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The resistance of polyglycolic acid sutures to attack by infected human urine
Abstract:
Polyglycolic acid sutures were incubated at 37 degrees C in broth, and in 0.22 mu millipore filtered human urine infected with Escherichia coli, Str. faecalis, Proteus mirabilis and Pseudomonas aeruginosa. At 3 days the Proteus had destroyed the polyglycolic acid sutures in the urine but not in the broth. None of the other organisms had any effect on the tensile strength of the suture material. Under the scanning electron microscope the Proteus-destroyed polyglycolic acid sutures showed multiple transverse microfractures. Polyglycolic acid sutures should not be used for closing urothelium in patients with a proven Proteus infection.
Insights
Proteus mirabilis bacteria can degrade polyglycolic acid sutures in human urine, compromising their integrity. This finding suggests avoiding these sutures in patients with Proteus infections to prevent complications.
Area of Science:
- Biomaterials Science
- Microbiology
- Surgical Sutures
Background:
- Polyglycolic acid (PGA) sutures are commonly used in surgical procedures.
- The degradation of synthetic sutures by microorganisms can impact surgical outcomes.
- Understanding microbial interactions with biomaterials is crucial for patient safety.
Purpose of the Study:
- To investigate the effect of common urinary tract bacteria on the tensile strength and integrity of polyglycolic acid sutures.
- To identify specific bacterial species responsible for suture degradation.
- To provide recommendations for suture material selection in infected environments.
Main Methods:
- Polyglycolic acid sutures were incubated in sterile broth and filtered human urine inoculated with Escherichia coli, Streptococcus faecalis, Proteus mirabilis, and Pseudomonas aeruginosa at 37°C.
- Suture tensile strength was assessed after incubation.
- Scanning electron microscopy (SEM) was used to examine the surface morphology of degraded sutures.
Main Results:
- Proteus mirabilis significantly degraded polyglycolic acid sutures within 3 days when incubated in infected urine.
- No other tested organisms (E. coli, Str. faecalis, P. aeruginosa) affected suture strength.
- SEM revealed extensive microfractures on the surface of sutures degraded by Proteus.
- Sutures incubated in broth showed no degradation.
Conclusions:
- Proteus mirabilis poses a risk of degrading polyglycolic acid sutures in the urinary tract.
- The use of polyglycolic acid sutures for closing urothelium should be avoided in patients with confirmed Proteus infections.
- Further research may explore alternative suture materials resistant to Proteus degradation.