Researchers have been working to improve the wound healingand antibacterial properties of sutures to maintain good human health. Toachieve these properties in past, most works were done on chemical processes.However, using many chemical antimicrobial agents and drugs for healing hasbeen avoided because of their possible harmful or toxic effects.
Previous studies have shown that triclosan-coatedsutures greatly affect the growth of Gram-positive bacteria, e.g.Staphylococcus aureus and coagulase-negative staphylococci, and Gram-negativebacteria, e.g.
Pseudomonas aeruginosa and Escherichia coli1. In 2006, Charles E Edmiston with his team appliedtriclosan on Polyglactine 910 surgical sutures and experimented its resistivityagainst gram-positive (Staphylococcus aureus) and gram-negative bacteria(Escherichia coli) that may infect surgical wounds. According to results, therewas a substantial reduction in the adherence of both gram-positive(Staphylococcus aureus) and gram-negative bacteria (Escherichia coli) wasobserved in coated sutures than that of normal ones2.
In another research in 2013, Seiichiro Hoshino with his team i.e. Yoichiro Yoshida,SyuTanimura, Yasushi Yamauchi, Tomoaki Noritomi, Yuichi Yamashita studied the efficacy of antibacterial suturesfor surgical site infections.
They used triclosan-coated Polyglactine 910sutures and non-coated Polyglactine 910 sutures for the closure of fascia indigestive surgeries and collected data of one year from July 2010 to June 2011.Two groups were made and there was no significant difference in groupsregarding age, sex and other risk factors for Surgical Site Infections.According to results, there was 6 % decrease in the surgical site infection.
Inthis study, there was a major difference in SSI’s only in clean andclean/contaminated cases. Another outcome of this research was that it wasdifficult to prevent SSI’s in dirty cases even with triclosan-coatedPolyglactine 910 sutures3.In 2011, S Viju and G Thilagavathi in their workapplied chitosan on silk sutures and studied the effect of coating on thecharacteristics of the suture. The result shows that high concentration i.e. 5%of chitosan increases antimicrobial activity, reduces the coefficient offriction, increases knot performance and tenacity of sutures.
The braided silksuture treated with higher chitosan concentration exhibits excellentantimicrobial activity against both the gram-positive (Staphylococcus aureus)and gram-negative bacteria (Escherichia coli)4.In 2015, Malik Muhammad Umair, Zhiming Jiang,NaseebUllah, WaseemSafdar, ZhiweiXie and Xuehong Ren made an antibacterialsuture functionalized with the help of chitosan. To improve antimicrobialefficacy, chitosan has been chemically modified using Multilayers of chitosan(polycation) and poly-sodium-p-styrenesulfonate (polyanion) and its coatingwere applied on polyglycolide suture. Upon chlorination amino groups ofchitosan transformed into N-halamine structures.
This chlorinated suture with chitosan coating completely destroyed bothEscherichia coli and Staphylococcus aureus bacteria within a short time5.Silver nanoparticles also show great resistance tomicrobial substances. In 2016, Vinay G.
Nadiger & Sanjeev R. Shukla appliedsilver nanoparticles for the first time with the help of cross-linking agentssuch as 1,2,3,4 butane tetracarboxylic acid(BTCA) to entrap silver moleculesupon silk to make it resistant to microbes and its use for the reduction inSSI’s. Application of 6 % BTCA and 3 % SHP (sodium hypophosphite) using silvernanoparticles gives satisfactory results against microbes6.At present, triclosan is the only commerciallyavailable synthetic antibacterial coating used on suture material1.
In our study, we will go for the application ofnaturally occurring herbs and materials to achieve biocompatibility,biodegradability and enhanced healing properties. So we will apply locallyoccurring herbs on natural textile materials to produce antibacterial and woundhealing sutures.