title: Antibacterial Surgical Silk Sutures Using a High-Performance Slow-Release Carrier Coating System.
abstract: Sutures are a vital part for surgical operation, and suture-associated surgical site infections are an important issue of postoperative care. Antibacterial sutures have been proved to reduce challenging complications caused by bacterial infections. In recent decades, triclosan-free sutures have been on their way to commercialization. Alternative antibacterial substances are becoming relevant to processing surgical suture materials. Most of the antibacterial substances are loaded directly on sutures by dipping or coating methods. The aim of this study was to optimize novel antibacterial braided silk sutures based on levofloxacin hydrochloride and poly(ε-caprolactone) by two different processing sequences, to achieve suture materials with slow-release antibacterial efficacy and ideal physical and handling properties. Silk strands were processed into sutures on a circular braiding machine, and antibacterial treatment was introduced alternatively before or after braiding by two-dipping-two-rolling method (M1 group and M2 group). The antibacterial activity and durability against Staphylococcus aureus and Escherichia coli were tested. Drug release profiles were measured in phosphate buffer with different pH values, and release kinetics model was built to analyze the sustained drug release mechanism between the interface of biomaterials and the in vitro aqueous environment. Knot-pull tensile strength, thread-to-thread friction, and bending stiffness were determined to evaluate physical and handling properties of sutures. All coated sutures showed continuous antibacterial efficacy and slow drug release features for more than 5 days. Besides, treated sutures fulfilled U.S. Pharmacopoeia required knot-pull tensile strength. The thread-to-thread friction and bending stiffness for the M1 group changed slightly when compared with those of uncoated ones. However, physical and handling characteristics of the M2 group tend to approach those of monofilament ones. The novel suture showed acceptable in vitro cytotoxicity according to ISO 10993-5. Generally speaking, all coated sutures show potential in acting as antibacterial suture materials, and M1 group is proved to have a higher prospect for clinical applications.
authors.affiliation: Key Laboratory of Textile Science and Technology, Ministry of Education, College of Textiles, Donghua University , Songjiang District, Shanghai 201620, China.
authors.forename: Xiaojie
authors.initials: X
authors.lastname: Chen
authors.affiliation: Key Laboratory of Textile Science and Technology, Ministry of Education, College of Textiles, Donghua University , Songjiang District, Shanghai 201620, China.
authors.forename: Dandan
authors.initials: D
authors.lastname: Hou
authors.affiliation: Key Laboratory of Textile Science and Technology, Ministry of Education, College of Textiles, Donghua University , Songjiang District, Shanghai 201620, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Wang
authors.affiliation: Key Laboratory of Textile Science and Technology, Ministry of Education, College of Textiles, Donghua University , Songjiang District, Shanghai 201620, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Key Laboratory of Textile Science and Technology, Ministry of Education, College of Textiles, Donghua University , Songjiang District, Shanghai 201620, China.
authors.forename: Jiahan
authors.initials: J
authors.lastname: Zou
authors.affiliation: Key Laboratory of Textile Science and Technology, Ministry of Education, College of Textiles, Donghua University , Songjiang District, Shanghai 201620, China.|Division of Textiles and Clothing, University of California , Davis, California 95616, United States.
authors.forename: Gang
authors.initials: G
authors.lastname: Sun
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000737:chemistry* / Q000494:pharmacology; D002460:Cell Line; D002470:Cell Survival / Q000187:drug effects; D052978:Disk Diffusion Antimicrobial Tests; D004337:Drug Carriers / Q000737:chemistry / Q000633:toxicity; D065546:Drug Liberation; D004926:Escherichia coli / Q000187:drug effects; D064704:Levofloxacin / Q000737:chemistry / Q000494:pharmacology; D051379:Mice; D011091:Polyesters / Q000737:chemistry; D047011:Silk / Q000737:chemistry*; D013211:Staphylococcus aureus / Q000187:drug effects; D013537:Sutures; D013718:Tensile Strength
chemical_list: D000900:Anti-Bacterial Agents; D004337:Drug Carriers; D011091:Polyesters; D047011:Silk; C016240:polycaprolactone; D064704:Levofloxacin
keywords: antibacterial properties; coating; controlled release/sustained release; physical and handling characteristics; surgical silk suture