A Review of Sutures and the Prospective Applications of Nanofiber Technology in Suture Engineering

Introduction: Suturing is a method to close surgical or traumatic wounds to promote healing. The ideal suture should have high tensile strength that loses strength at the same rate as the healing tissue gains strength, be easy to handle and form secure knots, induce minimal inflammation, and stretch/recoil according to wound contraction. While there are suture materials available for use in various procedures that fulfill most requirements, no one suture possesses every desirable characteristic, and limitations are still prevalent. Nanofiber geometry has a well-known ability to modulate cell morphology, attachment, gene expression, extracellular matrix production, and macrophage polarization in vitro and in vivo when compared to flat/conventional geometries. Therefore, the purpose of this review is to provide an overview of sutures and the current market on sutures in different surgical fields, while highlighting the opportunities for nanofiber technology in suture engineering. Methods: A comprehensive literature review was performed using key terms on PubMed to examine works regarding the physical and mechanical properties of sutures, the current market on sutures in different surgical specialties, limitations of current sutures, future directions in suture fabrication, polymeric nanofibers, and suitable applications of nanofiber technology in suture engineering. Articles were not excluded based on year of publication or country of origin. Results: A summary of results is provided in Table 1. Conclusion: Nanofibers can play an important role in developing new kinds of sutures to replace the traditional threads in terms of properties and functional performances such as drug delivery and wound healing.