Sustainable Antibacterial Surgical Suture Based on Recycled Silk Resource by an Internal Combination of Inorganic Nanomaterials

The current antibacterial treatment methods of silk sutures can only be finished by surface modification, leading to problems of short antibacterial effects, easy slow-release consumption, prominent toxicity, and susceptibility to drug resistance. Speculatively, surgical sutures combining antibacterial material internally will possess a more promising efficacy. Hence, we extracted recycled regenerated silk fibroin (RRSF) from waste silk resources to make RRSF solutions. Internally combining with inorganic titanium dioxide (TiO₂) nanoparticles, we fabricated antibacterial RRSF-based surgical sutures. The morphologies, mechanical and antibacterial properties, biocompatibility tests, and in vivo experiments were carried out. The results showed that the surgical sutures with 1.25 wt % TiO₂ acquired 2.40 N knot strength (143 μm diameter) and achieved a sustainable antibacterial effect of 93.58%. Surprisingly, the sutures significantly reduced inflammatory reactions and promoted wound healing. Surgical sutures in this paper realize high-value recovery of waste silk fibers and provide a novel approach to preparing multifunctional sutures.

Antibacterial Surgical Sutures Developed Using Electrostatic Yarn Wrapping Technology

A significant amount of research has been conducted on applying functional materials as surgical sutures. Therefore, research on how to solve the shortcomings of surgical sutures through available materials has been given increasing attention. In this study, hydroxypropyl cellulose (HPC)/PVP/zinc acetate nanofibers were coated on absorbable collagen sutures using an electrostatic yarn winding technique. The metal disk of an electrostatic yarn spinning machine gathers nanofibers between two needles with positive and negative charges. By adjusting the positive and negative voltage, the liquid in the spinneret is stretched into fibers. The selected materials are toxicity free and have high biocompatibility. Test results indicate that the nanofiber membrane comprises evenly formed nanofibers despite the presence of zinc acetate. In addition, zinc acetate can effectively kill 99.9% of E. coli and S. aureus. Cell assay results indicate that HPC/PVP/Zn nanofiber membranes are not toxic; moreover, they improve cell adhesion, suggesting that the absorbable collagen surgical suture is profoundly wrapped in a nanofiber membrane that exerts antibacterial efficacy and reduces inflammation, thus providing a suitable environment for cell growth. The employment of electrostatic yarn wrapping technology is proven effective in providing surgical sutures with antibacterial efficacy and a more flexible range of functions.

Core-Shell Filament with Excellent Wound Healing Property Made of Cellulose Nanofibrils and Guar Gum via Interfacial Polyelectrolyte Complexation Spinning

Natural polymer-based sutures have attractive cytocompatibility and degradability in surgical operations. Herein, anionic cellulose nanofibrils (ACNF) and cationic guar gum (CGG) are employed to produce nontoxic CGG/ACNF composite filament with a unique core-shell structure via interfacial polyelectrolyte complexation (IPC) spinning. The comprehensive characterization and application performance of the resultant CGG/ACNF filament as a surgical suture are thoroughly investigated in comparison with silk and PGLA (90% glycolide and 10% l-lactide) sutures in vitro and in vivo, respectively. Results show that the CGG/ACNF filament with the typical core-shell structure and nervation pattern surface exhibits a high orientation index (0.74) and good mechanical properties. The tensile strength and knotting strength of CGG/ACNF suture prepared by twisting CGG/ACNF filaments increase by 69.5%, and CGG/ACNF suture has a similar friction coefficient to silk and PGLA sutures. Moreover, CGG/ACNF suture with antibiosis and cytocompatibility exhibits better growth promotion of cells than silk suture, similar to PGLA suture in vitro. In addition, the stitching experiment of mice with the CGG/ACNF suture further confirms better healing properties and less inflammation in vivo than silk and PGLA sutures do. Hence, the CGG/ACNF suture with a simple preparation method and excellent application properties is promising in surgical operations.

Influence of Loading Conditions on the Mechanical Performance of Multifilament Coreless UHMWPE Sutures Used in Orthopaedic Surgery

This work studies the influence of loading velocity and previous cyclic loading history on the stiffness and strength of a multifilament coreless ultra-high-molecular-weight polyethylene (UHMWPE) surgical suture. Thread samples (n = 8) were subjected to a load-to-failure test at 0.1, 0.5, 1, 5, and 10 mm/s without previous loading history and after 10 cycles of loading at 1-10 N, 1-30 N, and 1-50 N. The experimental data were fitted to mathematical models to compute the stress-strain relation and the strength of the suture. The bilinear model involving two stress-strain ratios for low- and high-strain intervals was the best fit. The ratio in the low-strain range rose with loading speed, showing mean increases of 5.9%, 6.5%, 7.9%, and 7.3% between successive loading speeds. Without a previous loading history, this ratio was less than half than that at high strain. However, 10 cycles of 1-30 N or 1-50 N significantly increased the stress-strain ratio at a low strain level by 135% and 228%, respectively. The effect persisted after 2 min but vanished after 24 h. No influence was found on the suture strength. In conclusion, the stiffness of the studied suture was influenced by the strain level, loading velocity, and recent cyclic loading history. Conversely, the suture strength was not affected.

Assessment of surgical sutures POLYMED(®) by intracutaneous irritation test in rabbits

The aim of the present study was to evaluate local irritant effects to rabbit skin following a single application of test samples of non-sterile polyamide non-absorbable surgical sutures POLYMED^®. The polar and nonpolar extracts were prepared by using saline solution and olive oil, respectively, after sinking the materials tested (2.0 g) in 10 ml of the corresponding liquid. Incubation was carried out at the temperature of 37 °C for 72 h. The saline solution and pure olive oil, which had no contact with the materials tested, were used as negative control samples and were incubated under the same conditions as above. Assessments of the extracts from each material were conducted on 2 albino rabbits of the New Zealand breed. On the back of each animal, 5 intracutaneous injections of the extract tested and 5 injections of the control solution, each of 0.2 ml, were carried out. The degree of irritation was scored at 4, 24, 48, 72 hours after injection and no skin changes were found. The intracutaneous irritation index (III) was calculated and yielded 0.0. Hence it was concluded that under the experimental conditions the extracts of the material tested, i.e. non-sterile polyamide non-absorbable surgical sutures POLYMED^®, were ‘non-irritant’ to the skin of rabbits when compared with the respective control groups. The experimental procedure was conducted according to ISO10993-10.