According RMIT University, Australia, surgical site infections are one of the most common medical infections, occurring in two to four per cent of patients post-surgery. For some procedures, including vaginal mesh implants to treat prolapse, infection rates can be higher.
Study lead author and Vice Chancellor’s Senior Research Fellow, Dr Shadi Houshyar, said their suture was being developed in partnership with clinicians specifically for this type of procedure.
“Our smart surgical sutures can play an important role in preventing infection and monitoring patient recovery and the proof-of-concept material we’ve developed has several important properties that make it an exciting candidate for this,” said Houshyar, from the School of Engineering at RMIT. The team’s findings have been published in OpenNano.
Lab tests on the surgical filament showed it was easily visible in CT scans when threaded through samples of chicken meat, even after three weeks. It also showed strong antimicrobial properties, killing 99 per cent of highly drug-resistant bacteria after six hours at body temperature.
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Houshyar said in a statement that the team was not aware of any commercially available suture products that combined these properties.
The multidisciplinary team led by RMIT – included nano-engineering, biomedical and textile experts working in partnership with a surgeon – used the university’s textile manufacturing facility to develop their proof-of-concept material.
The suture’s properties come from the combination of iodine and tiny nanoparticles (carbon dots) throughout the material.
Carbon dots are inherently fluorescent, due to their particular wavelength, but they can also be tuned to various levels of luminosity that stand out from surrounding tissue in medical imaging.
Attaching iodine to these carbon dots provides them with their antimicrobial properties and greater X-ray visibility.
Houshyar said carbon nano dots were safe, cheap and easy to produce in the lab from natural ingredients.
“They can be tailored to create biodegradable stitches or a permanent suture, or even to be adhesive on one side only, where required,” she said.
“This project opens up a lot of practical solutions for surgeons, which has been our aim from the start and the reason we have involved clinicians in the study.”
Team member Justin Yeung, a consultant colorectal surgeon and Professor of Surgery at the University of Melbourne, said the research addressed a real challenge faced by surgeons in trying to identify the precise anatomical location of internal meshes on CT scans.
"This mesh will enable us to help with improved identification of the causes of symptoms, reduce the incidence of mesh infections and will help with precise preoperative planning, if there is a need to surgically remove this mesh,” he said. “It has the potential to improve surgery outcomes and improve quality of life for a huge proportion of women, if used as vaginal mesh for example, by reducing the need for infected mesh removal.”
Yeung continued: “It may also significantly reduce surgery duration and increase surgical accuracy in general through the ability to visualise mesh location accurately on preoperative imaging.”
Professor Elisa Hill-Yardin, study co-author from RMIT’s School of Health and Biomedical Sciences, said the next steps were pre-clinical trials.
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