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.
Highlights
Surgical site infections (SSIs) are one of the most critical parameters after surgical intervention, especially in contexts in which foreign materials such as implants or sutures are brought into the wound
The turbidity of the inoculated totarol-laced media, indicating bacterial growth, became less pronounced at 64 μg/mL until the medium appeared clear at even higher concentrations of totarol
These findings were verified by a photometric analysis, which indicates that the lowest concentration of totarol completely inhibiting the bacterial growth after 24 h was 128 μg/mL
Summary
Surgical site infections (SSIs) are one of the most critical parameters after surgical intervention, especially in contexts in which foreign materials such as implants or sutures are brought into the wound. Different bacteria are able to adhere and colonize on the surface of surgical sutures, causing infection. Surgical sutures are sterile stiches used to seal wounds after surgical procedures. They are an important tool to support wound healing [1,2], and the increased risk of SSIs compromises their usefulness. The most common pathogen causing these infections is Staphylococcus aureus, a gram-positive bacterium, which is responsible in 23% of the cases [3,4].
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