Electrospun Medical Sutures for Wound Healing: A Review

Abstract

With the increasing demand for wound healing around the world, the level of medical equipment is also increasing, but sutures are still the preferred medical equipment for medical personnel to solve wound closures. Compared with the traditional sutures, the nanofiber sutures produced by combining the preparation technology of drug-eluting sutures have greatly improved both mechanical properties and biological properties. Electrospinning technology has attracted more attention as one of the most convenient and simple methods for preparing functional nanofibers and the related sutures. This review firstly discusses the structural classification of sutures and the performance analysis affecting the manufacture and use of sutures, followed by the discussion and classification of electrospinning technology, and then summarizes the relevant research on absorbable and non-absorbable sutures. Finally, several common polymers and biologically active substances used in creating sutures are concluded, the related applications of sutures are discussed, and the future prospects of electrospinning sutures are suggested.

Keywords: drug delivery; electrospinning; medical polymers; nanofibers; sutures; wound healing.

Figure 8

(A) AgNPs/TCA/PI nanofibers and AgNPs/Heads/PI schematic diagram of nanofiber structure. Reprinted from Ref. [140]. (B) PCL overlaid AN/VIM copolymer fibers NO controlled release. Reprinted with permission from Ref. [142] Copyright 2012 American Chemical Society. (C) Preparation of PVA/MEG nano-composite fibers and experimental diagrams of mice in vitro. Reprinted with permission from Ref. [143] Copyright 2018 American Chemical Society.

Figure 10

(A) Hollow porous suture line structure schematic. Reprinted with permission from Ref. [157] Copyright 2020 Elsevier.(B) PLLA/heparin preparation of core sheath structure nanofiber medical suture structure schematic. Reprinted with permission from Ref. [159] Copyright 2021 Royal Society of Chemistry. (C) PCL Schematic diagram of the manufacturing system of composite wire sutures. Reprinted from Ref. [163].

Figure 1

Statistics on the number of publications retrieved on the “Web of science” with the subject of “Sutures” and the subject of “Electrospun sutures”. The line chart represents the ratio of electrospinning sutures to sutures.

Figure 2

(A) Monofilament and (B) multifilament sutures. Reprinted from Ref. [38]. (C) Unidirectional barb sutures; barbs all point to the same direction (D) with two-way barbs stitched together, and the two sets of barbs are pointed in opposite directions according to the midpoint of the length of the sutures. Reprinted with permission from Ref. [39] Copyright 2021 John Wiley and Sons.

Figure 3

(A) SEM images of sutures made from core sheath nanofiber films with widths of 3, 6, 9 and 12 mm. Reprinted with permission from Ref. [55] Copyright 2017 Elsevier; (B) SEM images of PCL scaffolds with different tensile strengths (0.5 mpa, 0.8 mpa, 1.0 mpa, 1.3 mpa, 2.3 mpa and 3.0 mpa); arrows show fusion and bonding of the adjacent fibers. Reprinted with permission from ref. [56] Copyright 2017 Elsevier.

Figure 4

(A) Commercial suture (Vicryl (3-0) Ethicon), pure PLLA sutures and curcumin-laden PLLA sutures of SEM images of the inhibition of S. aureus and P. aeruginosa. (B) Comparison chart of the number of promoted cell migrations in the control group and sample group at 0, 24, 48 and 72 h. (C) Comparison figure of collagen fiber deposition on the surface of the control group and sample group. Reprinted with permission from Ref. [62] Copyright 2021 Elsevier. (D) SEM micrograph of the surface of the biodegradable suture of the nano-silver coating. (E) Nano-silver particles; antibacterial figure of nano-silver-coated biodegradable sutures (labeled I) and uncoated sutures (labeled K) inhibit the region of E. coli and S. aureus. Reprinted with permission from Ref. [63] Copyright 2021 Springer Nature.

Figure 5

The manufacturing process of drug-elution sutures, where electrospinning and melt extrusion are mainly used to produce absorbable drug-eluting sutures, while coating technology is mainly used to manufacture non-absorbable drug-eluting sutures. Reprinted with permission from Ref. [39] Copyright 2021 John Wiley and Sons.

Figure 6

Classification of electrospinning processes.

Figure 7

Common polymers used in medical sutures.

Figure 9

(A). Electrospinning preparation of bFGF-COL@PCL suture line principle experimental diagram. Reprinted with permission from Ref. [145] Copyright 2020 American Chemical Society. (B) Electrospinning preparation of PLGA core-sheath structure schematic of the suture line. Reprinted with permission from Ref. [146] Copyright 2018 Elsevier. (C) PLLA/PLGA/aceclofenac/insulin multifunctional suture preparation. Reprinted with permission from Ref. [96] Copyright 2016 American Chemical Society.