title: New anti-infective coatings of surgical sutures based on a combination of antiseptics and fatty acids.
abstract: Wound infection is a complication feared in surgery. The aim of this study was to develop new anti-infective coatings of surgical sutures and to compare the anti-microbial effectiveness and biocompatibility to the well-established Vicryl Plus. Synthetic absorbable PGA surgical sutures were coated with three different chlorhexidine concentrations and two different octenidine concentrations in combination with palmitic acid and lauric acid. Drug-release kinetics lasting 96 h were studied in phosphate-buffered saline at 37 degrees C. Anti-infective characteristics were determined by measuring the change in optical density of Staphylococcus aureus suspensions charged with coated sutures over time. Microorganisms adsorbed at the surface of coated sutures were assessed on blood agar plates and coated sutures eluted for 24 h were placed on bacterial lawns cultured on Mueller-Hinton plates to prove retained anti-microbial potency. A cell proliferation assay was performed to assess the degree of cytotoxicity. Anti-infective characteristics and biocompatibility were compared to Vicryl Plus. A coating technology for slow-release drug-delivery systems on surgical sutures could be developed. All coatings showed a continuous drug release within 96 h. Individual chlorhexidine and octenidine coated sutures showed superior anti-infective characteristics but inferior biocompatibility in comparison to Vicryl Plus. We conclude that the developed anti-infective suture coatings consisting of lipid-based drug-delivery systems in combination with antiseptics are highly effective against bacterial colonization in vitro; however, drug doses have to be adjusted to improve biocompatibility.
authors.affiliation: Institute of Medical Engineering, Technische Universität München, Boltzmannstrasse 11, 85748 Garching, Germany. florian.matl@lrz.tum.de
authors.forename: F D
authors.initials: FD
authors.lastname: Matl
authors.forename: J
authors.initials: J
authors.lastname: Zlotnyk
authors.forename: A
authors.initials: A
authors.lastname: Obermeier
authors.forename: W
authors.initials: W
authors.lastname: Friess
authors.forename: S
authors.initials: S
authors.lastname: Vogt
authors.forename: H
authors.initials: H
authors.lastname: Büchner
authors.forename: H
authors.initials: H
authors.lastname: Schnabelrauch
authors.forename: A
authors.initials: A
authors.lastname: Stemberger
authors.forename: K-D
authors.initials: KD
authors.lastname: Kühn
mesh_terms: D000818:Animals; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage* / Q000737:chemistry / Q000494:pharmacology; D001422:Bacterial Adhesion / Q000187:drug effects; D049109:Cell Proliferation / Q000187:drug effects; D002478:Cells, Cultured; D002710:Chlorhexidine / Q000008:administration & dosage* / Q000737:chemistry / Q000494:pharmacology; D020099:Coated Materials, Biocompatible / Q000737:chemistry*; D003692:Delayed-Action Preparations / Q000737:chemistry; D005227:Fatty Acids / Q000737:chemistry*; D005347:Fibroblasts / Q000166:cytology; D007097:Imines; D007850:Lauric Acids / Q000737:chemistry; D051379:Mice; D019308:Palmitic Acid / Q000737:chemistry; D011725:Pyridines / Q000008:administration & dosage* / Q000737:chemistry / Q000494:pharmacology; D013211:Staphylococcus aureus / Q000187:drug effects / Q000254:growth & development; D013537:Sutures; D013997:Time Factors
chemical_list: D000891:Anti-Infective Agents, Local; D020099:Coated Materials, Biocompatible; D003692:Delayed-Action Preparations; D005227:Fatty Acids; D007097:Imines; D007850:Lauric Acids; D011725:Pyridines; C030358:lauric acid; D019308:Palmitic Acid; C034213:octenidine; D002710:Chlorhexidine