Bacterial Adherence to Suture Materials

Masini, Brendan D.; Stinner, Daniel J.; Waterman, Scott M.; Wenke, Joseph C.

doi:10.1016/j.jsurg.2010.09.015

Cited by 122 publications

(83 citation statements)

References 11 publications

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“…Bacteria in a biofilm, a common finding in infected total joint arthroplasties, likely would show increased adherence and that could alter our findings. Our current study echoes those of Masini et al [13]. They used 10 8 CFU/mL of Staphylococcus aureus engineered to emit photons, allowing them to quantify the amount of bacteria adhered to each suture using imaging software.…”

Section: Discussionmentioning

confidence: 56%

“…It is possible that prolonged exposure to the antibacterial properties of the Vicryl* Plus (24-hour incubation) killed the bacteria before it was able to emit photons to be detected by their imaging software, whereas, in our study, the bacteria were washed off the suture in 5 minutes and the number of bacteria were recorded from the wash. Based on the findings of their study and ours, it is unclear whether the increased adherence was the result of the braided nature of Vicryl or the suture material, given that silk suture did not adhere a different amount of bacteria compared with monofilament sutures. Our study adds to the literature as Masini et al did not examine the most commonly used absorbable monofilament suture for deep layer closure [13].…”

Section: Discussionmentioning

confidence: 92%

“…Previous studies showed there were less infections in contaminated wounds closed with monofilament suture compared with braided suture [1,10,20]. Several studies have shown bacteria adhere more tightly to braided suture [2,10,12,13,25,27] and that braided suture leads to more infections as compared with monofilament suture [1,9,10,14,28].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Bacteria Adhere Less to Barbed Monofilament Than Braided Sutures in a Contaminated Wound Model

Fowler

Perkins

Buttaro

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 92%

See 1 more Smart Citation

Bacteria Adhere Less to Barbed Monofilament Than Braided Sutures in a Contaminated Wound Model

Fowler

Perkins

Buttaro

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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“…In contact with the wound, suture threads are quickly coated with proteins-rich fluids, like fibrinogen and fibronectin, which create the ideal environment for the proliferation of microorganisms infecting the surgical site. The bacterial infection in the contaminated suture triggers immune system cells, usually granulocytes, that may be ineffective to contrast the infection and that result in local inflammatory reaction (Masini et al 2011). Thus, additional therapies based on antibiotics and anti-inflammatory drugs are often required determining a further systemic burden, due to physiological detoxification and/or side effects, and even Electronic supplementary material The online version of this article (doi:10.1007/s00253-012-4283-x) contains supplementary material, which is available to authorized users.…”

Section: Introductionmentioning

confidence: 99%

Combining in the melt physical and biological properties of poly(caprolactone) and chlorhexidine to obtain antimicrobial surgical monofilaments

Scaffaro

Botta

Sanfilippo

et al. 2012

Appl Microbiol Biotechnol

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Bacterial infections on a sutured wound represent a critical problem, and the preparation of suture threads possessing antimicrobial properties is valuable. In this work, poly(caprolactone) (PCL) monofilaments were compounded at the concentration of 1, 2 and 4 % (w/w), respectively, to the antiseptic chlorhexidine diacetate (CHX). The incorporation was carried out in the melt by a single-step methodology, i.e. "online" approach. Mechanical tests revealed that the incorporation of CHX does not significantly change tensile properties of PCL fibres as the thermal profile adopted to prepare the compounded fibres does not compromise the antibacterial activity of CHX. In fact, CHX confers to compounded PCL fibres' antimicrobial property even at the lowest CHX concentration as revealed by microbiological assays performed on Escherichia coli, Micrococcus luteus and Bacillus subtilis strains. The scanning electron microscope micrographs and energy-dispersive X-ray analysis of compounded threads revealed that CHX is uniformly distributed on fibre surface and that the overall amount of superficial CHX increases by increasing compounded CHX concentration. This distribution determines a biphasic CHX release kinetics characterized by an initial rapid solubilisation of superficial CHX micro-crystals, followed by a slow and gradual release of CHX incorporated in the bulk. Interestingly, the compounded threads did not show any toxic effect compromising cell viability of human fibroblasts in vitro, differently from that observed using an equal amount of pure CHX. Thus, this study originally demonstrated the effectiveness of an "online" approach to confer antimicrobial properties to an organic thermoplastic polymeric material commonly used for medical devices.

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“…The last step of atrioventricular valve repair is generally implantation of a conventional annuloplasty ring (CAR) covered with a stable-woven material in order to implant the prosthesis onto the native annulus [3]. This woven material may provide a milieu for colonization and proliferation for bacteria if it is contaminated during the implantation or if the implantation is performed in an infected patient who is operated for valve pathology secondary to infected endocarditis (IE) [4,5,6,7]. A biodegradable annuloplasty ring (BAR) (Kalangos-Bioring®) is a tool mainly developed for pediatric heart operations and formed by a monofilament of biodegradable poly-1,4-dioxanone [8,9].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Infection Resistance of Biodegradable versus Conventional Annuloplasty Rings in an in vivo Rat Subcutaneous Model

et al. 2017

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Background: Biodegradable atrioventricular annuloplasty rings are theoretically more infection resistant due to their intra-annular implantation technique and nonporous structures (monofilament of poly-1,4-dioxanone). The aim of this study was to investigate the infection resistance of a biodegradable annuloplasty ring (Kalangos-Bioring®) in a rat subcutaneous implantation model and to compare it with a commonly used conventional annuloplasty ring (Edwards Physio II®). Methods: This study included 32 Wistar albino rats which were divided into 2 groups according to the implantation of sterile or infected annuloplasty rings as control and study groups. Each animal had 2 implantation pockets (made on the right and left side of the dorsal median line) where 1 cm of the biodegradable annuloplasty ring was implanted into one pocket and 1 cm of the conventional annuloplasty ring was implanted into the other pocket. The infection model was created by topical inoculation of 1 mL Staphylococcus aureus strain (2 × 10⁷ colony-forming units/mL) into the implantation pockets before skin closure. Each group was equally divided into 4 subgroups according to different follow-up schedules. The animals were inspected for local as well as systemic infection signs, and the rings were explanted at weeks 2, 4, 9, and 14 following implantation. Implantation pockets were evaluated macroscopically as well as by histopathological examinations. Microbiological analysis of the explanted implants with surrounding tissue was done by using quantitative sonication method. Results: Conventional ring-implanted pockets showed a more prominent inflammation reaction than the biodegradable ring-implanted pockets, and this characteristic was found to be accentuated with bacterial contamination. The sterile rings did not reveal any positive cultures in either group. The number of positive cultures found in conventional rings contaminated with S. aureus was greater than in the biodegradable ring group (11/16 vs. 2/16 positive cultures, respectively; p = 0.0032). The amounts of growing bacteria in the culture environment were also statistically significantly higher in the conventional ring group (7,175 ± 5,936 vs. 181 ± 130 colony-forming units/mL, respectively; p < 0.0005). Conclusions: This is the first experimental study confirming the theoretical advantage of the infection resistance of the biodegradable annuloplasty ring (Kalangos-Bioring®) when implanted in an active infectious environment. Large animal models mimicking clinical scenarios and clinical comparative studies are needed to verify our results.

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Bacterial Adherence to Suture Materials

Cited by 122 publications

References 11 publications

Bacteria Adhere Less to Barbed Monofilament Than Braided Sutures in a Contaminated Wound Model

Bacteria Adhere Less to Barbed Monofilament Than Braided Sutures in a Contaminated Wound Model

Combining in the melt physical and biological properties of poly(caprolactone) and chlorhexidine to obtain antimicrobial surgical monofilaments

Evaluation of Infection Resistance of Biodegradable versus Conventional Annuloplasty Rings in an in vivo Rat Subcutaneous Model

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