A Nano-Silver Loaded PVA/Keratin Hydrogel With Strong Mechanical Properties Provides Excellent Antibacterial Effect for Delayed Sternal Closure.

Yanjun Pan,Jiang Yuan,Pengfei Li,Meng Yin,Jingyi Zhang,Fubang Liang

doi:10.3389/fbioe.2021.733980

Abstract

Delayed chest closure (DSC) is widely performed during the treatment of congenital heart diseases. However, the high prevalence of surgical site infection (SSI) in patients undergoing DSC affects prognosis negatively. Herein, we designed a suturable poly (vinyl alcohol)/keratin film loaded with silver nanoparticles (AgNPs) as an alternative material for DSC, which was named PVA/Keratin/AgNPs. The PVA/Keratin/AgNPs films exhibited significantly enhanced mechanical strength after crosslinking by sodium trimetaphosphate (STMP). These films were non-toxic, and cells proliferated with good morphology after 1 week of culture. In addition, PVA/Keratin/AgNPs films provided superior antibacterial ability, as evidenced by the eradication and lower growth rate of Staphylococcus aureus and Escherichia coli. Finally, the PVA/Keratin/AgNPs films were demonstrated to successfully cover the chest cavity temporarily and protect the chest cavity from bacterial infection. These results indicated that the PVA/Keratin/AgNPs films have great prospects to be further exploited for clinical applications in DSC.

Highlights

Congenital heart disease (CHD) is the most common human birth defect, accounting for about a quarter of cases
The PVA/Keratin hydrogel before sodium trimetaphosphate (STMP) treatment displayed a flat surface (Figure 1C), similar to PVA and PVA/Keratin hydrogels crosslinked by STMP (Figure 1D)
The scanning electron microscopy (SEM) images of PVA/ Keratin/silver nanoparticles (AgNPs) films revealed that AgNPs were successfully fixed and exhibited spherical shapes without aggregation (Figures 1E,F)

Summary

Introduction

Congenital heart disease (CHD) is the most common human birth defect, accounting for about a quarter of cases. Once the chest is closed immediately after surgery, it will cause a sharp increase in intrathoracic pressure occurs, leading to ventricular dysfunction and poor ventilation, eventually resulting in mortality (Nelson-McMillan et al, 2016). DSC has been reported to increase the risk of surgical site infection (SSI), mainly caused by Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli). The most common method to prevent SSI after DSC is to suture sterile gloves on the skin around the incision to cover the thoracic cavity temporarily (Yabrodi et al, 2019). The poor light permeability of sterile gloves makes it impossible for surgeons to deal with sudden and unexpected events in time, such as postoperative bleeding and pericardial tamponade, delaying the optimal time for treatment

Methods

Results

Conclusion