Centre for Bioengineering and Nanomedicine (Dunedin), Faculty of Dentistry, Division of Health Sciences, University of Otago, Dunedin, New Zealand.
J Biomed Mater Res A. 2021 Oct;109(10):2065-2081. doi: 10.1002/jbm.a.37194. Epub 2021 Apr 8.
Sutures are the most popular surgical implants in the global surgical equipment market. They are used for holding tissues together to achieve wound closure. However, controlling the body's immune response to these "foreign bodies" at site of infection is challenging. Natural polymers such as collagen, silk, nylon, and cotton, and synthetic polymers such as polycaprolactone, poly(lactic-co-glycolic acid), poly(p-dioxanone) and so forth, contribute the robust foundation for the engineering of drug-eluting sutures. The incorporation of active pharmaceutical ingredients (APIs) with polymeric composition of suture materials is an efficient way to reduce inflammatory reaction in the wound site as well as to control bacterial growth, while allowing wound healing. The incorporation of polymeric composition in surgical sutures has been found to add high flexibility as well as excellent physical and mechanical properties. Fabrication processes and polymer materials allow control over drug-eluting profiles to effectively address wound healing requirements. This review outlines and discusses (a) polymer materials and APIs used in suture applications, including absorbable and nonabsorbable sutures; (b) suture structures, such as monofilament, multifilament, barded and smart sutures; and (c) the existing manufacturing techniques for drug-eluting suture production, including electrospinning, melt-extrusion and coating.
缝线是全球外科手术设备市场中最受欢迎的外科植入物。它们用于将组织缝合在一起以实现伤口闭合。然而，控制身体对感染部位这些“异物”的免疫反应具有挑战性。天然聚合物如胶原蛋白、丝、尼龙和棉花，以及合成聚合物如聚己内酯、聚（乳酸-共-乙醇酸）、聚（对二氧环己酮）等，为载药缝线的工程学提供了坚实的基础。将活性药物成分 (API) 与缝线材料的聚合物成分结合使用是减少伤口部位炎症反应和控制细菌生长的有效方法，同时允许伤口愈合。在外科缝线中加入聚合物成分已被发现增加了高度的灵活性以及优异的物理和机械性能。制造工艺和聚合物材料允许控制药物释放曲线，从而有效地满足伤口愈合的要求。本文综述并讨论了（a）缝线应用中使用的聚合物材料和 API，包括可吸收和不可吸收缝线；（b）缝线结构，如单丝、多丝、有齿和智能缝线；和（c）载药缝线生产的现有制造技术，包括静电纺丝、熔融挤出和涂层。
