A potential replacement for mesh implants and internal stitches could be a new antibacterial suture material that glows in medical imaging.
One of the most prevalent medical infections is a surgical site infection, which affects 2 to 4% of patients after surgery. Infection rates may be higher for particular treatments, such as vaginal mesh implants to treat prolapse.
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 University, Australia.
When threaded through samples of chicken meat in lab tests for the surgical filament, which were published in OpenNano, it was still clearly discernible in CT scans three weeks later. Additionally, it demonstrated potent antibacterial activity, eliminating 99% of bacteria with a high treatment resistance after six hours at body temperature.
Houshyar said the team was not aware of any commercially available suture products that combined these properties.
How they did it
To create its proof-of-concept material, the multidisciplinary team, led by RMIT, collaborated with a practicing surgeon and included experts in nanoengineering, biomedicine, and textiles. They also employed the university’s state-of-the-art textile production facilities.
The suture’s properties come from the combination of iodine and tiny nanoparticles, called carbon dots, throughout the material.
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.
Dr. Shadi Houshyar
Due to their unique wavelength, carbon dots are fluorescent by nature, but they may also be tweaked to different levels of luminosity that make them easily distinguishable from surrounding tissue in medical imaging.
Iodine is then attached to these carbon dots, giving them their potent antibacterial effects and improved 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.”
Clinical possibilities
Consultant colorectal surgeon and Professor of Surgery at the University of Melbourne, Justin Yeung, was involved in the study. He said it 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.”
“It may also significantly reduce surgery duration and increase surgical accuracy in general through the ability to visualize mesh location accurately on preoperative imaging.”
Next steps
Study co-author from RMIT’s School of Health and Biomedical Sciences, Professor Elisa Hill-Yardin, said the next steps were pre-clinical trials.
“While this research is at an early stage, we believe we are onto something very promising that could help a lot of people and are really keen to speak with industry partners who are interested in working with us to take it further,” she said.
“We see potential, especially in vaginal mesh implants and similar procedures.”
The research team at RMIT’s Centre created the proof-of-concept material for Materials Innovation and Future Fashion, one of Australia’s top university-based textile manufacturing facilities. They just got seed money from RMIT and will soon begin making larger suture samples to utilize in pre-clinical trials.
