Preventing Surgical Site Infections Using a Natural, Biodegradable, Antibacterial Coating on Surgical Sutures

Abstract

Surgical site infections (SSIs) are one of the most common nosocomial infections, which can result in serious complications after surgical interventions. Foreign materials such as implants or surgical sutures are optimal surfaces for the adherence of bacteria and subsequent colonization and biofilm formation. Due to a significant increase in antibiotic-resistant bacterial strains, naturally occurring agents exhibiting antibacterial properties have great potential in prophylactic therapies. The aim of this study was to develop a coating for surgical sutures consisting of the antibacterial substance totarol, a naturally occurring diterpenoid isolated from Podocarpus totara in combination with poly(lactide-co-glycolide acid) (PLGA) as a biodegradable drug delivery system. Hence, non-absorbable monofilament and multifilament sutures were coated with solutions containing different amounts and ratios of totarol and PLGA, resulting in a smooth, crystalline coating. Using an agar diffusion test (ADT), it became evident that the PLGA/totarol-coated sutures inhibited the growth of Staphylococcus aureus over a period of 15 days. A 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay showed that the coated sutures were not cytotoxic to murine fibroblasts. Overall, the data indicates that our innovative, biodegradable suture coating has the potential to reduce the risk of SSIs and postoperative biofilm-formation on suture material without adverse effects on tissue.

Improved exposure of bioactive peptides to the outermost surface of the polylactic acid nanofiber scaffold

“…Recently, various biodegradable polymers have been used in a variety of applications: the making of artificial organs, such as vessels (Cheng et al, ; Li et al, ; William, ), orthopedics (Agrawal, Niederauer, & Athanasiou, ; Zhao, Wu, Ni, Zhang, & Zhang, ), absorbable surgical sutures (Lou et al, ; Reinbold et al, ), and matrices for drug delivery (Jeong, Bae, Lee, & Kim, ; Lee, Hughes, Ross, & Robinson, ). In particular, the use of poly(lactic acid) (PLA) polymers is preferred because they are nontoxic and easily molded (Mligiliche et al, ; Oh et al, ; Sundback, Hadlock, Cheney, & Vacanti, ).…”

Development of a Novel Polymer-Based mRNA Coating for Surgical Suture to Enhance Wound Healing

“…The development of coatings for surgical suture, until now, was mostly targeted at antimicrobial characteristics to prevent surgical site infections using antiseptic agents such as chlorhexidine, natural products such as totarol, or different kinds of silver nanoparticles [28][29][30]. Additionally, several kinds of drug-eluting sutures have been produced by a variety of manufacturing processes [31].…”

Inhibition of Streptococcus mutans (ATCC 25175) biofilm formation on eugenol-impregnated surgical sutures

“…Sutures impregnated or coated with several antibacterial agents, including plant-derived metabolites, have been extensively explored by many researchers (Reinbold et al, 2017;Sudha et al, 2017). Therefore, the aim of this study was to suggest a safe and inexpensive eugenol-coating for surgical sutures.…”

“…Among these, aerobic and anaerobic bacteria comprised >40 and >25%, respectively, and included pathogenic microorganisms that did not belong in the oral cavity (Otten et al, 2005). Thus, antimicrobial suture coatings have been developed to avoid bacterial adherence and colonization on suture surfaces (Serrano et al, 2015;Gallo et al, 2016;Reinbold et al, 2017).…”