Tailoring surgical sutures with chitosan and non-thermal atmospheric plasma: biofunctionalization for antimicrobial efficacy and enhanced wound healing

Surgical sutures serve as medical devices designed to facilitate the closure of wounds by securing opposing tissues. While sutures are an integral part of the surgical healing process, also present favorable surfaces for microbial attachment, increasing surgical site infections (SSIs). In this study, sutures that have antimicrobial and improved wound healing properties are described as novel approaches for minimizing SSIs. The absorbable multifilament suture, poly (glycolic-co-lactic acid) (PGLA), and non-absorbable multifilament suture (silk) are treated with non-thermal atmospheric plasma (NTAP) and subsequently coated with chitosan/chitosan nanoparticles (Ch/ChNp). Suture samples are analyzed in terms of antibacterial properties, in vitro bioactivity, wound healing efficiency, mechanical strength, chemical characterization, and surface morphologies. Bacterial adherence of Staphylococcus aureus and Escherichia coli on both sutures is inhibited effectively due to the surface modification after plasma treatment. The NTAP treatment results in reduced wound healing for silk sutures without a selective effect on PGLA sutures. However, subsequent coating with Ch/ChNp significantly enhances wound healing for both sutures. Although the maximum tensile strength decreases after NTAP treatment, improves following the Ch/ChNp coating. Our findings indicate that the developed sutures demonstrate notable antimicrobial properties, enhance wound healing, and hold promise as a potential material for suturing applications.

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