivered to the healing site. To the best of our knowledge, there is no reported literature on using Aloe vera-coated sutures for the closure of wounds following flap surgery. Materials and Methods It was a split-mouth, randomized clinical trial, in which 24 sites requiring conventional flap surgery were selected, of which 12 were assigned to Group A (uncoated sutures) and 12 to Group B (Aloe vera-coated sutures). On the 8th day, sutures were sent for microbiological analysis to count the colony-forming units (CFUs). The Early Healing Score (EHS) and Visual Analog Scale (VAS) Scores were recorded. Results The intergroup comparison of VAS scores, EHSs, and CFUs between Group 1 and Group 2 was done using the Whitney U-test. It showed statistically significant differences between the two groups for the EHS and CFUs, but not for VAS scores. Thus, Group 2 shows better results as compared to Group 1. Conclusion Based on the results, it was interpreted that the use of microbicidal sutures coated with Aloe vera demonstrates microbicidal properties and aids in preventing SSIs.
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Affiliation(s)
- Dipika Mitra
- Department of Periodontology, Sakalchand Patel University, Visnagar, India
- Department of Periodontology, TPCT’s Terna Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Rhea Vivek Kashid
- Department of Periodontology, TPCT’s Terna Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Gaurav Prabhakar Shetty
- Department of Periodontology, TPCT’s Terna Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Shruti Prasanna Patil
- Department of Periodontology, TPCT’s Terna Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Rohit Ajay Shah
- Department of Periodontology, TPCT’s Terna Dental College and Hospital, Navi Mumbai, Maharashtra, India
- Department of Periodontology, Karnavati University, Gandhinagar, Gujarat, India
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Han X, Sharma N, Xu Z, Krajewski S, Li P, Spintzyk S, Lv L, Zhou Y, Thieringer FM, Rupp F. A balance of biocompatibility and antibacterial capability of 3D printed PEEK implants with natural totarol coating. Dent Mater 2024; 40:674-688. [PMID: 38388252 DOI: 10.1016/j.dental.2024.02.011] [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: 10/21/2022] [Revised: 12/22/2023] [Accepted: 02/12/2024] [Indexed: 02/24/2024]
Abstract
OBJECTIVE Polyetheretherketone (PEEK), a biomaterial with appropriate bone-like mechanical properties and excellent biocompatibility, is widely applied in cranio-maxillofacial and dental applications. However, the lack of antibacterial effect is an essential drawback of PEEK material and might lead to infection and osseointegration issues. This study aims to apply a natural antibacterial agent, totarol coating onto the 3D printed PEEK surface and find an optimized concentration with balanced cytocompatibility, osteogenesis, and antibacterial capability. METHODS In this study, a natural antibacterial agent, totarol, was applied as a coating to fused filament fabrication (FFF) 3D printed PEEK surfaces at a series of increasing concentrations (1 mg/ml, 5 mg/ml, 10 mg/ml, 15 mg/ml, and 20 mg/ml). The samples were then evaluated for cytocompatibility with L929 fibroblast and SAOS-2 osteoblast using live/dead staining and CCK-8 assay. The antibacterial capability was assessed by crystal violet staining, live/dead staining, and scanning electron microscopy (SEM) utilizing the oral primary colonizer S. gordonii and isolates of mixed oral bacteria in a stirring system simulating the oral environment. The appropriate safe working concentration for totarol coating is selected based on the results of the cytocompatibility and antibacterial test. Subsequently, the influence on osteogenic differentiation was evaluated by alkaline phosphatase (ALP) and alizarin red staining (ARS) analysis of pre-osteoblasts. RESULTS Our results showed that the optimal concentration of totarol solution for promising antibacterial coating was approximately 10 mg/ml. Such surfaces could play an excellent antibacterial role by inducing a contact-killing effect with an inhibitory effect against biofilm development without affecting the healing of soft and hard tissues around FFF 3D printed PEEK implants or abutments. SIGNIFICANCE This study indicates that the totarol coated PEEK has an improved antibacterial effect with excellent biocompatibility providing great clinical potential as an orthopedic/dental implant/abutment material.
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Affiliation(s)
- Xingting Han
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, NHC Key Laboratory of Digital Technology of Stomatology, 22 Zhongguancun Avenue South, Haidian District, Beijing 100081, China; Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology; Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai 200011, China; University Hospital Tübingen, Department of Medical Materials Science and Technology, Osianderstr. 2-8, Tübingen D-72076, Germany
| | - Neha Sharma
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland; Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Basel, Switzerland
| | - Zeqian Xu
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology; Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai 200011, China; University Hospital Tübingen, Department of Medical Materials Science and Technology, Osianderstr. 2-8, Tübingen D-72076, Germany.
| | - Stefanie Krajewski
- University Hospital Tübingen, Department of Medical Materials Science and Technology, Osianderstr. 2-8, Tübingen D-72076, Germany
| | - Ping Li
- University Hospital Tübingen, Department of Medical Materials Science and Technology, Osianderstr. 2-8, Tübingen D-72076, Germany; Department of Prosthodontics, School and Hospital of Stomatology, Guangzhou Medical University, Guangzhou, Guangdong 510182, China
| | - Sebastian Spintzyk
- University Hospital Tübingen, Department of Medical Materials Science and Technology, Osianderstr. 2-8, Tübingen D-72076, Germany; ADMiRE Research Center - Additive Manufacturing, Intelligent Robotics, Sensors and Engineering, School of Engineering and IT, Carinthia University of Applied Sciences, Villach, Austria
| | - Longwei Lv
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, NHC Key Laboratory of Digital Technology of Stomatology, 22 Zhongguancun Avenue South, Haidian District, Beijing 100081, China
| | - Yongsheng Zhou
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, NHC Key Laboratory of Digital Technology of Stomatology, 22 Zhongguancun Avenue South, Haidian District, Beijing 100081, China
| | - Florian M Thieringer
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland; Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Basel, Switzerland
| | - Frank Rupp
- University Hospital Tübingen, Department of Medical Materials Science and Technology, Osianderstr. 2-8, Tübingen D-72076, Germany
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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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Shah FA, Shyam A. Non-metallic Fixation of Patella Fractures: A Paradigm Shift. J Orthop Case Rep 2023; 13:1-3. [PMID: 37654747 PMCID: PMC10465750 DOI: 10.13107/jocr.2023.v13.i08.3791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/18/2023] [Indexed: 09/02/2023] Open
Affiliation(s)
- Faaiz Ali Shah
- Department of Orthopaedics, Lady Reading Hospital, Peshawar, Pakistan
| | - Ashok Shyam
- Department of Orthopaedics, Sancheti Institute for Orthopaedics and Rehabilitation, Pune, Maharashtra, India
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Pesset CM, Fonseca COD, Antunes M, Santos ALLD, Teixeira IM, Ribeiro TAN, Sachs D, Penna B. Characterizing biofilm formation of Staphylococcus pseudintermedius in different suture materials. Microb Pathog 2022; 172:105796. [PMID: 36155066 DOI: 10.1016/j.micpath.2022.105796] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 10/31/2022]
Abstract
Staphylococcus pseudintermedius is the primary cause of pyoderma and surgical site infection (SSI) in dogs, and biofilm formation is the main reason for persistent SSI. The presence of biofilm in medical devices can directly impact treatment. Methicillin-resistant S. pseudintermedius (MRSP) emerged rapidly in companion animals, limiting treatment options. MRSP is a public health problem since zoonotic transmission can occur. The study seeks to evaluate biofilm formation capacity via Staphylococcus pseudintermedius collected from dogs affected by topical infections, in suture materials commonly used in companion animal surgery. We tested segments of four types of sutures. Biofilm production was measured by staining with safranin and colorimetric absorbance measurement. We calculated colony-forming units (CFUs) for each type of sutures and visualized biofilm via Scanning Electron Microscopy (SEM) images. The genes associated with biofilm formation (icaA and icaD) were identified using PCR. The colorimetric tests showed that the biofilm is most abundantly formed on the cotton sutures and polyglactin 910. The ability to form biofilm on polypropylene and nylon sutures has also been demonstrated, although at varying intensities. PCR revealed the presence of the two genes (icaA and icaD) in all the isolates. We used a positive control using a reference strain and negative control without bacteria for comparisons. Suture material allowing biofilm formation makes it difficult to prevent and treat surgical site infections. Therefore, it is important to know which suture thread is more susceptible to biofilm formation by bacteria to prevent possible secondary infections at surgical sites.
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Affiliation(s)
- Camilla M Pesset
- Laboratory of Gram-Positive Cocci, Federal Fluminense University, Biomedical Institute, Rua Professor Hernani Melo N.° 101, São Domingos, Niterói, RJ, Cep: 24210-130, Brazil
| | - Carolina O da Fonseca
- Laboratory of Gram-Positive Cocci, Federal Fluminense University, Biomedical Institute, Rua Professor Hernani Melo N.° 101, São Domingos, Niterói, RJ, Cep: 24210-130, Brazil
| | - Milena Antunes
- Laboratory of Gram-Positive Cocci, Federal Fluminense University, Biomedical Institute, Rua Professor Hernani Melo N.° 101, São Domingos, Niterói, RJ, Cep: 24210-130, Brazil
| | - Ana Luiza L Dos Santos
- Laboratory of Gram-Positive Cocci, Federal Fluminense University, Biomedical Institute, Rua Professor Hernani Melo N.° 101, São Domingos, Niterói, RJ, Cep: 24210-130, Brazil
| | - Izabel M Teixeira
- Laboratory of Gram-Positive Cocci, Federal Fluminense University, Biomedical Institute, Rua Professor Hernani Melo N.° 101, São Domingos, Niterói, RJ, Cep: 24210-130, Brazil
| | - Tainara A N Ribeiro
- Microbiological Testing Laboratory Associated with Materials and Drugs of the Center for Studies, Research and Innovation in Biofunctional Materials and Biotechnology, Federal, University of Itajubá, 37500-903, Itajubá, Brazil
| | - Daniela Sachs
- Microbiological Testing Laboratory Associated with Materials and Drugs of the Center for Studies, Research and Innovation in Biofunctional Materials and Biotechnology, Federal, University of Itajubá, 37500-903, Itajubá, Brazil
| | - Bruno Penna
- Laboratory of Gram-Positive Cocci, Federal Fluminense University, Biomedical Institute, Rua Professor Hernani Melo N.° 101, São Domingos, Niterói, RJ, Cep: 24210-130, Brazil.
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Shariati A, Chegini Z, Ghaznavi-Rad E, Zare EN, Hosseini SM. PLGA-Based Nanoplatforms in Drug Delivery for Inhibition and Destruction of Microbial Biofilm. Front Cell Infect Microbiol 2022; 12:926363. [PMID: 35800390 PMCID: PMC9253276 DOI: 10.3389/fcimb.2022.926363] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 05/23/2022] [Indexed: 12/12/2022] Open
Abstract
The biofilm community of microorganisms has been identified as the dominant mode of microbial growth in nature and a common characteristic of different microorganisms such as Pseudomonas aeruginosa, Staphylococcus aureus, and Staphylococcus epidermidis. The biofilm structure helps in the protection from environmental threats including host immune system and antimicrobial agents. Thus, the biofilm community has led to a higher prevalence of multidrug-resistant (MDR) strains in recent years. In this regard, the use of a new class of antibiotics, natural compounds, and anti-biofilm enzymes has been considered for the destruction of the microbial biofilm. However, different drawbacks such as low penetration, high susceptibility to degradation, instability, and poor solubility in aqueous solutions limit the use of anti-biofilm agents (ABAs) in a clinical setting. As such, recent studies have been using poly lactic-co-glycolic acid (PLGA)-based nanoplatforms (PLGA NPFs) for delivery of ABAs that have reported promising results. These particles, due to proper drug loading and release kinetics, could suppress microbial attachment, colonization, and biofilm formation for a long time. Additionally, PLGA NPFs, because of the high drug-loading efficiencies, hydrophilic surface, negative charge, and electrostatic interaction, lead to effective penetration of antibiotics to the deeper layer of the biofilm, thereby eliminating the microbial biofilm. Thus, PLGA NPFs could be considered as a potential candidate for coating catheters and other medical material surfaces for inhibition and destruction of the microbial biofilm. However, the exact interaction of PLGA NPFs and the microbial biofilm should be evaluated in animal studies. Additionally, a future goal will be to develop PLGA formulations as systems that can be used for the treatment of the MDR microbial biofilm, since the exact interactions of PLGA NPFs and these biofilm structures are not elucidated. In the present review article, we have discussed various aspects of PLGA usage for inhibition and destruction of the microbial biofilm along with different methods and procedures that have been used for improving PLGA NPF efficacy against the microbial biofilm.
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Affiliation(s)
- Aref Shariati
- Molecular and Medicine Research Center, Khomein University of Medical Sciences, Khomein, Iran
| | - Zahra Chegini
- Department of Microbiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ehsanollah Ghaznavi-Rad
- Department of Microbiology, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran
| | | | - Seyed Mostafa Hosseini
- Department of Microbiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
- *Correspondence: Seyed Mostafa Hosseini,
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Xu L, Liu Y, Zhou W, Yu D. Electrospun Medical Sutures for Wound Healing: A Review. Polymers (Basel) 2022; 14:1637. [PMID: 35566807 PMCID: PMC9105379 DOI: 10.3390/polym14091637] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [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.)
| | - 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
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11
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Utilization of supercritical carbon dioxide for development of antibacterial surgical sutures. J Supercrit Fluids 2022. [DOI: 10.1016/j.supflu.2021.105490] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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12
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Akin M, Sahin B, Saki N. Hydroxypropyl methyl cellulose-Satureja hortensis L. ethanol extract mixtures as antimicrobial coating for sutures, identification of phenolic acids by using LC-MS-MS and TLC techniques. J LIQ CHROMATOGR R T 2022. [DOI: 10.1080/10826076.2022.2029745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Mustafa Akin
- Department of Chemistry, Faculty of Art and Sciences, Kocaeli University, Kocaeli, Turkey
- Petroyag ve Kimyasallar San. Ve Tic. A.Ş, R&D Center, Kocaeli, Turkey
| | - Bayram Sahin
- Department of Otorhinolaryngology and Head and Neck Surgery, Kocaeli Health and Sciences University, Derince Training and Research Hospital, Derince/Kocaeli, Turkey
| | - Neslihan Saki
- Department of Chemistry, Faculty of Art and Sciences, Kocaeli University, Kocaeli, Turkey
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13
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Lee BH, Shen Xuanrong M, Wang Tzong-Yee C, Huang Y, Wong KLF, Lin HA, Wong MK, Bin Abd Razak HR. Radiographic Outcomes Following the Suture Fixation of Mid-pole Patellar Fractures. Cureus 2021; 13:e20448. [PMID: 35047284 PMCID: PMC8760177 DOI: 10.7759/cureus.20448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2021] [Indexed: 11/21/2022] Open
Abstract
Background Mid-pole patellar fractures are typically fixed with metal implants in the conventional “11-8” tension band construct. However, this technique is fraught with numerous implant-related complications. The aim of this study is to evaluate the union rate following “all-suture” fixation of mid-pole patellar fractures. Methods We retrospectively evaluated a consecutive case series of patients with displaced mid-pole patella fractures treated with “all-suture” fixation in our institution. Fifteen cases were available for this study. The average age was 61.5 years. Clinical and radiological outcomes were evaluated. Union time, complications, and revision rate were recorded. The minimum follow-up was one year. Results There were eight males and seven females, with a mean age of 61.5 ± 13.3 years. Fourteen out of 15 cases (93.3%) achieved radiographic union at 12 weeks postoperatively. The average time to radiographic union was 8.0 ± 2.7 weeks. Five cases (33.3%) had an increase in the fracture gap (>2 mm) at around four to six weeks postoperatively. Four of these cases had an eventual union, whereas one patient had fibrous non-union. There was one case of superficial surgical site infection and one case of infected hematoma. None of the patients required revision surgery. Conclusion “All-suture” fixation of mid-pole transverse patellar fractures is a safe and viable alternative to the conventional “11-8” tension band constructs with metal implants, with good union time, rates, and added benefits of not requiring additional surgery for implant removal.
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14
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Xu X, Liu B, Wu H, Zhang Y, Tian X, Tian J, Liu T. Poly Lactic- co-Glycolic Acid-Coated Toluidine Blue Nanoparticles for the Antibacterial Therapy of Wounds. NANOMATERIALS (BASEL, SWITZERLAND) 2021; 11:3394. [PMID: 34947743 PMCID: PMC8708285 DOI: 10.3390/nano11123394] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/03/2021] [Accepted: 12/09/2021] [Indexed: 12/03/2022]
Abstract
Bacterial infections in wounded skin are associated with high mortality. The emergence of drug-resistant bacteria in wounded skin has been a challenge. Toluidine blue (TB) is a safe and inexpensive photosensitizer that can be activated and used in near-infrared photodynamic therapy to effectively kill methicillin-resistant Staphylococcus aureus (MRSA). However, its aggregation-induced quenching effect largely affects its clinical applications. In this study, TB nanoparticles (NPs) were synthesized using an ultrasound-assisted coating method. Their physicochemical and biological properties were studied and evaluated by scanning electron microscopy and Fourier-transform infrared spectroscopy. The TBNPs had a broad-spectrum antibacterial activity against Gram-positive bacteria (MRSA) and Gram-negative bacteria (E. coli). In addition, MTT, hemolysis, and acute toxicity tests confirmed that TBNPs had good biocompatibility. The TBNPs exhibited a high photodynamic performance under laser irradiation and efficiently killed E. coli and MRSA through generated reactive oxygen species, which destroyed the cell wall structure. The potential application of TBNPs in vivo was studied using an MRSA-infected wound model. The TBNPs could promote wound healing within 7 days, mainly by reducing the inflammation and promoting collagen deposition and granulation tissue formation. In conclusion, the TBNPs offer a promising strategy for clinical applications against multiple-drug resistance.
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Affiliation(s)
| | | | | | | | | | - Jijing Tian
- Laboratory of Veterinary Pathology and Nanopathology, College of Veterinary Medicine, China Agricultural University, No. 2 West Road Yuanmingyuan, Beijing 100193, China; (X.X.); (B.L.); (H.W.); (Y.Z.); (X.T.)
| | - Tianlong Liu
- Laboratory of Veterinary Pathology and Nanopathology, College of Veterinary Medicine, China Agricultural University, No. 2 West Road Yuanmingyuan, Beijing 100193, China; (X.X.); (B.L.); (H.W.); (Y.Z.); (X.T.)
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15
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Sneha KR, Steny PS, Sailaja GS. Intrinsically radiopaque and antimicrobial cellulose based surgical sutures from mechanically powerful Agave sisalana plant leaf fibers. Biomater Sci 2021; 9:7944-7961. [PMID: 34704988 DOI: 10.1039/d1bm01316e] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The judicious configuration of a flexible radiopaque suture would be exemplary to facilitate effortless tracking and precise diagnosis of the sutured surgical site by various X-ray assisted imaging modalities and simultaneously serve as a complementary tool for monitoring the fate of the suture material during the post-operative course. A unique radiopaque cellulose based surgical suture (RF) with good mechanical properties was developed by strategically controlled mercerization and bleaching of mechanically strong natural cellulosic fibers extracted from Agave sisalana plant leaves followed by the facile dip-coating of SrO integrated polylactic acid (PLA). RF exhibited admirable straight-pull tensile strength (184 MPa) and commendable contrast enhancement (277.4%) under digital X-ray radiographic imaging which was further validated by micro-CT analysis. Further, RF has a controlled hydrolytic degradation profile favorable for surgical suturing (mass loss ∼22% in 28 days). The microporous surface architecture of RF (pore size < 10 μm) as a result of SrO-PLA coating enabled the loading of antibiotic (ciprofloxacin) deep inside the pores with a cumulative release of 24% at 28 days under physiological conditions substantiating its feasibility to be used as an efficient antimicrobial suture (CRF) that prevents possible bacterial infections at the surgical site. This has been demonstrated by antibacterial disc diffusion assay performed against two Gram-positive and two Gram-negative bacterial strains. Significantly, both RF and CRF are highly biocompatible as confirmed by MTT assay and F-actin staining. Hence, CRF would be a good biocompatible suture candidate holding good tensile properties, exceptional antimicrobial property and intrinsic radiopacity retention for a period >28 days.
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Affiliation(s)
- K R Sneha
- Department of Polymer Science and Rubber Technology, Cochin University of Science and Technology, Ernakulam, India.
| | - P S Steny
- Department of Polymer Science and Rubber Technology, Cochin University of Science and Technology, Ernakulam, India.
| | - G S Sailaja
- Department of Polymer Science and Rubber Technology, Cochin University of Science and Technology, Ernakulam, India. .,Inter University Centre for Nanomaterials and Devices, CUSAT, Ernakulam, India.,Centre for Advanced materials, CUSAT, Ernakulam, India
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16
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Green Copolymers Based on Poly(Lactic Acid)-Short Review. MATERIALS 2021; 14:ma14185254. [PMID: 34576477 PMCID: PMC8469957 DOI: 10.3390/ma14185254] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/04/2021] [Accepted: 09/09/2021] [Indexed: 12/18/2022]
Abstract
Polylactic acid (PLA) is a biodegradable and biocompatible polymer that can be applied in the field of packaging and medicine. Its starting substrate is lactic acid and, on this account, PLA can also be considered an ecological material produced from renewable resources. Apart from several advantages, polylactic acid has drawbacks such as brittleness and relatively high glass transition and melting temperatures. However, copolymerization of PLA with other polymers improves PLA features, and a desirable material marked by preferable physical properties can be obtained. Presenting a detailed overview of the accounts on the PLA copolymerization accomplishments is the innovation of this paper. Scientific findings, examples of copolymers (including branched, star, grafted or block macromolecules), and its applications are discussed. As PLA copolymers can be potentially used in pharmaceutical and biomedical areas, the attention of this article is also placed on the advances present in this field of study. Moreover, the subject of PLA synthesis is described. Three methods are given: azeotropic dehydrative condensation, direct poly-condensation, and ring-opening polymerization (ROP), along with its mechanisms. The applied catalyst also has an impact on the end product and should be adequately selected depending on the intended use of the synthesized PLA. Different ways of using stannous octoate (Sn(Oct)2) and examples of the other inorganic and organic catalysts used in PLA synthesis are presented.
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17
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Deng X, Qasim M, Ali A. Engineering and polymeric composition of drug-eluting suture: A review. J Biomed Mater Res A 2021; 109:2065-2081. [PMID: 33830631 DOI: 10.1002/jbm.a.37194] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 12/14/2020] [Accepted: 03/24/2021] [Indexed: 12/12/2022]
Abstract
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.
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Affiliation(s)
- Xiaoxuan Deng
- Centre for Bioengineering and Nanomedicine (Dunedin), Faculty of Dentistry, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Muhammad Qasim
- Centre for Bioengineering and Nanomedicine (Dunedin), Faculty of Dentistry, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Azam Ali
- Centre for Bioengineering and Nanomedicine (Dunedin), Faculty of Dentistry, Division of Health Sciences, University of Otago, Dunedin, New Zealand
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18
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Singh M, Jonnalagadda S. Design and characterization of 3D printed, neomycin-eluting poly-L-lactide mats for wound-healing applications. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2021; 32:44. [PMID: 33830338 PMCID: PMC8032582 DOI: 10.1007/s10856-021-06509-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 03/15/2021] [Indexed: 05/04/2023]
Abstract
This study evaluates the suitability of 3D printed biodegradable mats to load and deliver the topical antibiotic, neomycin, for up to 3 weeks in vitro. A 3D printer equipped with a hot melt extruder was used to print bandage-like wound coverings with porous sizes appropriate for cellular attachment and viability. The semicrystalline polyester, poly-l-lactic acid (PLLA) was used as the base polymer, coated (post-printing) with polyethylene glycols (PEGs) of MWs 400 Da, 6 kDa, or 20 kDa to enable manipulation of physicochemical and biological properties to suit intended applications. The mats were further loaded with a topical antibiotic (neomycin sulfate), and cumulative drug-release monitored for 3 weeks in vitro. Microscopic imaging as well as Scanning Electron Microscopy (SEM) studies showed pore dimensions of 100 × 400 µm. These pore dimensions were achieved without compromising mechanical strength; because of the "tough" individual fibers constituting the mat (Young's Moduli of 50 ± 20 MPa and Elastic Elongation of 10 ± 5%). The in vitro dissolution study showed first-order release kinetics for neomycin during the first 20 h, followed by diffusion-controlled (Fickian) release for the remaining duration of the study. The release of neomycin suggested that the ability to load neomycin on to PLLA mats increases threefold, as the MW of the applied PEG coating is lowered from 20 kDa to 400 Da. Overall, this study demonstrates a successful approach to using a 3D printer to prepare porous degradable mats for antibiotic delivery with potential applications to dermal regeneration and tissue engineering. Illustration of the process used to create and characterize 3D printed PLLA mats.
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Affiliation(s)
- Mahima Singh
- Department of Pharmaceutical Sciences, Philadelphia College of Pharmacy, USciences 600 S 43rd St, Philadelphia, PA, 19143, USA
| | - Sriramakamal Jonnalagadda
- Department of Pharmaceutical Sciences, Philadelphia College of Pharmacy, USciences 600 S 43rd St, Philadelphia, PA, 19143, USA.
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19
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Eidmann A, Ewald A, Boelch SP, Rudert M, Holzapfel BM, Stratos I. In vitro evaluation of antibacterial efficacy of vancomycin-loaded suture tapes and cerclage wires. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2021; 32:42. [PMID: 33825078 PMCID: PMC8024230 DOI: 10.1007/s10856-021-06513-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 03/16/2021] [Indexed: 05/10/2023]
Abstract
Usage of implants containing antibiotic agents has been a common strategy to prevent implant related infections in orthopedic surgery. Unfortunately, most implants with microbial repellent properties are characterized by accessibility limitations during daily clinical practice. Aim of this in vitro study was to investigate whether suture tapes and cerclage wires, which were treated with vancomycin, show a sustainable antibacterial activity. For this purpose, we used 24 stainless steel wire cerclages and 24 ultra-high molecular weight polyethylene and polyester suture tape test bodies. The test bodies were incubated for 30 min. in 100 mg/ml vancomycin solution or equivalent volumes of 0.9% NaCl. After measuring the initial solution uptake of the test bodies, antibacterial efficacy via agar diffusion test with Staphylococcus aureus and vancomycin elution tests were performed 1, 2, 3, and 6 days after incubation. Vancomycin-loaded tapes as well as vancomycin-loaded cerclage wires demonstrated increased bacterial growth inhibition when compared to NaCl-treated controls. Vancomycin-loaded tapes showed an additional twofold and eightfold increase of bacterial growth inhibition compared to vancomycin-loaded wires at day 1 and 2, respectively. Elution tests at day 1 revealed high levels of vancomycin concentration in vancomycin loaded tapes and wires. Additionally, the concentration in vancomycin loaded tapes was 14-fold higher when compared to vancomycin loaded wires. Incubating suture tapes and cerclage wires in vancomycin solution showed a good short-term antibacterial activity compared to controls. Considering the ease of vancomycin application on suture tapes or wires, our method could represent an attractive therapeutic strategy in biofilm prevention in orthopedic surgery.
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Affiliation(s)
- Annette Eidmann
- Department of Orthopaedic Surgery, Julius-Maximilians University Wuerzburg, Koenig-Ludwig-Haus, Brettreichstrasse 11, 97074, Wuerzburg, Germany
| | - Andrea Ewald
- Department for Functional Materials in Medicine and Dentistry, University Hospital Wuerzburg, Pleicherwall 2, 97070, Wuerzburg, Germany
| | - Sebastian P Boelch
- Department of Orthopaedic Surgery, Julius-Maximilians University Wuerzburg, Koenig-Ludwig-Haus, Brettreichstrasse 11, 97074, Wuerzburg, Germany
| | - Maximilian Rudert
- Department of Orthopaedic Surgery, Julius-Maximilians University Wuerzburg, Koenig-Ludwig-Haus, Brettreichstrasse 11, 97074, Wuerzburg, Germany
| | - Boris M Holzapfel
- Department of Orthopaedic Surgery, Julius-Maximilians University Wuerzburg, Koenig-Ludwig-Haus, Brettreichstrasse 11, 97074, Wuerzburg, Germany
| | - Ioannis Stratos
- Department of Orthopaedic Surgery, Julius-Maximilians University Wuerzburg, Koenig-Ludwig-Haus, Brettreichstrasse 11, 97074, Wuerzburg, Germany.
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20
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Morikane K, Russo PL, Lee KY, Chakravarthy M, Ling ML, Saguil E, Spencer M, Danker W, Seno A, Charles EE. Expert commentary on the challenges and opportunities for surgical site infection prevention through implementation of evidence-based guidelines in the Asia-Pacific Region. Antimicrob Resist Infect Control 2021; 10:65. [PMID: 33795007 PMCID: PMC8017777 DOI: 10.1186/s13756-021-00916-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 02/26/2021] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Surgical site infections (SSIs) are a significant source of morbidity and mortality in the Asia-Pacific region (APAC), adversely impacting patient quality of life, fiscal productivity and placing a major economic burden on the country's healthcare system. This commentary reports the findings of a two-day meeting that was held in Singapore on July 30-31, 2019, where a series of consensus recommendations were developed by an expert panel composed of infection control, surgical and quality experts from APAC nations in an effort to develop an evidence-based pathway to improving surgical patient outcomes in APAC. METHODS The expert panel conducted a literature review targeting four sentinel areas within the APAC region: national and societal guidelines, implementation strategies, postoperative surveillance and clinical outcomes. The panel formulated a series of key questions regarding APAC-specific challenges and opportunities for SSI prevention. RESULTS The expert panel identified several challenges for mitigating SSIs in APAC; (a) constraints on human resources, (b) lack of adequate policies and procedures, (c) lack of a strong safety culture, (d) limitation in funding resources, (e) environmental and geographic challenges, (f) cultural diversity, (g) poor patient awareness and (h) limitation in self-responsibility. Corrective strategies for guideline implementation in APAC were proposed that included: (a) institutional ownership of infection prevention strategies, (b) perform baseline assessments, (c) review evidence-based practices within the local context, (d) develop a plan for guideline implementation, (e) assess outcome and stakeholder feedback, and (f) ensure long-term sustainability. CONCLUSIONS Reducing the risk of SSIs in APAC region will require: (a) ongoing consultation and collaboration among stakeholders with a high level of clinical staff engagement and (b) a strong institutional and national commitment to alleviate the burden of SSIs by embracing a safety culture and accountability.
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Affiliation(s)
- K Morikane
- Division of Clinical Laboratory and Infection Control, Yamagata University Hospital, Yamagata, Japan
| | - P L Russo
- School of Nursing and Midwifery, Monash University, Frankston, VC, Australia
| | - K Y Lee
- Department of Surgery, KyungHee University Medical Center, Seoul, South Korea
| | | | - M L Ling
- Infection Prevention and Epidemiology, Singapore General Hospital, Singapore, Singapore
| | - E Saguil
- Philippine General Hospital, Manila, Philippines
| | - M Spencer
- Infection Prevention Consultant, Boston, MA, USA
| | - W Danker
- Ethicon, Johnson and Johnson Medical Device Companies, Somerville, NJ, USA
| | - A Seno
- Johnson and Johnson Medical Asia Pacific, Singapore, Singapore
| | - E Edmiston Charles
- Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
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21
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Abstract
Biocontamination of medical devices and implants is a growing issue that causes medical complications and increased expenses. In the fight against biocontamination, developing synthetic surfaces, which reduce the adhesion of microbes and provide biocidal activity or combinatory effects, has emerged as a major global strategy. Advances in nanotechnology and biological sciences have made it possible to design smart surfaces for decreasing infections. Nevertheless, the clinical performance of these surfaces is highly depending on the choice of material. This review focuses on the antimicrobial surfaces with functional material coatings, such as cationic polymers, metal coatings and antifouling micro-/nanostructures. One of the highlights of the review is providing insights into the virus-inactivating surface development, which might particularly be useful for controlling the currently confronted pandemic coronavirus disease 2019 (COVID-19). The nanotechnology-based strategies presented here might be beneficial to produce materials that reduce or prevent the transmission of airborne viral droplets, once applied to biomedical devices and protective equipment of medical workers. Overall, this review compiles existing studies in this broad field by focusing on the recent related developments, draws attention to the possible activity mechanisms, discusses the key challenges and provides future recommendations for developing new, efficient antimicrobial and antiviral surface coatings.
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Deng X, Gould M, Ali MA. Fabrication and characterisation of melt-extruded chitosan/keratin/PCL/PEG drug-eluting sutures designed for wound healing. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 120:111696. [PMID: 33545855 DOI: 10.1016/j.msec.2020.111696] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 10/20/2020] [Accepted: 10/30/2020] [Indexed: 02/07/2023]
Abstract
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.
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Affiliation(s)
- Xiaoxuan Deng
- Centre for Bioengineering & Nanomedicine (Dunedin), Department of Food Science, Division of Sciences, University of Otago, PO Box 56, Dunedin 9054, New Zealand
| | - Maree Gould
- Centre for Bioengineering & Nanomedicine (Dunedin), Department of Food Science, Division of Sciences, University of Otago, PO Box 56, Dunedin 9054, New Zealand
| | - M Azam Ali
- Centre for Bioengineering & Nanomedicine (Dunedin), Department of Food Science, Division of Sciences, University of Otago, PO Box 56, Dunedin 9054, New Zealand.
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Xu Z, Krajewski S, Weindl T, Loeffler R, Li P, Han X, Geis-Gerstorfer J, Wendel HP, Scheideler L, Rupp F. Application of totarol as natural antibacterial coating on dental implants for prevention of peri-implantitis. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 110:110701. [PMID: 32204015 DOI: 10.1016/j.msec.2020.110701] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 01/08/2020] [Accepted: 01/27/2020] [Indexed: 12/11/2022]
Abstract
Peri-implantitis is the most important issue threatening the long-term survival rate of dental implants. Various efforts have been made to reduce implant surface plaque formation, which is one of the essential causes of peri-implantitis. In our study, we applied the natural antibacterial agent totarol as a coating on experimental silicon wafer and titanium implant surfaces. To analyze the interaction between the totarol coating and the oral primary colonizer S. gordonii and isolates of mixed oral bacteria, samples were incubated in a model system simulating the oral environment and analyzed by Live/Dead staining, crystal violet staining and scanning electron microscopy (SEM). After 4 d, 8 d, 12 d, 16 d, and 24 d salivary incubation, the stability and antibacterial efficiency of totarol coating was evaluated through SEM. The results indicated that totarol coatings on both silicon wafer and Ti surfaces caused efficient contact killing and an inhibition effect towards S. gordonii and mixed oral bacterial film growth after 4 h, 8 h, 24 h, and 48 h incubation. After longtime salivary incubation of 12 d, the bactericidal effect started to weaken, but the anti-adhesion and inhibition effect to biofilm development still exist after 24 d of salivary incubation. The application of a totarol coating on implant or abutment surfaces is a promising potential prophylactic approach against peri-implantitis.
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Affiliation(s)
- Zeqian Xu
- University Hospital Tübingen, Section Medical Materials Science & Technology, Osianderstr. 2-8, Tübingen D-72076, Germany.
| | - Stefanie Krajewski
- University Hospital Tübingen, Department of Thoracic, Cardiac and Vascular Surgery, Calwerstr. 7/1, D-72076 Tübingen, Germany
| | | | - Ronny Loeffler
- Center for Light-Matter Interaction, Sensors and Analytics (LISA(+)), Eberhard Karls University Tübingen, Auf der Morgenstelle 15, D-72076 Tübingen, Germany
| | - Ping Li
- University Hospital Tübingen, Section Medical Materials Science & Technology, Osianderstr. 2-8, Tübingen D-72076, Germany
| | - Xingting Han
- University Hospital Tübingen, Section Medical Materials Science & Technology, Osianderstr. 2-8, Tübingen D-72076, Germany
| | - Jürgen Geis-Gerstorfer
- University Hospital Tübingen, Section Medical Materials Science & Technology, Osianderstr. 2-8, Tübingen D-72076, Germany
| | - Hans-Peter Wendel
- University Hospital Tübingen, Department of Thoracic, Cardiac and Vascular Surgery, Calwerstr. 7/1, D-72076 Tübingen, Germany
| | - Lutz Scheideler
- University Hospital Tübingen, Section Medical Materials Science & Technology, Osianderstr. 2-8, Tübingen D-72076, Germany
| | - Frank Rupp
- University Hospital Tübingen, Section Medical Materials Science & Technology, Osianderstr. 2-8, Tübingen D-72076, Germany.
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Chang C, Ginn B, Livingston NK, Yao Z, Slavin B, King MW, Chung S, Mao HQ. Medical Fibers and Biotextiles. Biomater Sci 2020. [DOI: 10.1016/b978-0-12-816137-1.00038-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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25
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Obuobi S, Tay HKL, Tram NDT, Selvarajan V, Khara JS, Wang Y, Ee PLR. Facile and efficient encapsulation of antimicrobial peptides via crosslinked DNA nanostructures and their application in wound therapy. J Control Release 2019; 313:120-130. [DOI: 10.1016/j.jconrel.2019.10.013] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 10/01/2019] [Accepted: 10/07/2019] [Indexed: 01/02/2023]
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Hsu YI, Yamaoka T. Improved exposure of bioactive peptides to the outermost surface of the polylactic acid nanofiber scaffold. J Biomed Mater Res B Appl Biomater 2019; 108:1274-1280. [PMID: 31429188 DOI: 10.1002/jbm.b.34475] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 07/02/2019] [Accepted: 08/06/2019] [Indexed: 12/26/2022]
Abstract
We recently reported a novel method to modify the polylactic acid (PLLA) nanofiber scaffold with IKVAV peptide/oligo (d-lactic acid) (ODLA) heteroconjugates. However, a part of the IKVAV sequence was not exposed to the outermost surface and therefore, cell adhesion was not optimized. In this study, we evaluated two strategies to improve the exposing efficiency of IKVAV. One strategy introduced a hydrophilic diethylene glycol (diEG) segment between IKVAV and ODLA. In the second method, these modified nanofibers were heated to a given temperature and cooled to room temperature in water. The IKVAV peptides at the outermost surface were quantified by the fluorescein isothiocyanate staining method. After being heated above the PLLA glass transition temperature, the exposing efficiency of the IKVAV sequence on the PLLA/ODLA-diEG-IKVAV nanofiber was three times higher than that on the PLLA/ODLA-IKVAV unheated nanofiber. Moreover, nearly 100% of the PC-12 cells seeded onto the PLLA/ODLA-diEG-IKVAV nanofiber and were well distributed, while only 50% of the PC-12 cells seeded onto the PLLA and PLLA/ODLA-IKVAV nanofibers. These strategies markedly enhanced the exposing efficiency of the bioactive peptides; therefore, their use can be applicable to other nanofiber scaffolds.
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Affiliation(s)
- Yu-I Hsu
- Department of Biomedical Engineering, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan
| | - Tetsuji Yamaoka
- Department of Biomedical Engineering, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan
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The Antibiofilm Effect of a Medical Device Containing TIAB on Microorganisms Associated with Surgical Site Infection. Molecules 2019; 24:molecules24122280. [PMID: 31248162 PMCID: PMC6630542 DOI: 10.3390/molecules24122280] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 06/10/2019] [Accepted: 06/18/2019] [Indexed: 01/21/2023] Open
Abstract
Surgical site infections (SSIs) represent the most common nosocomial infections, and surgical sutures are optimal surfaces for bacterial adhesion and biofilm formation. Staphylococcus spp., Enterococcus spp., and Escherichia coli are the most commonly isolated microorganisms. The aim of this research was to evaluate the antibiofilm activity of a medical device (MD) containing TIAB, which is a silver-nanotech patented product. The antibacterial effect was evaluated against Staphylococcus aureus ATCC 29213, Enterococcus faecalis ATCC 29212, and E. coli ATCC 25922 by assessing the minimum inhibitory concentration (MIC) by the Alamar Blue® (AB) assay. The antibiofilm effect was determined by evaluation of the minimum biofilm inhibitory concentration (MBIC) and colony-forming unit (CFU) count. Subsequently, the MD was applied on sutures exposed to the bacterial species. The antimicrobial and antibiofilm effects were evaluated by the agar diffusion test method, confocal laser scanning microscopy (CLSM), and scanning electron microscopy (SEM). The MIC was determined for S. aureus and E. faecalis at 2 mg/mL, while the MBIC was 1.5 mg/mL for S. aureus and 1 mg/mL for E. faecalis. The formation of an inhibition zone around three different treated sutures confirmed the antimicrobial activity, while the SEM and CLSM analysis performed on the MD-treated sutures underlined the presence of a few adhesive cells, which were for the most part dead. The MD showed antimicrobial and antibiofilm activities versus S. aureus and E. faecalis, but a lower efficacy against E. coli. Surgical sutures coated with the MD have the potential to reduce SSIs as well as the risk of biofilm formation post-surgery.
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28
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Development of a Novel Polymer-Based mRNA Coating for Surgical Suture to Enhance Wound Healing. COATINGS 2019. [DOI: 10.3390/coatings9060374] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
A therapeutic strategy to improve wound healing has become an increasingly important medical task due to the rising incidence of adiposity and type II diabetes as well as the proceeding population aging. In order to cope with the resulting burdens, new strategies to achieve rapid and complete wound healing must now be developed. Accordingly, the development of a bioactive wound dressing in the form of a messengerRNA (mRNA)-bearing poly(lactide-co-glycolide acid) (PLGA) coating on surgical suture is being pushed further with this study. Furthermore, the evaluation of the polymer-based transfection reagent Viromer RED has shown that it can be used for the transfection of eukaryotic cells: The mRNA gets properly complexed and translated into a functional protein. In addition, the mRNA-PLGA coating triggered the expression of the keratinocyte growth factor (KGF) in HaCat cells although KGF is not expressed under physiological conditions. Moreover, transfection via surgical sutures coated with mRNA does not affect the cell viability and a proinflammatory reaction in the transfected cells is not induced. These properties make the mRNA-PLGA coating very attractive for the in vivo application. For the future, this could mean that through the use of mRNA-coated sutures in surgical wound closure, cells in the wound area can be transfected directly, thus accelerating and improving wound healing.
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COSTA RC, CAVALCANTI YW, VALENÇA AMG, ALMEIDA LDFDD. Sutures modified by incorporation of chlorhexidine and cinnamaldehyde: anti-Candida effect, bioavailability and mechanical properties. REVISTA DE ODONTOLOGIA DA UNESP 2019. [DOI: 10.1590/1807-2577.04219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Introduction Antimicrobial sutures are a therapeutic alternative for the control of oral infections. Objective Incorporate Chlorhexidine (CHX) and Cinnamaldehyde (CN) in sutures and evaluate the anti-Candida effect, release of antimicrobials and mechanical properties. Material and method Silk (S) and Polyglactin 910 (P) sutures were aseptically sectioned (20 mm) and immersed for incorporation in 0.12% CHX, 0.4% CN and 0.9% saline solutions under stirring for 60 minutes (n = 10 / group). Suspensions of 500 μL of Candida albicans (ATCC 90028/ 1 × 106 CFU/mL) were used to evaluate fungal adhesion after the 48 h period at 37°C. The release of CLX and CN were evaluated at 0, 24 and 48 hours (n=3/group) by UV-VIS spectrophotometer (275 nm). The tensile strength and displacement (n=5/group) were evaluated after incorporation (30 mm/min, 50N). Data were analyzed by Anova and Tukey (α = 5%). Result No anti-Candida effect was observed on S and P sutures incorporated with CLX and CN (p>0.05). However, progressive release was verified up to 48 after treatment with CLX (S = 0.075 / P = 0.073 μg/mL) and CN (S = 35.33 /P= 5.72 μg/mL). There was a decrease in tensile strength in S (CLX = 9.9 / CN = 9.9 N) and P (CLX = 14.4 / CN = 15.5 N) (p<0.05). No differences were observed for the displacement for S (CLX = 19.3 / CN=20.7 mm) and P (CLX = 16.2 / CN=15.8 mm) (p>0.05). Conclusion The incorporation of CLX and CN did not have a positive effect on the biological and mechanical properties of the sutures evaluated.
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Ravishankar PL, Vijayan V, Rao SK, Vadivelu SA, Narayanaswamy D, Teja S. In Vitro Antibacterial Efficacy of Sutures Coated With Aloe vera and Ciprofloxacin: A Comparative Evaluation. J Pharm Bioallied Sci 2019; 11:S164-S168. [PMID: 31198330 PMCID: PMC6555338 DOI: 10.4103/jpbs.jpbs_284_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: Sutures which are used for wound approximation can act as a reservoir of microbes at the surgical site leading to increased chances of surgical site infection (SSI). Sutures used in oral cavity are continuously bathed in saliva which results in wicking. Several studies on sutures treated with nanoparticles, antibacterial agent and various drugs to advance the therapeutical value of surgical sutures are in consideration, drug-eluting sutures has been notable in research to deliver localized effect on the site of incision. Ciprofloxacin and Aloe vera are routinely used agents in coating sutures. Aim: This study is to evaluate the antibacterial efficacy and oral biofilm inhibition of Ciprofloxacin and Aloe vera coated 3-0 silk sutures in comparison to uncoated sutures against E.coli. Material and Methods: Equal segments of ciprofloxacin and aloe vera coated 3-0 silk sutures are to be incubated in E.coli culture media (blood agar) at 37°C for 24 hours in aerobic atmosphere. Plain uncoated suture served as control. Assessment was done using Total Colony Forming Units and biofilm inhibition potential of sutures. Results awaited. Results: The zone of inhibition around ciprofloxacin coated suture is nearly double than that of with Aloe vera indicted that antibacterial efficacy of ciprofloxacin is more comparatively. No inhibition zone around uncoated plain 3-0 braided silk shows that it has no significant antibacterial activity. Conclusion: Within limitation of our study, it can be concluded that both ciprofloxacin and Aloe vera coated sutures have antibacterial property against gram negative E. coli and can have a promising role in prevention of SSI although it would require further in vivo validation.
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Affiliation(s)
- Potluri Leela Ravishankar
- Department of periodontics, SRM Kattankulathur Dental College and Hospital, Potheri, Tamil Nadu, India
| | - Vandana Vijayan
- Department of periodontics, SRM Kattankulathur Dental College and Hospital, Potheri, Tamil Nadu, India
| | - Sunanda K Rao
- Department of periodontics, SRM Kattankulathur Dental College and Hospital, Potheri, Tamil Nadu, India
| | - Saravanan A Vadivelu
- Department of periodontics, SRM Kattankulathur Dental College and Hospital, Potheri, Tamil Nadu, India
| | - Damodaran Narayanaswamy
- Department of Pharmacy, SRM Kattankulathur Dental College and Hospital, Potheri, Tamil Nadu, India
| | - Surya Teja
- Department of Pharmacy, SRM Kattankulathur Dental College and Hospital, Potheri, Tamil Nadu, India
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Biomedical Applications of Polylactide (PLA) and Its Copolymers. Molecules 2018; 23:molecules23040980. [PMID: 29690615 PMCID: PMC6017518 DOI: 10.3390/molecules23040980] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 04/21/2018] [Accepted: 04/21/2018] [Indexed: 12/15/2022] Open
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