Matl F D, Zlotnyk J, Obermeier A, Friess W, Vogt S, Büchner H, Schnabelrauch H, Stemberger A, Kühn K-D
Institute of Medical Engineering, Technische Universität München, Boltzmannstrasse 11, 85748 Garching, Germany.
J Biomater Sci Polym Ed. 2009;20(10):1439-49. doi: 10.1163/092050609X12457418973107.
Wound infection is a complication feared in surgery. The aim of this study was to develop new anti-infective coatings of surgical sutures and to compare the anti-microbial effectiveness and biocompatibility to the well-established Vicryl Plus. Synthetic absorbable PGA surgical sutures were coated with three different chlorhexidine concentrations and two different octenidine concentrations in combination with palmitic acid and lauric acid. Drug-release kinetics lasting 96 h were studied in phosphate-buffered saline at 37 degrees C. Anti-infective characteristics were determined by measuring the change in optical density of Staphylococcus aureus suspensions charged with coated sutures over time. Microorganisms adsorbed at the surface of coated sutures were assessed on blood agar plates and coated sutures eluted for 24 h were placed on bacterial lawns cultured on Mueller-Hinton plates to prove retained anti-microbial potency. A cell proliferation assay was performed to assess the degree of cytotoxicity. Anti-infective characteristics and biocompatibility were compared to Vicryl Plus. A coating technology for slow-release drug-delivery systems on surgical sutures could be developed. All coatings showed a continuous drug release within 96 h. Individual chlorhexidine and octenidine coated sutures showed superior anti-infective characteristics but inferior biocompatibility in comparison to Vicryl Plus. We conclude that the developed anti-infective suture coatings consisting of lipid-based drug-delivery systems in combination with antiseptics are highly effective against bacterial colonization in vitro; however, drug doses have to be adjusted to improve biocompatibility.
伤口感染是外科手术中令人担忧的一种并发症。本研究的目的是开发新型的外科缝线抗感染涂层，并将其抗菌效果和生物相容性与成熟的薇乔加强缝线（Vicryl Plus）进行比较。合成可吸收聚乙醇酸（PGA）外科缝线用三种不同浓度的氯己定和两种不同浓度的奥替尼啶与棕榈酸和月桂酸组合进行涂层处理。在37℃的磷酸盐缓冲盐溶液中研究了持续96小时的药物释放动力学。通过测量接种有涂层缝线的金黄色葡萄球菌悬液随时间的光密度变化来确定抗感染特性。在血琼脂平板上评估吸附在涂层缝线表面的微生物，并将洗脱24小时的涂层缝线放置在穆勒-欣顿平板上培养的细菌菌苔上，以证明其保留的抗菌效力。进行细胞增殖试验以评估细胞毒性程度。将抗感染特性和生物相容性与薇乔加强缝线进行比较。可以开发一种用于外科缝线缓释药物递送系统的涂层技术。所有涂层在96小时内均显示出持续的药物释放。与薇乔加强缝线相比，单独的氯己定和奥替尼啶涂层缝线显示出优异的抗感染特性，但生物相容性较差。我们得出结论，所开发的由基于脂质的药物递送系统与防腐剂组合而成的抗感染缝线涂层在体外对细菌定植具有高度有效性；然而，必须调整药物剂量以提高生物相容性。
