Drug-Eluting Sutures by Hot-Melt Extrusion: Current Trends and Future Potentials

Abstract

Surgical site infections (SSIs) may result from surgical procedures requiring a secondary administration of drugs at site or systemically in treating the infection. Drug-eluting sutures containing antimicrobial agents symbolise a latent strategy that precludes a secondary drug administration. It also offers the possibility of delivering a myriad of therapeutic agents to a localised wound site to effect analgesia, anti-inflammation, or the deployment of proteins useful for wound healing. Further, the use of biodegradable drug-eluting sutures eliminates the need for implanting foreign material into the wound, which needs to be removed after healing. In this review, we expound on recent trends in the manufacture of drug-eluting sutures with a focus on the hot-melt extrusion (HME) technique. HME provides a solvent-free, continuous one-step manufacturing conduit for drug-eluting sutures, hence, there is no drying step, which can be detrimental to the drug or suture threads and, thus, environmentally friendly. There is the possibility of combining the technology with additive manufacturing platforms to generate personalised drug-loaded implantable devices through prototyping and scalability. The review also highlights key material requirements for fabricating drug-eluting sutures by HME, as well as quality attributes. Finally, a preview of emerging drug-eluting sutures and advocacy for harmonisation of quality assurance by regulatory authorities that permits quality evaluation of novelty sutures is presented.

Melt-extruded biocompatible surgical sutures loaded with microspheres designed for wound healing

“…Drug incorporation during suture manufacturing has been made possible through advanced techniques such as electrospinning or hot melt extrusion. Electrospinning allows for the creation of porous nanofiber sutures by injecting a drug/polymer blend into a syringe and then electrospinning it into porous nanofibers [72]. However, since they are nonwoven, electrospun nanofibers generally have poor mechanical performance compared to melt-extruded products.…”

Silk-based intelligent fibers and textiles: structures, properties, and applications

“…86 Compared to other composite suture materials, silk suture has a greater affinity and adaptability, but the absorption process of this suture is relatively much slower, so it is classified as a non-absorbable suture in the United States Pharmacopeia (USP), but it can also be degraded slowly in the body for about 2–6 months. 87,88 The degradation products are amino acids that can be absorbed by the body and are non-toxic and harmless to the body. Sutures, however, are the most widely used implants in surgery and their performance is important for wound healing.…”