Using Smart Stitches Shows Better Surgery Results and Patient Well-Being

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Medical infections are common, and surgical site infections account for one of the most frequent ones affecting 2% to 4% of patients post-surgery. Some procedures even record higher infection rates than others, such as vaginal mesh implants for prolapse. Surgery tools like mesh implants and internal stitches contribute significantly to surgical site problems, but a study has found a better and more promising replacement: smart stitches.

Smart stitches, made from an antimicrobial suture material that glows in medical imaging, can improve surgery results and enhance the patient’s health and well-being. According to Dr. Shadi Houshyar, study lead author and Vice Chancellor’s Senior Research Fellow, his team partnered with clinicians to develop this new surgery-focused suture to prevent infection and observe patient recovery.

The lab tests on the surgical filament showed that the smart stitches had clear visibility in CT scans when threaded through chicken meat samples. The suture’s antimicrobial properties are effective against 99% of highly drug-resistant bacteria after six hours at body temperature. The first of its kind, there has yet to be any other commercially available suture tools exhibiting the same properties and results, Houshyar added.

The multidisciplinary team, led by RMIT, used the university’s latest textile manufacturing facility to design this antimicrobial material. The suture gets its properties from combining iodine and tiny nanoparticles, known as carbon dots, throughout the material. Carbon dots have a unique wavelength, making them fluorescent by default. However, they can also be altered to various luminous levels that make them visible in medical imaging, making it easy to differentiate them from surrounding tissues.

Combining iodine and carbon dots instills antimicrobial properties within them, giving them clear and excellent X-ray visibility. Houshyar’s team could produce nanodots in laboratories safely and efficiently from natural ingredients. “They can be tailored to create biodegradable stitches or a permanent suture, or even to be adhesive on one side only, where required,” Houshyar said. She added, “This project opens up a lot of practical solutions for surgeons, which has been our aim from the start and the reason we have involved clinicians in the study.”

Surgical infections caused by mesh implants and internal stitches are a genuine concern that surgeons raise, especially when finding the exact anatomical location of internal meshes on CT scans. Justin Yeung, consultant colorectal surgeon and Professor of Surgery at the University of Melbourne, claims smart stitches solve this challenge.

According to Yeung, the mesh enables surgeons to improve symptom identification, reduce mesh-caused infections, and allow precise preoperative planning when surgically removing the mesh. “It has the potential to improve surgery outcomes and improve quality of life for a huge proportion of women, if used as vaginal mesh, for example, by reducing the need for infected mesh removal,” he said.

The study’s next steps included pre-clinical trials. Study co-author Professor Elisa Hill-Yardin believes developing the study further will generate promising discoveries that could “help a lot of people.” She adds that the team will speak with industry partners to collaborate on this study and find better alternatives to vaginal mesh implants and similar surgeries.

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