Silk suture reinforced with Cefixime nanoparticles using polymer hydrogel (CFX@PVA); Preparation, Bacterial resistance and Mechanical properties

Objective(s): The objective of the current study was to prevent surgical site infection (SSI) by creating a new antibacterial silk suture. Methods: Cefixime trihydrate (CFX) was prepared as nanoparticles via mixing with polyvinyl alcohol (PVA) hydrogel by covalent cross-linkage. The mixture was stirred vigorously to obtain a homogenous gel. Under this condition the polymer chains separate CFX as nanoparticles and trap them (CFX@PVA). The enrichment of silk suture was performed by immersing it in the CFX@PVA solution. The trapped CFX nanoparticles in PVA hydrogel on the surface of sutures were confirmed by SEM. The effect of CFX@PVA silk sutures on tensile strength was analyzed, using a Santammachine controller. The antibacterial activity of the reinforced silk suture was tested on E. coli (ATCC25922) and S. aureus (ATCC25924). Results: All antibacterial studies clearly showed that the use of novel CFX@PVA silk sutures could represent clinical advantages, in terms of prevention of resistant bacteria, such as Staphylococcus aureus (S. aureus), the same as the sensitive bacteria, for 15 days. The maximum elongation of composite before rupture, modulus and extension, showed statistically significant difference between reinforced silk sutures and untreated silk suture. No statistically significant difference was found between the Failure load, Stress, Bending and Energy. Conclusions: Our data indicate that CFX@ Silk sutures are capable of reducing the risk of SSIs, and has a good mechanical strength to keep the wound sides closed, during early healing recovery.