Antimicrobials tethering on suture surface through a hydrogel: a novel strategy to combat postoperative wound infections

Abstract

The present study aimed to develop a novel biocompatible suture biomaterial from Eri silk waste to avoid surgical site infections. To achieve this, silk waste fibers were reeled through a five-loop technique into a suture and embedded with an antimicrobial agents-growth factor cocktail in a hydrogel base comprising of Aloe-Vera and gum acacia (PRWSc). Characterization techniques like scanning electron microscopy (SEM), attenuated total reflection Fourier infrared spectroscopy (ATR-FTIR), thermo gravimetric analysis (TGA), and tensile properties analysis revealed the surface morphology, functionalization analysis, thermal and mechanical stability of PRWSc. Drug release study confirms the sustained release of the drugs from the suture. PRWSc was found to be biocompatible towards mammalian cells. In vitro antimicrobial study revealed that the PRWSc could inhibit the growth of Gram +ve, Gram −ve bacteria and opportunistic fungus. Further, confocal microscopy analysis confirmed the successful inhibition of biofilm on PRWSc surface. Clinical examination of the wound sutured with PRWSc revealed the successful wound healing which was confirmed by reduced microbial burden (CFU load) and inflammatory markers at the surgical site. This result was further confirmed by histopathology data where all skin adnexal structures were observed. This advanced suture material (PRWSc) can reduce the unwanted side effects of antibiotic overdose and can avoid serious problems related to postoperative complications.