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Ertem SY. Partially resorbed unremoved silk sutures after tooth extraction: A unique Case report. Clin Case Rep 2021; 9:1621-1623. [PMID: 33768902 PMCID: PMC7981646 DOI: 10.1002/ccr3.3853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 01/06/2021] [Accepted: 01/09/2021] [Indexed: 11/21/2022] Open
Abstract
Suturation may remain in the mouth for a long time due to incomplete information to patients due to inadvertency. Forgotten silk sutures might be sunk and cause irritation into the alveolar mucosa.
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Affiliation(s)
- Sinan Yasin Ertem
- Department of Oral and Maxillofacial SurgerySchool of DentistryAnkara Yildirim Beyazit UniversityAnkaraTurkey
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2
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Jang SH, Oh MS, Baek HI, Ha KC, Lee JY, Jang YS. Silk peptide treatment potentiates natural killer cell activity in vitro and induces natural killer cell maturation and activation in mouse splenocytes. PHARMACEUTICAL BIOLOGY 2019; 57:369-379. [PMID: 31156004 PMCID: PMC6567191 DOI: 10.1080/13880209.2019.1617749] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Context: Silk peptide from cocoons of silkworm (Bombyx mori L., Bombycidae) has been employed as a biomedical material and exhibits various bioactivities, including immune-modulating activity. Objective: We analyzed whether silk peptide exerts direct modulating effects on NK cells using an NK cell line in vitro and ex vivo splenocytes. We also attempted to delineate the mechanism underlying the modulation. Material and methods: In vitro activity of silk peptide on NK cells was determined by measurement of cytolytic activity against K562 cells at an effector-to-target ratio of 5:1 after incubation of NK-92MI cells with silk peptide (0-2000 μg/mL) for 48 and 72 h. Ex vivo activity of silk peptide on mouse splenic NK cells was determined similarly by using YAC-1 cells. Results: Treatment of NK-92MI NK cells with silk peptide (500-2000 μg/mL) significantly increased cytolytic activity on target cells by 2- to 4-fold. The same concentrations (500-2000 μg/mL) of silk peptide treatment also significantly enhanced the cytolytic activity of splenic NK cells against YAC-1 cells. Silk peptide treatment of IL-2-stimulated splenocytes induced enhanced expression of Th1, 2 and 17 cytokines including TNF-α, IFN-γ, IL-6, IL-4 and IL-17. Finally, ex vivo treatment with silk peptide on mouse splenocytes significantly enhanced the degree of NK cell maturation in a dose-dependent manner from 3.49 to 23.79%. Discussion and conclusions: These findings suggest that silk peptide stimulates NK cells, thereby influencing systemic immune functions and improving natural immunity. Thus, silk peptide could be useful as a complementary therapy in cancer patients.
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Affiliation(s)
- Sun-Hee Jang
- Department of Molecular Biology and the Institute for Molecular Biology and Genetics, Chonbuk National University, Jeonju, Korea
| | | | | | - Ki-Chan Ha
- Healthcare Claims and Management Inc, Jeonju, Korea
| | | | - Yong-Suk Jang
- Department of Molecular Biology and the Institute for Molecular Biology and Genetics, Chonbuk National University, Jeonju, Korea
- Department of Bioactive Material Sciences and Research Center of Bioactive Materials, Chonbuk National University, Jeonju, Korea
- CONTACT Yong-Suk Jang Department of Molecular Biology and the Institute for Molecular Biology and Genetics, Chonbuk National University, 567 Baekje-daero, Dukjin-gu, Jeonju54896, Korea
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Mahesh L, Kumar VR, Jain A, Shukla S, Aragoneses JM, Martínez González JM, Fernández-Domínguez M, Calvo-Guirado JL. Bacterial Adherence Around Sutures of Different Material at Grafted Site: A Microbiological Analysis. MATERIALS 2019; 12:ma12182848. [PMID: 31487852 PMCID: PMC6765980 DOI: 10.3390/ma12182848] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 08/21/2019] [Accepted: 08/31/2019] [Indexed: 01/08/2023]
Abstract
Closure of the surgical incision has been the primary function of sutures since their introduction. However, whatever the type, they are known to carry bacteria, which can be a source of infection. Five types of surgical sutures, Gut, Silk, Vicryl, PTFE, and Polyamide, were selected and tested on their ability to carry aerobic and anaerobic bacteria and were rated on the basis of forming colony-forming units (CFUs). Aerobic bacteria grown around gut sutures showed minimum CFUs (≈30 × 104/suture). Though very less anaerobic bacteria growth was seen among all tested suture materials, it was maximum around Vicryl and polyamide sutures. Every suture material is capable, albeit not equally, of holding bacterial biofilm formation, which can be a source of surgical site infection.
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Affiliation(s)
| | | | - Anshi Jain
- Department of Oral Pathology, ITS Dental College, Ghaziabad 201009, Uttar Pradesh, India
| | - Sagrika Shukla
- Private Practice in Periodontology, New Delhi 110001, India
| | - Juan Manuel Aragoneses
- Department of Dental Research in Universidad Federico Henríquez y Carvajal (UFHEC), Santo Domingo 10107, Dominican Republic
| | | | - Manuel Fernández-Domínguez
- Department of Oral Surgery and Implantology and Director of Research in Dentistry in the Doctoral Program of Translational Medicine, CEU San Pablo University, 28223 Madrid, Spain
| | - José Luis Calvo-Guirado
- Department of Oral Surgery and Implant Dentistry, Faculty of Health Sciences, Universidad Católica de Murcia, UCAM, 30107 Murcia, Spain.
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4
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Sukeik M, George D, Gabr A, Kallala R, Wilson P, Haddad FS. Randomised controlled trial of triclosan coated vs uncoated sutures in primary hip and knee arthroplasty. World J Orthop 2019; 10:268-277. [PMID: 31363457 PMCID: PMC6650636 DOI: 10.5312/wjo.v10.i7.268] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 06/29/2019] [Accepted: 07/08/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Triclosan-coated vicryl plus suture (Ethicon, Inc.) was developed to reduce microbial colonisation during surgical procedures. However, its effect on wound healing and surgical site infections remain unclear after hip and knee arthro-plasty surgery.
AIM To determine the effect of triclosan-coated sutures (TCS) vs non-coated sutures on wound healing, following primary hip and knee arthroplasties.
METHODS A single-centred, double-blind randomised controlled trial (RCT) was undertaken. We randomly allocated patients to receive either the triclosan-coated sutures (TCS vicryl plus) or non-coated sutures (NCS vicryl) during the closure of unilateral primary hip and knee arthroplasties. We utilised the ASEPSIS wound scoring system to evaluate wound healing for the first 6 weeks post-operatively.
RESULTS One hundred and fifty patients undergoing primary total hip or knee arthroplasty over a one-year period were included. Eighty-one were randomised to the TCS group and 69 to the NCS group. Despite no statistically significant difference in the ASEPSIS scores among the study groups (P = 0.75), sensitivity analysis using the Mann Whitney test (P = 0.036) as well as assessment of the wound complications at 6 weeks follow up, demonstrated significantly higher wound complication rates in the TCS group (8 vs 1, P = 0.03).
CONCLUSION No clear advantage was demonstrated for using the TCS. However, larger multi-centred RCTs are required to validate their use in hip and knee arthroplasty surgery.
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Affiliation(s)
- Mohamed Sukeik
- Department of Trauma and Orthopaedics, University College London Hospital, London NW1 2BU, United Kingdom
- Department of Trauma and Orthopaedics, Dr. Sulaiman Al-Habib Hospital – Al Khobar, King Salman Bin Abdulaziz Rd, Al Bandariyah, Al Khobar 34423, Saudi Arabia
| | - David George
- Department of Trauma and Orthopaedics, University College London Hospital, London NW1 2BU, United Kingdom
| | - Ayman Gabr
- Department of Trauma and Orthopaedics, University College London Hospital, London NW1 2BU, United Kingdom
| | - Rami Kallala
- Department of Trauma and Orthopaedics, University College London Hospital, London NW1 2BU, United Kingdom
| | - Peter Wilson
- Department of Clinical Microbiology, UCLH, London NW1 2PG, United Kingdom
| | - Fares Sami Haddad
- Department of Trauma and Orthopaedics, University College London Hospital, London NW1 2BU, United Kingdom
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5
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Jang SH, Oh MS, Baek HI, Ha KC, Lee JY, Jang YS. Oral Administration of Silk Peptide Enhances the Maturation and Cytolytic Activity of Natural Killer Cells. Immune Netw 2018; 18:e37. [PMID: 30402332 PMCID: PMC6215900 DOI: 10.4110/in.2018.18.e37] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 10/21/2018] [Accepted: 10/23/2018] [Indexed: 02/07/2023] Open
Abstract
Silk peptide, the hydrolysate of silk protein derived from cocoons, has been employed as a biomedical material and is believed to be safe for human use. Silk peptide display various bioactivities, including anti-inflammatory, immune-regulatory, anti-tumor, anti-viral, and anti-bacterial. Although earlier investigations demonstrated that silk peptide stimulates macrophages and the production of pro-inflammatory cytokines, its effect on natural killer (NK) cell function has not yet been explored. In this study, we initially confirmed that silk peptide enhances NK cell activity in vitro and ex vivo. To assess the modulatory activity of silk peptide on NK cells, mice were fed various amounts of a silk peptide-supplemented diet for 2 months and the effects on immune stimulation, including NK cell activation, were evaluated. Oral administration of silk peptide significantly enhanced the proliferation of mitogen- or IL-2-stimulated splenocytes. In addition, oral silk peptide treatment enhanced the frequency and degree of maturation of NK cells in splenocytes. The same treatment also significantly enhanced the target cell cytolytic activity of NK cells, which was determined by cell surface CD107a expression and intracellular interferon-γ expression. Finally, oral administration of silk peptide stimulated T helper 1-type cytokine expression from splenic lymphocytes. Collectively, our results suggest that silk peptide potentiates NK cell activity in vivo and could be used as a compound for immune-modulating anti-tumor treatment.
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Affiliation(s)
- Sun-Hee Jang
- Department of Molecular Biology and The Institute for Molecular Biology and Genetics, Chonbuk National University, Jeonju 54896, Korea
| | - Mi-Sun Oh
- Worldway Co., Ltd., Sejong 30003, Korea
| | - Hyang-Im Baek
- Healthcare Claims & Management Inc., Jeonju 54810, Korea
| | - Ki-Chan Ha
- Healthcare Claims & Management Inc., Jeonju 54810, Korea
| | | | - Yong-Suk Jang
- Department of Molecular Biology and The Institute for Molecular Biology and Genetics, Chonbuk National University, Jeonju 54896, Korea.,Department of Bioactive Material Sciences and Research Center of Bioactive Materials, Chonbuk National University, Jeonju 54896, Korea
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6
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Lee CG, Jung J, Hwang S, Park CO, Hwang S, Jo M, Sin MH, Kim HH, Rhee KJ. Histological Evaluation of Bioresorbable Threads in Rats. KOREAN JOURNAL OF CLINICAL LABORATORY SCIENCE 2018. [DOI: 10.15324/kjcls.2018.50.3.217] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Chang Gun Lee
- Department of Biomedical Laboratory Science, College of Health Sciences, Yonsei University, Wonju, Korea
| | - Jaeyun Jung
- Mielle Dermatology & Plastic Surgery Network Clinic, Busan, Korea
| | - Samnoh Hwang
- Department of Pathology, The Catholic University of Korea, Seoul Saint Mary’s Hospital, Seoul, Korea
| | - Chan Oh Park
- Department of Biomedical Laboratory Science, College of Health Sciences, Yonsei University, Wonju, Korea
| | - Soonjae Hwang
- Department of Biomedical Laboratory Science, College of Health Sciences, Yonsei University, Wonju, Korea
| | - Minjeong Jo
- Department of Biomedical Laboratory Science, College of Health Sciences, Yonsei University, Wonju, Korea
| | - Min Hi Sin
- Department of Pathology, Wonju Severance Christian Hospital, Wonju, Korea
| | | | - Ki-Jong Rhee
- Department of Biomedical Laboratory Science, College of Health Sciences, Yonsei University, Wonju, Korea
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7
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Risbud M, Bhonde M, Bhonde R. Chitosan-Polyvinyl Pyrrolidone Hydrogel does Not Activate Macrophages: Potentials for Transplantation Applications. Cell Transplant 2017. [DOI: 10.3727/000000001783986828] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Makarand Risbud
- Tissue Engineering and Banking Laboratory, National Centre for Cell Science, Ganeshkhind, Pune 411 007, India
| | - Mandar Bhonde
- Tissue Engineering and Banking Laboratory, National Centre for Cell Science, Ganeshkhind, Pune 411 007, India
| | - Ramesh Bhonde
- Tissue Engineering and Banking Laboratory, National Centre for Cell Science, Ganeshkhind, Pune 411 007, India
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8
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Lock AM, Gao R, Naot D, Coleman B, Cornish J, Musson DS. Induction of immune gene expression and inflammatory mediator release by commonly used surgical suture materials: an experimental in vitro study. Patient Saf Surg 2017; 11:16. [PMID: 28580016 PMCID: PMC5452533 DOI: 10.1186/s13037-017-0132-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 05/22/2017] [Indexed: 12/23/2022] Open
Abstract
Background Surgeons have a range of materials to choose from to complete wound closure, yet surprisingly very little is still known about the body’s immune response to the suture materials in current use. The growing literature of adverse suture material reactions provided the objective of this study, to use in vitro assays to quantify levels of inflammation produced by seven commonly used suture materials in surgical procedures. Methods Human monocyte/macrophage THP-1 cells were exposed to suture materials for 1, 3 and 5 days. Gene expression and protein secretion of six inflammatory cytokines and two cell surface markers were assessed using qPCR and ELISA respectively, with LPS exposure providing a positive control. Furthermore, a IL-1β/IL-1RA marker ratio was assessed to determine the balance between pro-/anti-inflammatory expression. Results The findings from our in vitro study suggest that four commonly used suture materials cause upregulation of pro-inflammatory markers indicative of an early foreign body reaction, with no balance from anti-inflammatory markers. Conclusions As prolonged early pro-inflammation is known to produce delayed wound healing responses, the knowledge produced from this study has potential to improve informed surgical decision making and patient safety. This work has the capability to reduce suture-related adverse immune reactions, and therefore positively affect patient outcomes.
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Affiliation(s)
- Alistair M Lock
- Department of Medicine, University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand
| | - Ryan Gao
- Department of Medicine, University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand
| | - Dorit Naot
- Department of Medicine, University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand
| | - Brendan Coleman
- Department of Orthopaedics, Middlemore Hospital, Private Bag 93311, Auckland, New Zealand
| | - Jillian Cornish
- Department of Medicine, University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand
| | - David S Musson
- Department of Medicine, University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand
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Kweon H, Jo YY, Seok H, Kim SG, Chae WS, Sapru S, Kundu SC, Kim DW, Park NR, Che X, Choi JY. In vivo bone regeneration ability of different layers of natural silk cocoon processed using an eco-friendly method. Macromol Res 2017. [DOI: 10.1007/s13233-017-5085-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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10
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Dhom J, Bloes DA, Peschel A, Hofmann UK. Bacterial adhesion to suture material in a contaminated wound model: Comparison of monofilament, braided, and barbed sutures. J Orthop Res 2017; 35:925-933. [PMID: 27208547 DOI: 10.1002/jor.23305] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 05/11/2016] [Indexed: 02/04/2023]
Abstract
Contaminated suture material plays an important role in the physiopathology of surgical site infections. Recently, suture material has been developed characterized by barbs projecting from a monofilament base. Claimed advantages for barbed sutures are a shortened wound closure time and reduced maximum wound tension. It has also been suggested that these sutures would be advantageous microbiologically. The aim of this study was to test the microbiological characteristics of the barbed Quill in comparison to the monofilament Ethilon II and the braided sutures Vicryl and triclosan-coated Vicryl Plus. In our study, sutures were cultivated on color-change agar with Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecium, Escherichia coli, and Pseudomonas aeruginosa and the halo size was measured. In a second study arm with longer cultivation bacterial growth was followed by antibiotic treatment. Ethilon II and Quill showed good comparable results, whereas large halos were found around Vicryl. Vicryl Plus results depended on triclosan sensitivity. After longer bacterial cultivation and antibiotic treatment, halos were up to 3.6 times smaller on Quill than on Vicryl (p < 0.001), but 1.4 times larger than on Ethilon II (p < 0.001) regarding S. aureus. Confocal microscopy analysis showed bacterial colonization between the braided filaments on Vicryl and beneath the barbs on Quill. From a microbiological perspective, barbed sutures can be recommended in aseptic surgery, but should only be used carefully in septic surgery. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:925-933, 2017.
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Affiliation(s)
- Jonas Dhom
- Medical Faculty of the University of Tübingen, D-72076 Tübingen, Germany
| | - Dominik A Bloes
- Cellular and Molecular Microbiology Division, Interfaculty Institute of Microbiology and Infection Medicine, University of Tübingen, D-72076 Tübingen, Germany
- German Center for Infection Research, Partner site Tübingen, D-72076 Tübingen, Germany
| | - Andreas Peschel
- Cellular and Molecular Microbiology Division, Interfaculty Institute of Microbiology and Infection Medicine, University of Tübingen, D-72076 Tübingen, Germany
- German Center for Infection Research, Partner site Tübingen, D-72076 Tübingen, Germany
| | - Ulf K Hofmann
- Department of Orthopaedic Surgery, University Hospital of Tübingen, D-72076 Tübingen, Germany
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Arkhipova AY, Nosenko MA, Malyuchenko NV, Zvartsev RV, Moisenovich AM, Zhdanova AS, Vasil'eva TV, Gorshkova EA, Agapov II, Drutskaya MS, Nedospasov SA, Moisenovich MM. Effects of Fibroin Microcarriers on Inflammation and Regeneration of Deep Skin Wounds in Mice. BIOCHEMISTRY (MOSCOW) 2017; 81:1251-1260. [PMID: 27914451 DOI: 10.1134/s0006297916110031] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The process of tissue regeneration following damage takes place with direct participation of the immune system. The use of biomaterials as scaffolds to facilitate healing of skin wounds is a new and interesting area of regenerative medicine and biomedical research. In many ways, the regenerative potential of biological material is related to its ability to modulate the inflammatory response. At the same time, all foreign materials, once implanted into a living tissue, to varying degree cause an immune reaction. The modern approach to the development of bioengineered structures for applications in regenerative medicine should be directed toward using the properties of the inflammatory response that improve healing, but do not lead to negative chronic manifestations. In this work, we studied the effect of microcarriers comprised of either fibroin or fibroin supplemented with gelatin on the dynamics of the healing, as well as inflammation, during regeneration of deep skin wounds in mice. We found that subcutaneous administration of microcarriers to the wound area resulted in uniform contraction of the wounds in mice in our experimental model, and microcarrier particles induced the infiltration of immune cells. This was associated with increased expression of proinflammatory cytokines TNF, IL-6, IL-1β, and chemokines CXCL1 and CXCL2, which contributed to full functional recovery of the injured area and the absence of fibrosis as compared to the control group.
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Affiliation(s)
- A Y Arkhipova
- Lomonosov Moscow State University, Biological Faculty, Moscow, 119991, Russia.
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Triclosan-containing sutures versus ordinary sutures for reducing surgical site infections in children: a double-blind, randomised controlled trial. THE LANCET. INFECTIOUS DISEASES 2017; 17:50-57. [DOI: 10.1016/s1473-3099(16)30373-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 07/19/2016] [Accepted: 07/26/2016] [Indexed: 01/27/2023]
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13
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Guo J, Pan LH, Li YX, Yang XD, Li LQ, Zhang CY, Zhong JH. Efficacy of triclosan-coated sutures for reducing risk of surgical site infection in adults: a meta-analysis of randomized clinical trials. J Surg Res 2016; 201:105-17. [PMID: 26850191 DOI: 10.1016/j.jss.2015.10.015] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Revised: 09/19/2015] [Accepted: 10/07/2015] [Indexed: 01/27/2023]
Abstract
BACKGROUND Surgical site infection (SSI) is the third most frequent type of nosocomial infections. Triclosan-coated sutures are often used to reduce the risk of SSI, but studies examining this have given conflicting results. Therefore, this meta-analysis was performed to assess the efficacy of triclosan-coated sutures for reducing risk of SSI in adults. METHODS PubMed, EMBASE, Google Scholar, and ClinicalTrials.gov were searched to identify randomized clinical trials evaluating triclosan-coated sutures for preventing SSI on patients 18 y or older. RESULTS Thirteen randomized clinical trials involving 5256 participants were included. Triclosan-coated sutures were associated with lower risk of SSI than uncoated sutures across all surgeries (risk ratio [RR] 0.76, 95% confidence interval [CI] 0.65-0.88, P < 0.001). Similar proportions of patients experienced wound dehiscence with either type of suture (RR 0.97, 95% CI 0.49-1.89, P = 0.92). Subgroup analysis showed lower risk of SSI with triclosan-coated sutures in abdominal surgeries (RR 0.70, 95% CI 0.50-0.99, P = 0.04) and group with prophylactic antibiotic (RR 0.79, 95% CI 0.63-0.99, P = 0.04). However, such risk reduction was not observed in cardiac surgeries, breast surgeries, or group without prophylactic antibiotic. CONCLUSIONS Triclosan-coated sutures can decrease the incidence of SSI in abdominal surgeries and might not interfere with wound healing process. Nevertheless, further studies are needed to examine whether triclosan-coated sutures are effective at preventing SSI in non-abdominal surgeries and to further study the interaction of antibiotic prophylaxis with triclosan-coated sutures.
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Affiliation(s)
- Jiao Guo
- Experimental Department, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, PR China
| | - Ling-Hui Pan
- Anesthesia Department, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, PR China
| | - Yun-Xi Li
- Cancer Registry Department, People's Hospital of Fusui County, Fusui, PR China
| | - Xiang-Di Yang
- Experimental Department, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, PR China
| | - Le-Qun Li
- Hepatobiliary Surgery Department, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, PR China
| | - Chun-Yan Zhang
- Experimental Department, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, PR China.
| | - Jian-Hong Zhong
- Hepatobiliary Surgery Department, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, PR China.
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14
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George DA, Gant V, Haddad FS. The management of periprosthetic infections in the future: a review of new forms of treatment. Bone Joint J 2015; 97-B:1162-9. [PMID: 26330580 DOI: 10.1302/0301-620x.97b9.35295] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The number of arthroplasties being undertaken is expected to grow year on year, and periprosthetic joint infections will be an increasing socioeconomic burden. The challenge to prevent and eradicate these infections has resulted in the emergence of several new strategies, which are discussed in this review. Cite this article: Bone Joint J 2015;97-B:1162-9.
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Affiliation(s)
- D A George
- University College London Hospitals, 235 Euston Road, London, NW1 2BU, UK
| | - V Gant
- University College London Hospitals, 235 Euston Road, London, NW1 2BU, UK
| | - F S Haddad
- University College London Hospitals, 235 Euston Road, London, NW1 2BU, UK
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15
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Jung KH, Oh SJ, Choi KK, Kim SM, Choi MG, Lee JH, Noh JH, Sohn TS, Bae JM, Kim S. Effect of triclosan-coated sutures on surgical site infection after gastric cancer surgery via midline laparotomy. Ann Surg Treat Res 2014; 87:311-8. [PMID: 25485239 PMCID: PMC4255552 DOI: 10.4174/astr.2014.87.6.311] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 05/27/2014] [Accepted: 07/03/2014] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Surgical site infection (SSI) after open abdominal surgery is still a frequently reported nosocomial infection. To reduce the incidence of SSI, triclosan-coated sutures with antiseptic activity (Vicryl Plus) were developed. The aim of this study was to analyze the effect of Vicryl Plus on SSI after gastric cancer surgery via midline laparotomy. METHODS A total of 916 patients who underwent gastric cancer surgery at Samsung Medical Center between December 2009 and September 2011 were prospectively collected. We examined the occurrence of SSI (primary endpoint), assessments of wound healing (secondary endpoint). They were evaluated postoperatively on days 3, 7, and 30. RESULTS Of the 916 patients, 122 were excluded postoperatively by screening (out of the study protocol, adverse events, etc.). The remaining 794 patients were enrolled and monitored postoperatively. The cumulative SSI incidence was 11 cases (1.39%; 95% confidence interval [CI], 0.77-2.50) on day 30. Seromas were most frequently detected in wound healing assessments, with a cumulative incidence of 147 cases (18.51%; 95% CI, 15.98-21.39) on day 30. CONCLUSION The use of triclosan-coated sutures (Vicryl Plus) for abdominal wall closure can reduce the number of SSIs in gastric cancer surgery.
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Affiliation(s)
- Kuk Hyun Jung
- Department of Surgery, Bundang Jesaeng Hospital, Seongnam, Korea
| | - Seung Jong Oh
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kang Kook Choi
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Su Mi Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Min Gew Choi
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jun Ho Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Hyung Noh
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae Sung Sohn
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Moon Bae
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Bhattacharjee M, Schultz-Thater E, Trella E, Miot S, Das S, Loparic M, Ray AR, Martin I, Spagnoli GC, Ghosh S. The role of 3D structure and protein conformation on the innate and adaptive immune responses to silk-based biomaterials. Biomaterials 2013; 34:8161-71. [DOI: 10.1016/j.biomaterials.2013.07.018] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Accepted: 07/03/2013] [Indexed: 12/12/2022]
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Alberti A, Fuochi P, Guerra M, Macciantelli D, Torri G, Valerio A, Vismara E. Radical-based grafting of GMA on sutures of different nature. Org Biomol Chem 2011; 9:3199-204. [DOI: 10.1039/c0ob01196g] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Zamiri P, Kuang Y, Sharma U, Ng TF, Busold RH, Rago AP, Core LA, Palasis M. The biocompatibility of rapidly degrading polymeric stents in porcine carotid arteries. Biomaterials 2010; 31:7847-55. [PMID: 20696471 DOI: 10.1016/j.biomaterials.2010.06.057] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Accepted: 06/28/2010] [Indexed: 11/19/2022]
Abstract
The goal of this study was to evaluate the biocompatibility of materials for use in fully bioabsorbable vascular stents. 10:90 poly(L-lactic-co-glycolic acid) (10:90 L-PLGA), 85:15 poly(L-lactic-co-glycolic acid) (85:15 L-PLGA), polydioxanone (PDO), and poly-L-lactic acid (L-PLA) polymers were chosen as materials. Polymeric fibers were woven into a braided structure with a mass equivalent to or greater than that expected for a vascular stent, secured to balloon-expandable bare metal stents and implanted into porcine carotid arteries. The in vivo response was analyzed at 30 and 90 days by angiography, histopathology, and histomorphometry. All vessels were patent at 30 and 90 days. Injury score and neointima formation was mild for all samples. The faster-degrading 10:90 L-PLGA had the highest inflammatory response at 30 days, but was completely absorbed with minimal inflammation and neointimal formation at 90 days. PDO showed signs of partial absorption at 90 days, while 85:15 L-PLGA and L-PLA demonstrated minimal absorption at 30 and 90 days. The inflammatory response to these three groups was similar over the experimental period. Using a robust materials-testing platform, we demonstrated long-term patency and intravascular biocompatibility of bioabsorbable polymers with varying rates of resorption. The data point to biocompatibility of a polymeric stent in the vascular space that is fully absorbable in less than a year.
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Affiliation(s)
- P Zamiri
- Arsenal Medical, Inc., 480 Arsenal Street, Watertown, MA 02472, USA.
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Smith MJ, Smith DC, Bowlin GL, White KL. Modulation of murine innate and acquired immune responses following in vitro exposure to electrospun blends of collagen and polydioxanone. J Biomed Mater Res A 2010; 93:793-806. [PMID: 19653305 DOI: 10.1002/jbm.a.32579] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
In light of cell sourcing issues and the lack of a bioreactor comparable to the body, many in the field of tissue engineering have focused their efforts on designing biomaterials capable of in situ regeneration. The theory is that, by using the body as both the bioreactor and the source for cell infiltration, scaffolds composed of bioresorbable materials can be remodeled into native tissue. Thus, research into the effects of such materials on the host immune response is increasingly important. This study applies an immunotoxicological approach to evaluate the effects of electrospun blends of polydioxanone (PDO) and collagen type I on murine innate and acquired immune responses. Results indicated that these materials had few effects on innate immune responses, yet they produced significant immunomodulatory effects in multiple endpoints evaluating both branches of acquired immunity (i.e., cell-mediated and humoral immunity). Specifically, collagen content appeared to be responsible for suppression of cell-mediated immunity, while blends of PDO and collagen appeared to be more suppressive of antibody-forming cell responses than either PDO or collagen alone. These results demonstrate the importance of completing evaluations into the immunotoxicological effects of biomaterials, and they suggest that such testing should become a primary focus when evaluating a material's potential foruse in tissue engineering applications.
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Affiliation(s)
- Matthew J Smith
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, Virginia 23284
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Hakimi O, Gheysens T, Vollrath F, Grahn MF, Knight DP, Vadgama P. Modulation of cell growth on exposure to silkworm and spider silk fibers. J Biomed Mater Res A 2010; 92:1366-72. [PMID: 19353564 DOI: 10.1002/jbm.a.32462] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Recent years have seen an increased interest in the use of natural and modified silks for tissue engineering. Despite longstanding concerns regarding the biocompatibility of silk sutures, only a few studies have been carried out to investigate the biocompatibility of natural silk fibers. Here, we report an in vitro assessment of the effect of nonmodified, degummed silks on cells. We describe the effects of degummed silk fibers as well as extracted sericin on cell metabolism and proliferation. Endothelial cells directly exposed to native degummed Bombyx mori and Antheraea pernyi silks showed lower rates of proliferation and metabolism than nonexposed cells. A similar but milder effect was observed for cells in direct contact with Nephila edulis egg sack fibers. Sericin and silk-conditioned medium had no negative effect on cell proliferation except in medium supplemented with 5% bovine serum prior to conditioning with A. pernyi silk. The toxicity of A. pernyi was negligible after thorough enzymatic treatment of the fibers with trypsin. It is, therefore, proposed that A. pernyi silk contain one or more cytotoxic components, which need to be removed prior to medical use.
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Affiliation(s)
- Osnat Hakimi
- IRC in Biomedical Materials, Queen Mary, University of London, London, United Kingdom.
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Abstract
Silk from the Bombyx mori silkworm is a protein-based fiber. Bombyx mori silk fibroin (SF) is one of the most important candidates for biomedical porous material based on its superior machinability, biocompatibility, biodegradation, bioresorbability, and so on. In this paper, we have reviewed the key features of SF. Moreover we have focused on the morphous, technical processing, and biocompatibility of SF porous materials, followed by the application research. Finally, we provide a perspective the potential and problems of SF porous materials.
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Affiliation(s)
| | | | - Mingzhong Li
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +86-512-6706-1150; Fax: +86-512-6724-6786
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Justinger C, Moussavian MR, Schlueter C, Kopp B, Kollmar O, Schilling MK. Antibacterial [corrected] coating of abdominal closure sutures and wound infection. Surgery 2009; 145:330-4. [PMID: 19231586 DOI: 10.1016/j.surg.2008.11.007] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2008] [Accepted: 11/15/2008] [Indexed: 01/03/2023]
Abstract
BACKGROUND Poor wound healing and the development of infection in incisional wounds continue to be among the most common complications of open abdominal surgery. Various bacteria may contaminate not only the tissue in the operative wound, but also the actual suture material. To prevent the contamination of suture material in surgical wounds, triclosan-coated polyglactin 910 suture materials with antibacterial activity (Vicryl plus) was developed. The aim of this study was to ascertain if the use of Vicryl plus reduced the number of wound infections after midline laparotomy comparing to polydioxanon suture (PDS II). METHODS We performed 2,088 operations in our department between October 2004 and September 2006 via midline incision. In the first time period (TP1), a PDS II loop suture was used. In the second time period (TP2), we used Vicryl plus. All variables were recorded prospectively in a database. The primary outcome was the number of wound infections. Risk factors for poor wound healing were collected prospectively to compare the 2 groups. RESULTS Using a PDS loop suture for abdominal wall closure in TP1, 10.8% of patients with wound infections were detected. The number of patients with wound infections decreased in TP2 using Vicryl plus for abdominal wall closure to 4.9% (P < .001) despite no other changes in protocols of patient care. Other risk factors for the development of site infections were comparable in the 2 groups. CONCLUSION The use of antibiotic-coated loop suture for abdominal wall closure can decrease the number wound infections after abdominal surgery.
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Affiliation(s)
- Christoph Justinger
- Department of General, Visceral, Vascular, and Pediatric Surgery, University of Saarland, Homburg/Saar, Germany
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23
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Smith MJ, White KL, Smith DC, Bowlin GL. In vitro evaluations of innate and acquired immune responses to electrospun polydioxanone–elastin blends. Biomaterials 2009; 30:149-59. [DOI: 10.1016/j.biomaterials.2008.09.019] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2008] [Accepted: 09/02/2008] [Indexed: 11/27/2022]
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Edmiston Jr CE, Krepel CJ, Wilson PJ, Grahn BF, Sadenwasser PJ, Welter DL, Seabrook GR. Reducing the risk of surgical site infections: embracing basic and innovative risk reduction strategies. ACTA ACUST UNITED AC 2008. [DOI: 10.1071/hi08033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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25
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Gellynck K, Verdonk P, Forsyth R, Almqvist KF, Van Nimmen E, Gheysens T, Mertens J, Van Langenhove L, Kiekens P, Verbruggen G. Biocompatibility and biodegradability of spider egg sac silk. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2008; 19:2963-70. [PMID: 18360800 DOI: 10.1007/s10856-007-3330-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2006] [Accepted: 11/19/2007] [Indexed: 05/11/2023]
Abstract
Spider egg sac silk (SpESS) were enzymatically cleaned and their biodegradation in vivo and in vitro, as well as their biocompatibility were studied. Proteinase K treatment diminished the tenacity and the strain of the SpESS fibers in proportion to the enzyme concentration. Fibers treated with trypsin were not significantly affected. Tensile properties of Vicryl, SpESS and of silkworm (Bombyx mori) silk fibers (SWS) were measured after incubation in phosphate buffered saline (PBS) at 37 degrees C up to 12 weeks. Biodegradation of SpESS and SWS was insignificant compared to Vicryl. Five milligram SpESS fibers from laboratory grown spiders (Araneus diadematus) were treated with proteinases before sterilization and subcutaneously implanted in Wistar rats. After 1, 4 and 7 weeks the immunological reaction was compared to untreated SpESS and polyglactin (Vicryl) control samples. SpESS samples treated with trypsin only or in combination with a Proteinase K treatment induced less inflammatory reactions than untreated silk fibers. The enzymatical cleaning could diminish the tensile properties, but enhanced the biocompatibility of the SpESS fibers rendering them appropriate for use in biomaterial application where the slow biodegradability is an advantage.
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Affiliation(s)
- Kris Gellynck
- Faculty of Applied Sciences, Department of Textiles, Ghent University, Technologiepark 9, 9052 Zwijnaarde, Belgium.
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Andrade MGS, Weissman R, Reis SRA. Tissue reaction and surface morphology of absorbable sutures after in vivo exposure. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2006; 17:949-61. [PMID: 16977393 DOI: 10.1007/s10856-006-0185-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2005] [Accepted: 10/21/2005] [Indexed: 05/11/2023]
Abstract
Tissue reaction to suture materials depends mainly on how the polymer they are composed of interacts with the tissues. There are few in vivo studies evaluating the suture material modifications resulting from its interaction with tissues. This paper aimed to study rat subcutaneous tissue reaction to irradiated polyglactin 910, polydioxanone, poliglecaprone 25 and chromic gut and its correlation with the ultra-structural alterations the materials undergo. The histological alterations were studied on the 1st, 2nd, 3rd, 7th and 14th day after suture implantations. In these periods, the materials were removed from the tissues and their surfaces were analyzed by scanning electron microscopy. Irradiated polyglactin 910 stimulated the formation of multinucleated giant cells and its filaments underwent cleavage and dissolution. In potydioxanone, a few inflammatory cells and scar fibrosis was observed, and triangular cracks appeared on its surface. Around the poliglecaprone 25, a diffused infiltration of a few mononuclear cells and fibrosis was recorded and formation of craters was observed on its surface. Chromic gut induced necrosis and granulation tissue and underwent dissolution in the tissues during the studied periods. In this study, it was observed that suture materials induced differentiated tissue reactions and morphologic surface changes, suggesting that indications should be individualized.
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Affiliation(s)
- Miguel G S Andrade
- Post-graduation Program on Oral and Maxillofacial Surgery and Traumatology, Catholic University of Rio Grande do Sul, Brazil
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Edmiston CE, Seabrook GR, Goheen MP, Krepel CJ, Johnson CP, Lewis BD, Brown KR, Towne JB. Bacterial adherence to surgical sutures: can antibacterial-coated sutures reduce the risk of microbial contamination? J Am Coll Surg 2006; 203:481-9. [PMID: 17000391 DOI: 10.1016/j.jamcollsurg.2006.06.026] [Citation(s) in RCA: 142] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2006] [Revised: 06/25/2006] [Accepted: 06/27/2006] [Indexed: 12/12/2022]
Abstract
BACKGROUND Surgical site infections are associated with severe morbidity and mortality. The role of surgical sutures in the etiology of surgical site infection has been the objective of discussion for decades. This study used a standardized in vitro microbiologic model to assess bacterial adherence and the antibacterial activity of a triclosan-coated polyglactin 910 (braided) suture against selected Gram-positive and Gram-negative clinical isolates that may infect surgical wounds. STUDY DESIGN Standardized cultures (2.0 log(10) colony forming units/mL and 5.0 log(10) colony forming units/mL of three clinical strains, Staphyllococcus aureus (methicillin-resistant S aureus [MRSA]), S epidermidis (biofilm-positive) and Escherichia coli (extended-spectrum beta-lactamase [ESBL]-producer) were inoculated to triclosan-coated and noncoated polyglactin 910 sutures to evaluate comparative adherence of bacterial isolates to the antibacterial coated and noncoated surgical sutures; to assess the impact of serum proteins (bovine serum albumin) on antibacterial activity of triclosan-coated suture; and to document the duration of antibacterial activity of the triclosan-coated material. Selected suture samples were prepared for scanning electron microscopy to demonstrate bacterial adherence. RESULTS Substantial (p < 0.01) reductions in both Gram-positive and Gram-negative bacterial adherence were observed on triclosan-coated sutures compared with noncoated material. Pretreatment of surgical sutures with 20% BSA did not diminish antibacterial activity of the triclosan-coated braided device compared with noncoated suture (p < 0.01), and antibacterial activity was documented to persist for at least 96 hours compared with controls (p < 0.01). CONCLUSIONS The in vitro model demonstrated a considerable reduction (p < 0.01) in Gram-positive and Gram-negative bacterial adherence to a triclosan-coated braided suture, which was associated with decreased microbial viability (p < 0.001). Because bacterial contamination of suture material within a surgical wound may increase the virulence of a surgical site infection, treating the suture with triclosan provides an effective strategy for reducing perioperative surgical morbidity.
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Affiliation(s)
- Charles E Edmiston
- Division of Vascular Surgery, Department of Surgery, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA
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Abstract
Silk fibers have potential biomedical applications beyond their traditional use as sutures. The physical properties of silk fibers and films make it a promising candidate for tissue engineering scaffold applications, particularly where high mechanical loads or tensile forces are applied or in cases where low rates of degradation are desirable. A critical issue for biomaterial scaffolds is biocompatibility. The direct inflammatory potential of intact silk fibers as well as extracts was studied in an in vitro system. The results indicate that silk fibers are largely immunologically inert in short- and long-term culture with RAW 264.7 murine macrophage cells while insoluble fibroin particles induced significant TNF release. Soluble sericin proteins extracted from native silk fibers did not induce significant macrophage activation. While sericin did not activate macrophages by itself, it demonstrated a synergistic effect with bacterial lipopolysaccharide. The low level of inflammatory potential of silk fibers makes them promising candidates in future biomedical applications.
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Affiliation(s)
- Bruce Panilaitis
- Department of Biomedical Engineering, Tufts University, Bioengineering Center, 4 Colby Street, Medford, Massachusetts, MA 02155, USA
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Altman GH, Diaz F, Jakuba C, Calabro T, Horan RL, Chen J, Lu H, Richmond J, Kaplan DL. Silk-based biomaterials. Biomaterials 2003; 24:401-16. [PMID: 12423595 DOI: 10.1016/s0142-9612(02)00353-8] [Citation(s) in RCA: 2028] [Impact Index Per Article: 96.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Silk from the silkworm, Bombyx mori, has been used as biomedical suture material for centuries. The unique mechanical properties of these fibers provided important clinical repair options for many applications. During the past 20 years, some biocompatibility problems have been reported for silkworm silk; however, contamination from residual sericin (glue-like proteins) was the likely cause. More recent studies with well-defined silkworm silk fibers and films suggest that the core silk fibroin fibers exhibit comparable biocompatibility in vitro and in vivo with other commonly used biomaterials such as polylactic acid and collagen. Furthermore, the unique mechanical properties of the silk fibers, the diversity of side chain chemistries for 'decoration' with growth and adhesion factors, and the ability to genetically tailor the protein provide additional rationale for the exploration of this family of fibrous proteins for biomaterial applications. For example, in designing scaffolds for tissue engineering these properties are particularly relevant and recent results with bone and ligament formation in vitro support the potential role for this biomaterial in future applications. To date, studies with silks to address biomaterial and matrix scaffold needs have focused on silkworm silk. With the diversity of silk-like fibrous proteins from spiders and insects, a range of native or bioengineered variants can be expected for application to a diverse set of clinical needs.
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Affiliation(s)
- Gregory H Altman
- Department of Chemical and Biological Engineering, Bioengineering Center, Tufts University, 4 Colby Street, Medford, MA 02155, USA
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Risbud MV, Hambir S, Jog J, Bhonde R. Biocompatibility assessment of polytetrafluoroethylene/wollastonite composites using endothelial cells and macrophages. JOURNAL OF BIOMATERIALS SCIENCE. POLYMER EDITION 2002; 12:1177-89. [PMID: 11853385 DOI: 10.1163/156856201753395734] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The aim of the study was to prepare a composite of polytetrafluoroethylene/wollastonite (PTFE/W) and evaluate its biocompatibility with endothelial cells. A composite of PTFE with wollastonite in the proportion 90/10 w/w was prepared. The dynamic storage modulus of composite is found to increase from 260 to about 453 MPa at room temperature while a marginal increase is observed in the compressive modulus. Higher values of storage modulus of PTFE/W relative to pristine PTFE over a range of temperature indicated the contribution of wollastonite in improving the rigidity of PTFE. Electron microscopic visualization of composite surface indicates suitable morphology for cell growth with the cross-section showing no evidence of bonding between PTFE and wollastonite. The water contact angle of the composite indicates increased hydrophilicity over native PTFE due to the presence of wollastonite. A direct-contact test did not show any deleterious effects on endothelial cell morphology and viability, indicating its compatibility. Leached-out products (LOP) from the composite were determined to be non-toxic as tested by tetrazolium (MTT) and Neutral red uptake (NRU) assays. Mouse peritoneal macrophages cultured in the presence of the composites did not show upregulation of activation markers such as CD11b/CD 18 (Mac-1), CD45, CD 14, and CD86 (B7.2) in comparison to macrophages cultured in contact with PTFE alone, indicating its non-activating nature. LOP did not induce proliferation of mouse splenic lymphocytes suggesting its immuno-tolerance. In static incubation assay contact with composite did not lead to hemolysis thus exhibiting preliminary hemocompatibility of the material. Suitable physico-chemical properties and well tolerance by endothelial cells and macrophages make this composite a prospective biomaterial. One could foresee the applications of this composite in areas where materials need to possess high rigidity and are subject to elevated temperatures.
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Affiliation(s)
- M V Risbud
- Tissue Engineering and Banking Laboratory, National Centre for Cell Science, Ganeshkhind, Pune, India.
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Risbud MV, Bhonde RR. Polyamide 6 composite membranes: properties and in vitro biocompatibility evaluation. JOURNAL OF BIOMATERIALS SCIENCE. POLYMER EDITION 2002; 12:125-36. [PMID: 11334186 DOI: 10.1163/156856201744498] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The aim of the present study was to develop polyamide 6 membrane blended with gelatin and chondroitin sulfate using the phase precipitation method and evaluate its in vitro biocompatibility. Morphology of membranes was studied by laser scanning confocal microscopy which allowed the nondestructive visualization of internal bulk morphology of membranes. Membranes exhibited porous morphology with pores spanning across the membrane width with interconnections at various depths. Membranes showed adequate mechanical properties with tensile strengths of 20.10 +/- 0.64 MPa, % strain of 3.01+/-0.07, and modulus of 1082.50+/-23.50 MPa. In vitro biocompatibility of membranes by direct contact test did not show degenerative effects on NIH3T3 cells and also its leach-out products (LOP), as determined by tetrazolium (MTT) and neutral red uptake (NRU) assay. Mouse peritoneal macrophage cultured in contact with membranes and PTFE control showed comparable expression of activation markers such as CD11b/CD18, CD45, CD14, and CD86 suggesting the membranes' non-activating nature. Membrane LOP did not induce excessive proliferation of mouse splenocytes suggesting its non-antigenic nature. Preliminary blood compatibility of membranes was observed with no detectable hemolysis in static incubation assay. Taken collectively, the present data demonstrate that polyamide 6 composite membranes are biocompatible and prospective candidates for tissue engineering applications.
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Affiliation(s)
- M V Risbud
- Tissue Engineering and Banking Laboratory, National Centre for Cell Science, Ganeshkhind, Pune, India.
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Foschi D, Corsi F, Cellerino P, Rizzi A, Morandi E, Trabucchi E. Angiogenic effects of suture biomaterials. An experimental study in rats. Eur Surg Res 2001; 33:16-20. [PMID: 11340267 DOI: 10.1159/000049687] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Angiogenesis is a limiting step of inflammation and wound healing. Although laboratory tests for the evaluation of the angiogenetic effects of biomaterials are available, no investigations have been performed. In this study we examine the angiogenetic effect of suture biomaterials in the rat mesenteric window model. Absolute controls had laparotomy only, controls had mesenteric window wounding, test groups had the insertion of either a thread of collagen, polyglactin 910, polyglycolic acid salt, silk or of a titanium clip. We considered the percentage area of the mesenteric window covered by neovessels. After 7 days, negligible angiogenesis was found in absolute controls, significant angiogenesis in controls, collagen, polyglactin 910 and polyglycolic acid salt treated rats, without differences between treatments. A significant increase of angiogenesis in comparison to the control group was found in rats treated with silk and titanium. Ultramicroscopy of the neovessels showed specific changes of their architecture in titanium-treated rats. In conclusion, angiogenesis during wound healing is differently influenced by the suture material used. Silk and titanium stimulated angiogenesis in a different way.
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Affiliation(s)
- D Foschi
- First Department of Surgery, Institute of Biomedical Sciences 'L. Sacco' and Wound Healing Centre, University of Milan, Italy
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Risbud M, Saheb DN, Jog J, Bhonde R. Preparation, characterization and in vitro biocompatibility evaluation of poly(butylene terephthalate)/wollastonite composites. Biomaterials 2001; 22:1591-7. [PMID: 11374459 DOI: 10.1016/s0142-9612(00)00325-2] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The aim of the study was to prepare composites of poly(butylene terepthalate)/wollastonite (PBT/W), evaluate their properties and in vitro biocompatibility. Composites of PBT with wollastonite in two different proportions, viz. 70/30 (PW-30), 50/50 (PW-50) were prepared. The DSC studies indicate marginal changes in the melting behavior and enhanced crystallization in PBT/W composites. The mechanical properties of the composites such as tensile modulus shows remarkable improvement as a result of incorporation of wollastonite. SEM studies of fractured surfaces of impact samples showed no evidence of bonding between PBT and wollastonite. Water contact angle of PW30 and PW50 was 73.7 and 78.7, respectively. In vitro biocompatibility of PW-30 was evaluated as a representative composite. Direct cell contact test did not show deleterious effects on NIH3T3 fibroblast morphology and DNA integrity indicating its compatibility. Leach out products (LOP) of PW-30 were evaluated non-toxic as tested by MTT assay. Mouse peritoneal macrophages in contact with PW-30 showed comparable expression of CD 11b/18, CD45, CD14 and B7.2 to macrophages in contact with PTFE control indicating its non-activating nature. LOP did not induce proliferation of mouse splenic lymphocytes suggesting its immuno-tolerance. PW-30 also exhibited preliminary blood compatibility. These physical properties and biocompatibility of PBT/W composites show their suitability as potential biomaterials.
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Affiliation(s)
- M Risbud
- Tissue Engineering and Banking Laboratory, National Centre for Cell Science, Ganeshkhind, Pune, India
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Nkamgueu EM, Adnet JJ, Bernard J, Zierold K, Kilian L, Jallot E, Benhayoune H, Bonhomme P. In vitro effects of zirconia and alumina particles on human blood monocyte-derived macrophages: X-ray microanalysis and flow cytometric studies. JOURNAL OF BIOMEDICAL MATERIALS RESEARCH 2000; 52:587-94. [PMID: 11033540 DOI: 10.1002/1097-4636(20001215)52:4<587::aid-jbm2>3.0.co;2-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The cytocompatibility of two particulate bioceramics, zirconia and alumina, was studied using human blood monocytes driven to differentiate into mature macrophages with granulocyte macrophage-colony-stimulating factor. Changes in individual cell elemental composition, particularly sodium and potassium content, were assessed by X-ray microanalysis of ultrathin freeze-dried sections. Phagocytosis and respiratory burst of macrophages exposed to biomaterial for 7 days were analyzed under flow cytometry using uptake of fluorescent latex beads and 2'7'-dichlorofluorescien diacetate oxidation, respectively. Zirconia and alumina particles were found to decrease the intracellular potassium/sodium ratio (an index of cell vitality) significantly (p<.01) in 7-day-cultured macrophages compared to control cells cultured out of material. Phagocytosis of both ceramic particles by macrophages was followed by a concomitant decrease in cell phagocytic ability (27%) and a marked altered oxidative metabolism (>2 times reduced by zirconia and >5 times reduced by alumina). The present study clearly demonstrates that reduction of the phagocytic capacity of macrophages associated with altered oxidative metabolism caused by biomaterial particles is characterized by changes in intracellular elemental content. Thus, investigation of cellular homeostasis by electron probe microanalysis together with analysis of functional changes may improve estimation of biomaterial cytocompatibility.
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Affiliation(s)
- E M Nkamgueu
- Laboratoire d'Histologie, UFR Médecine, 51 rue Cognacq-Jay, 51095 Reims Cedex, France.
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Bernatchez SF, Atkinson MR, Parks PJ. Expression of intercellular adhesion molecule-1 on macrophages in vitro as a marker of activation. Biomaterials 1997; 18:1371-8. [PMID: 9363337 DOI: 10.1016/s0142-9612(97)00072-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Macrophage activation is a major component of wound healing. It also determines the extent of inflammatory reactions and the response of the body to implanted materials. We have previously shown, using an in vitro model, that the extent of spreading of macrophages on different materials is a marker of activation, and that a soluble inducer has a dose-response effect on the secretion of cytokines in the culture medium. This work investigates the expression of three different cell surface markers [macrophages MAC-1, MAC-3 and intercellular adhesion molecule-1 (ICAM-1)] on macrophages in vitro using confocal microscopy and shows that ICAM-1 is also a marker of macrophage activation in this model. We observed increased amounts of ICAM-1 on activated macrophages compared to unactivated macrophages, whereas MAC-1 and MAC-3 were either expressed constitutively or demonstrated no quantitative change in expression after activation under the same experimental conditions. We also tested the expression of ICAM-1 with various concentrations of soluble inducers (lipopolysaccharide, 0.001, 0.01, 0.1, 1 and 10 micrograms ml-1. S-27609, 0.1, 0.25, 0.5, 1, 2 and 3 micrograms ml-1 and on a sheet of polylactic acid alone or in combination with soluble inducers. All doses of soluble inducers induced the expression of ICAM-1 on cells grown in glass chamber slides. The induction was not dose related but seemed to work rather in an on-off manner. There was no effect of material on ICAM-1 expression on the cell surface when no soluble inducer was added. This was similar to cytokine secretion, which was not induced by our material alone. When either lipopolysaccharide or S-27609 was used in combination with the material, there was an increase in the average measured intensity of ICAM-1. In this in vitro model, ICAM-1 staining as measured by confocal microscopy is a marker for macrophage activation. Our results suggest that the extent of macrophage activation as measured by ICAM-1 and by cytokine secretion is more sensitive to soluble inducers than to the action of the flat sheet of polylactic acid.
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Affiliation(s)
- S F Bernatchez
- Center for Interfacial Engineering, University of Minnesota, Minneapolis 55455, USA
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Winet H, Bao JY. Comparative bone healing near eroding polylactide-polyglycolide implants of differing crystallinity in rabbit tibial bone chambers. JOURNAL OF BIOMATERIALS SCIENCE. POLYMER EDITION 1997; 8:517-32. [PMID: 9195331 DOI: 10.1163/156856297x00425] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Eroding poly(DL-lactide-co-glycolide) (PDLLG) washers and poly(L-lactide-co-glycolide) (PLLG) threads were observed chronically in vivo following loading in a bone chamber tibial implant (BCI). Images were recorded using intravital microscopy of the implanted rabbit. Erosion and bone healing, as represented by angiogenesis and osteogenesis, was determined from changes in projected area of observed polymer, vessels and bone, respectively. Erosion rates of the two polymers were significantly different. Healing adjacent to both polymers differed significantly from controls. Healing response to each polymer was also different, with the faster eroding PDLLG causing more deviation from normal osteogenesis and angiogenesis than did PLLG. It was speculated that the faster eroding polymer released macrophage-stimulating fragments earlier in the healing process, thus altering the normal macrophage-endothelial cell interaction which in turn affected angiogenesis-linked components of osteogenesis.
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Affiliation(s)
- H Winet
- J. Vernon Luck Sr. Orthopaedic Research Center, Orthopaedic Hospital, Los Angeles, CA 90007, USA
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