Publications

Surgical sutures are long-established medical devices that play an important role closing and healing damaged tissues and organs postoperatively. However, current commercial sutures are not able to detect infections at the wound site, which are quite frequent after surgery. In this work, we present mechanically stable smart sutures for the real-time monitoring of bacterial growth and biofilm formation. For this purpose, a conducting polymer named poly(3,4-ethylenedioxythiophene) (PEDOT), which is able to detect bacteria metabolites, was implemented as a coating onto commercial biostable sutures. A protecting hydrogel layer with adhesive properties, which was made of polydopamine-polyacrylamide (PDA-PAM), was used to prevent the detachment of the sensing coating of PEDOT upon looping and knotting the suture. The protective hydrogel preserved not only the knot mechanical properties of the suture but also the electrochemical response of the PEDOT-coating and, therefore, its ability to detect NADH from bacteria respiration. Ex-vivo assays using sutured swine intestine samples demonstrated that the suture with the PDA-PAM hydrogel layer detects the growth of bacteria in real tissues. As a proof of concept, sutures coated with PEDOT and protected with PDA-PAM were used to inhibit the local growth of bacteria in sutured intestines by applying controlled electrostimuli. Results evidenced that smart electro-responsive sutures can be used as multi-task devices focused on fighting bacterial infections, meaning not only monitoring but also hampering bacteria growth.

JTD Keywords: 4-ethylenedioxythiophene), Bacteria growth detection, Bacteria growth inhibition, Multi-task biomedical devices, Nanoparticles, Pape, Poly(3, Polydopamine-polyacrylamide, Sensor, Smart suture

Virtually, all implantable medical devices are susceptible to infection. As the main healthcare issue concerning implantable devices is the elevated risk of infection, different strategies based on the coating or functionalization of biomedical devices with antiseptic agents or antibiotics are proposed. In this work, an alternative approach is presented, which consists of the functionalization of implantable medical devices with sensors capable of detecting infection at very early stages through continuous monitoring of the bacteria metabolism. This approach, which is implemented in surgical sutures as a representative case of implantable devices susceptible to bacteria colonization, is expected to minimize the risk of worsening the patient's clinical condition. More specifically, non-absorbable polypropylene/polyethylene (PP/PE) surgical sutures are functionalized with conducting polymers using a combination of low-pressure oxygen plasma, chemical oxidative polymerization, and anodic polymerization, to detect metabolites coming from bacteria respiration. Functionalized suture yarns are used for real-time monitoring of bacteria growth, demonstrating the potential of this strategy to fight against infections.© 2023 Wiley-VCH GmbH.

JTD Keywords: adhesion, biofilm, conducting polymers, contamination, derivatives, detections, functionalized sutures, nadh, poly(3,4-ethylenedioxythiophene), Bacteria growth, Conducting polymers, Detections, Functionalized sutures, Monofilament, Nadh

A connection between two vessels or other tubular structures is known as anastomosis, one of the most common procedures in its field but, at the same time, one of the most complex suture-based techniques. This procedure requires not only a lot of skill and dexterity but also a lot of attention and plenty of concentration from the surgeon. This makes many of the actions to be performed irregularly, exposing the patient to human error resulting from the monotony. On the other hand, the field of robotics has earned itself a place in medicine, especially as assistants during a surgical intervention. Even so, medical robotics is quite young and still has not done much in the field of vessel anastomosis. Therefore, this paper presents a preliminary study of the most common suturing techniques, taking into account their typology and performance, within all the possible anastomosis procedures known. Subsequently, a detailed study of workflow and actions during an anastomosis is made, obtaining a diagram for each of the suturing techniques studied. This allows analyzing all procedures and to create a tool to find those actions and repeated tasks and/or common in all of them, indicating which of these are potential candidates for an automation study. This preliminary work focuses on finding where robotics can help to avoid rutinary tasks, which can be learned in a mechanical level and therefore, relatively easy to be automated using a robotic system or to assist the surgeon in certain tasks that need a lot of skill and attention.

JTD Keywords: Suture, Robot Assisted Surgery, Robot Knotting