Researchers have been working to improve the wound healing
and antibacterial properties of sutures to maintain good human health. To
achieve these properties in past, most works were done on chemical processes.
However, using many chemical antimicrobial agents and drugs for healing has
been avoided because of their possible harmful or toxic effects.
Previous studies have shown that triclosan-coated
sutures greatly affect the growth of Gram-positive bacteria, e.g.
Staphylococcus aureus and coagulase-negative staphylococci, and Gram-negative
bacteria, e.g. Pseudomonas aeruginosa and Escherichia coli1. In 2006, Charles E Edmiston with his team applied
triclosan on Polyglactine 910 surgical sutures and experimented its resistivity
against gram-positive (Staphylococcus aureus) and gram-negative bacteria
(Escherichia coli) that may infect surgical wounds. According to results, there
was a substantial reduction in the adherence of both gram-positive
(Staphylococcus aureus) and gram-negative bacteria (Escherichia coli) was
observed 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 sutures
for surgical site infections. They used triclosan-coated Polyglactine 910
sutures and non-coated Polyglactine 910 sutures for the closure of fascia in
digestive surgeries and collected data of one year from July 2010 to June 2011.
Two groups were made and there was no significant difference in groups
regarding age, sex and other risk factors for Surgical Site Infections.
According to results, there was 6 % decrease in the surgical site infection. In
this study, there was a major difference in SSI’s only in clean and
clean/contaminated cases. Another outcome of this research was that it was
difficult to prevent SSI’s in dirty cases even with triclosan-coated
Polyglactine 910 sutures3.
In 2011, S Viju and G Thilagavathi in their work
applied chitosan on silk sutures and studied the effect of coating on the
characteristics of the suture. The result shows that high concentration i.e. 5%
of chitosan increases antimicrobial activity, reduces the coefficient of
friction, increases knot performance and tenacity of sutures. The braided silk
suture treated with higher chitosan concentration exhibits excellent
antimicrobial 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 antibacterial
suture functionalized with the help of chitosan. To improve antimicrobial
efficacy, chitosan has been chemically modified using Multilayers of chitosan
(polycation) and poly-sodium-p-styrenesulfonate (polyanion) and its coating
were applied on polyglycolide suture. Upon chlorination amino groups of
chitosan transformed into N-halamine structures. This chlorinated suture with chitosan coating completely destroyed both
Escherichia coli and Staphylococcus aureus bacteria within a short time5.
Silver nanoparticles also show great resistance to
microbial substances. In 2016, Vinay G. Nadiger & Sanjeev R. Shukla applied
silver nanoparticles for the first time with the help of cross-linking agents
such as 1,2,3,4 butane tetracarboxylic acid(BTCA) to entrap silver molecules
upon silk to make it resistant to microbes and its use for the reduction in
SSI’s. Application of 6 % BTCA and 3 % SHP (sodium hypophosphite) using silver
nanoparticles gives satisfactory results against microbes6.
At present, triclosan is the only commercially
available synthetic antibacterial coating used on suture material1. In our study, we will go for the application of
naturally occurring herbs and materials to achieve biocompatibility,
biodegradability and enhanced healing properties. So we will apply locally
occurring herbs on natural textile materials to produce antibacterial and wound