Development and utilization of a novel nanoantimicrobial suture for surgery: An in vivo and mechanical study

Development of surgical sutures coated with antimicrobial agents is a promising strategy to minimize surgical site infection (SSI) and improve wound healing. The antimicrobial features of <i>Hypericum Perforatum</i> and biogenic silver nanoparticles (AgNPs) have arised an increasing demand for processing surgical sutures. Herein the results of the animal experiments and mechanical tests of a novel antimicrobial silk suture coated with <i>H. perforatum</i> extract (Hp) and biogenic AgNPs (Hp-AgNP) are reported. The study used in vivo histological, histochemical, and immunohistochemical techniques to illustrate the variations in inflammatory response, re-epithelialization, and collagenization of the coated silk sutures in a rat buccal mucosa incision model. Diameter, knot-pull tensile strength, knot security, tie-down, and needle attachment tests were carried out for evaluating the effects of the coating process on mechanical and handling properties. Histopathological and immunohistochemical evaluations revealed progressive healing in all groups, with variations in wound closure, inflammation, and cytokine expression. Hp-AgNP-coated sutures showed significant improvements in re-epithelialization and reduced TNF-α and IL-6 levels over time, highlighting their potential benefits in enhancing wound healing compared to other materials. The coating process had a remarkable effect on the mechanical and handling properties. Coated sutures exhibited higher values than control groups. Suture diameter, knot-pull tensile strength and knot security revealed the highest values for Hp-AgNP-coated suture. The Hp-AgNP coating on the silk suture significantly improves wound healing, mechanical and handling properties. This implies that it has the potential to be a feasible substitute for commercially available silk sutures in surgical interventions. (Scheme 1).