Biopolymer - functionalized surgical sutures for tendon repair: A review from design to application

Tendon injury, as a common clinical condition, severely impairs the recovery of patients' limb functions, making the development of effective repair strategies an urgent necessity. Surgical sutures are key medical devices for tendon repair, among which biopolymer - functionalized sutures have become a research hotspot due to their unique performance advantages. This review takes them as the core research object and systematically sorts out their core design criteria. In terms of material selection, natural biopolymers (such as collagen, chitosan, and silk fibroin) exhibit good biocompatibility and bioactivity, while synthetic biopolymers (such as polylactic acid copolymers) possess tunable mechanical properties and degradation characteristics. Both types have their own strengths and can complement each other. Subsequently, a detailed introduction and discussion of various manufacturing strategies for producing surgical sutures are presented. Then, focusing on biopolymers, we highlight the advanced design and development of surgical sutures with multiple functions, mainly covering surface coating techniques and direct drug - loading technologies. Additionally, special emphasis is placed on some smart sutures capable of real - time monitoring of wound conditions and providing corresponding treatments. Through a systematic comparison of existing clinical suture methods and by combining the characteristics of biopolymer materials, selection principles for individualized suture protocols are proposed. This study emphasizes a material - structure - function integrated design concept centered on biopolymer engineering, providing a theoretical framework and practical pathway for the development of a new generation of biopolymer - functionalized tendon repair sutures.