Seamless innovations: exploring the latest advancements in sutures
DOI:
https://doi.org/10.18203/2349-3933.ijam20243825Keywords:
Drug-eluting sutures, Incisions, Stem cell-seeded sutures, Suturing, Surgical zippersAbstract
In the realm of surgical medicine, sutures play a pivotal role in the closure of wounds and incisions, serving as a cornerstone technique for promoting efficient healing and minimizing infection risk. The art of suturing demands a surgeon's deft touch and precision, ensuring the seamless union of tissue edges while striving to mitigate the formation of conspicuous scars. Over the years, the landscape of sutures has evolved significantly, witnessing the advent of novel methodologies aimed at enhancing both the efficacy and efficiency of wound closure. This review article delves into these pioneering advancements in sutures that have emerged, ushering in a new era of medical innovation. Among these advancements, modified antimicrobial sutures have emerged as a promising development, arming threads with properties to combat infections at the site of wound closure. Drug-eluting sutures represent another remarkable breakthrough, where medications can be released gradually, offering therapeutic benefits during the healing process. Stem cell-seeded sutures have taken regenerative medicine to a new level, promoting tissue regeneration, and accelerating recovery. In the age of cutting-edge technology, "smart sutures" have become a reality, equipped with sensors and integrated electronics to monitor wound healing in real-time, providing crucial data to healthcare professionals. Surgical zippers offer a unique approach to wound closure, simplifying the process and reducing operating time. Collectively, these novel advancements in sutures demonstrates a remarkable capacity to reduce the incidence of infections, expedite the healing process, and enhance patient outcomes. Moreover, they hold the promise of revolutionizing the field of surgery by rendering procedures less invasive and more effective. However, it is important to note that each suture has its own set of advantages and disadvantages, and the selection of the most suitable suture will be contingent on factors such as the nature and location of the wound, as well as the surgeon's preferences and expertise. As we stand on the precipice of medical innovation, these new sutures underscore the ongoing quest to refine surgical practices and improve patient care, illuminating a path towards a brighter and more advanced future in the field of surgery.
Metrics
References
Lee JS, Lu Y, Baer GS, Markel MD, Murphy WL. Controllable protein delivery from coated surgical sutures. J Mat Chemist. 2010;20(40):8894-903.
Arora A, Aggarwal G, Chander J, Maman P, Nagpal M. Drug eluting sutures: A recent update ARTICLE INFO. J Appl Pharmaceut Sci. 2019;9:111-23.
Phan PT, Hoang TT, Thai MT, Low H, Davies J, Lovell NH, Do TN. Smart surgical sutures using soft artificial muscles. Scientific Rep. 2021;11(1):22420.
Dietel E, Wilke T. Stitch by stitch: medical aspects of polymers in surgical suture materials for chemistry education. in conference proceedings. new perspectives in science education. 2023. Available at: https://www.grandviewresearch.com. Accessed on 12 August 2024.
Hau HC. Digital thread and analytics model to improve quality controls in surgical stapler (doctoral dissertation, massachusetts institute of technology). Global surgical suture market report. Available at: https://www.fortunebusinessinsights.com/industry. Accessed on 21 August 2024.
Gokarneshan N. Review article new generation surgical sutures. Global J Otolaryngol. 2018;16:19080.
Dennis C, Sethu S, Nayak S, Mohan L, Morsi YY, Manivasagam G. Suture materials - Current and emerging trends. J Biomed Mater Res A. 2016;104(6):1544-59.
Li Y, Kumar KN, Dabkowski JM, Corrigan M, Scott RW, Nüsslein K, Tew GN. New bactericidal surgical suture coating. Langmuir. 2012;28(33):12134-9.
Obermeier A, Schneider J, Wehner S, Matl FD, Schieker M, von Eisenhart-Rothe R, Stemberger A, Burgkart R. Novel highly efficient coatings for anti-microbial surgical sutures using chlorhexidine in fatty acid slow-release carrier systems. PLoS One. 2014;9(7):101426.
Obermeier A, Schneider J, Föhr P, Wehner S, Kühn KD, Stemberger A, Schieker M, Burgkart R. In vitro evaluation of novel antimicrobial coatings for surgical sutures using octenidine. BMC Microbiol. 2015;15:186.
Dubas ST, Wacharanad S, Potiyaraj P. Tunning of the antimicrobial activity of surgical sutures coated with silver nanoparticles. Colloids Surf A Physicochem Eng Aspects. 2011;380:25–8.
Chaloupka K, Malam Y, Seifalian AM. Nanosilver as a new generation of nanoproduct in biomedical applications. Trends Biotechnol. 2010;28(11):580-8.
AJ Dart, CM Dart. 7.38 Suture Material: Conventional and Stimuli Responsive, Editor(s): Paul Ducheyne, Comprehensive Biomaterials II, Elsevier. 2017: 746-71.
Ho CH, Odermatt EK, Berndt I, Tiller JC. Long-term active antimicrobial coatings for surgical sutures based on silver nanoparticles and hyperbranched polylysine. J Biomater Sci Polym Ed. 2013;24(13):1589-600.
Zhang S, Liu X, Wang H, Peng J, Wong KK. Silver nanoparticle-coated suture effectively reduces inflammation and improves mechanical strength at intestinal anastomosis in mice. J Pediatr Surg. 2014;49(4):606-13.
De Simone S, Gallo AL, Paladini F, Sannino A, Pollini M. Development of silver nano-coatings on silk sutures as a novel approach against surgical infections. J Mater Sci Mater Med. 2014 Sep;25(9):2205-14. doi: 10.1007/s10856-014-5262-9. Epub 2014 Jul 6. PMID: 24997984.
Champeau M, Thomassin JM, Tassaing T, Jérôme C. Current manufacturing processes of drug-eluting sutures. Expert Opin Drug Deliv. 2017;14(11):1293-303.
Drug eluting sutures. Available at: https://www.katsanas.com/en/drug-eluting-sutures/ drug eluting sutures. Accessed on 17 March 2024.
Chen X, Hou D, Wang L, Zhang Q, Zou J, Sun G. Antibacterial Surgical Silk Sutures Using a High-Performance Slow-Release Carrier Coating System. ACS Appl Mater Interfaces. 2015;7(40):22394-403.
Rothenburger S, Spangler D, Bhende S, Burkley D. In vitro antimicrobial evaluation of Coated VICRYL. Plus, antibacterial suture (coated polyglactin 910 with triclosan) using zone of inhibition assays. Surg Infect. 2002;3(1):79-87.
Chen X, Hou D, Tang X, Wang L. Quantitative physical and handling characteristics of novel antibacterial braided silk suture materials. J Mech Behav Biomed Mater. 2015;50:160-70.
García-Vargas M, González-Chomón C, Magariños B, Concheiro A, Alvarez-Lorenzo C, Bucio E. Acrylic polymer-grafted polypropylene sutures for covalent immobilization or reversible adsorption of vancomycin. Int J Pharm. 2014;461(1-2):286-95.
Casalini T, Masi M, Perale G. Drug eluting sutures: a model for in vivo estimations. Int J Pharm. 2012;429(1-2):148-57.
Weldon CB, Tsui JH, Shankarappa SA, Nguyen VT, Ma M, Anderson DG, Kohane DS. Electrospun drug-eluting sutures for local anesthesia. J Control Release. 2012;161(3):903-9.
Lee JE, Park S, Park M, Kim MH, Park CG, Lee SH, Choi SY, Kim BH, Park HJ, Park JH, Heo CY, Choy YB. Surgical suture assembled with polymeric drug-delivery sheet for sustained, local pain relief. Acta Biomater. 2013;9(9):8318-27.
Morizumi S, Suematsu Y, Gon S, Shimizu T. Inhibition of neointimal hyperplasia with a novel tacrolimus-eluting suture. J Am Coll Cardiol. 2011;58(4):441-2.
Greenberg JA, Goldman RH. Barbed suture: a review of the technology and clinical uses in obstetrics and gynecology. Rev Obstet Gynec, 2013; 6(3–4):107.
Guyette JP, Fakharzadeh M, Burford EJ, Tao ZW, Pins GD, Rolle MW, Gaudette GR. A novel suture-based method for efficient transplantation of stem cells. J Biomed Mater Res A. 2013;101(3):809-18.
Horváthy DB, Vácz G, Szabó T, Renner K, Vajda K, Sándor B, Lacza Z. Absorption and tensility of bioactive sutures prepared for cell transplantation. Materials (Basel). 2013;6(2):544-50.
Guyette JP, Fakharzadeh M, Burford EJ, Tao ZW, Pins GD, Rolle MW, Gaudette GR. A novel suture-based method for efficient transplantation of stem cells. J Biomed Mater Res A. 2013;101:809–18.
Yao J, Korotkova T, Riboh J, Chong A, Chang J, Smith RL. Bioactive sutures for tendon repair: assessment of a method of delivering pluripotential embryonic cells. J Hand Surg Am. 2008;33(9):1558-64.
Yao J, Woon CY, Behn A, Korotkova T, Park DY, Gajendran V, Smith RL. The effect of suture coated with mesenchymal stem cells and bioactive substrate on tendon repair strength in a rat model. J Hand Surg Am. 2012;37(8):1639-45.
Georgiev-Hristov T, García-Arranz M, García-Gómez I, García-Cabezas MA, Trébol J, Vega-Clemente L, et al. Sutures enriched with adipose-derived stem cells decrease the local acute inflammation after tracheal anastomosis in a murine model. Eur J Cardiothorac Surg. 2012;42(3):40-7.
Casado JG, Blazquez R, Jorge I, Alvarez V, Gomez-Mauricio G, Ortega-Muñoz M, et al. Mesenchymal stem cell-coated sutures enhance collagen depositions in sutured tissues. Wound repair regens. 2014;22(2):256-64.
Le K. Virtual Textiles: Making Realistic Fabrics in 3D. AATCC Review. 2017;17(3):30–7.
Lendlein A, Kelch S. Shape-memory polymers. Angew Chem Int Ed Engl. 2002;41(12):2035-57.
Lambertz A, Vogels RR, Busch D, Schuster P, Jockenhövel S, Neumann UP, Klinge U, Klink CD. Laparotomy closure using an elastic suture: a promising approach. J Biomed Mater Res B Appl Biomater. 2015;103(2):417-23.
Dargaville TR, Farrugia BL, Broadbent JA, Pace S, Upton Z, Voelcker NH. Sensors and imaging for wound healing: a review. Biosens Bioelectron. 2013;41:30-42.
Tao ZW, Favreau JT, Guyette JP, Hansen KJ, Lessard J, Burford E, Pins GD, Gaudette GR. Delivering stem cells to the healthy heart on biological sutures: effects on regional mechanical function. J Tissue Eng Regen Med. 2017;11(1):220-30.
Kim DH, Wang S, Keum H, Ghaffari R, Kim YS, Tao H, et al. Thin, flexible sensors and actuators as 'instrumented' surgical sutures for targeted wound monitoring and therapy. Small. 2012;8(21):3263-8.
Horeman T, Meijer EJ, Harlaar JJ, Lange JF, van den Dobbelsteen JJ, Dankelman J. Force sensing in surgical sutures. PLoS One. 2013 Dec 23;8(12):84466.
Xie CX, Yu CQ, Wang W, Wang CL, Yin D. A novel zipper device versus sutures for wound closure after surgery: a systematic review and meta-analysis. Int Wound J. 2020;17(6):1725-37.
Chen D, Song J, Zhao Y, Zheng X, Yu A. Systematic Review and Meta-Analysis of Surgical Zipper Technique versus Intracutaneous Sutures for the Closing of Surgical Incision. PLoS One. 2016;11(9):162471.