Ann Surg Treat Res.  2024 Aug;107(2):108-119. 10.4174/astr.2024.107.2.108.

Surface treatment of artificial implants with hybrid nanolayers: results of antibacterial tests, leachates and scanning electron microscope analysis

• Škach J
• Šlamborová I
• Hromádka P
• Exnar P
• Gürlich R

• KMID: 2558387
• DOI: http://doi.org/10.4174/astr.2024.107.2.108

Abstract

Purpose
The aim of this study was to evaluate the antibacterial efficacy of surface-treated hernia implants modified by a hybrid nanolayer with incorporated Ag, Cu, and Zn cations using the sol-gel method.
Methods
The materials (polypropylene, polyester, and polyvinylidene difluoride) were activated by vacuum plasma treatment or UV C radiation, then modified and tested for bacterial strains of Escherichia coli (gram-negative) and Staphylococcus aureus (gram-positive). The AATCC 100 (2019) method for quantitative and the ISO 20645 agar plate propagation method for qualitative evaluation of microbiological efficacy were used. The gradual release of incorporated ions was monitored over time in simulated body fluids (blood plasma, peritoneal fluid) and physiological saline using an inductively coupled plasma mass spectrometer. The thickness and the homogeneity of the layers were measured for individual random samples with scanning electron microscope analysis (SEMA) and evaluated with an elemental analysis.
Results
Qualitative and quantitative microbiological tests clearly show the great suitability of vacuum plasma and UV C with sol AD30 (dilution 1:1) surface treatment of the implants. The absolute concentration of Ag, Cu, and Zn cations in leachates was very low. SEMA showed a high degree of homogeneity of the layer and only very rare nanocracks by all tested materials appear after mechanical stress.
Conclusion
This study confirms that surface treatment of meshes using the sol-gel method significantly increases the antibacterial properties. The nanolayers are sufficiently mechanically resistant and stable and pose no threat to health.

Keyword

Antibacterial agent; Scanning electron microscopy; Sol gel; Surface; Surgical mesh

Figure

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  Fig. 1 Results of determination of Ag, Cu and Zn metals (as cations) in the leachate of the mesh modified by the antibacterial layer. (A) Polypropylene (PP) mesh (Bard Mesh, C.R. Bard Davol Inc.) in simulated blood plasma. (B) Polyester (PE) mesh (Parietex Hydrophilic 3-Dimensional Mesh, Medtronic) in simulated blood plasma. (C) PP mesh leachate in simulated peritoneal fluid. (D) PE mesh in simulated peritoneal fluid. (E) PP mesh in physiological saline. (F) PE mesh in physiological saline, as a function of sampling time (time dependence for all 3 metal cations, uncertainty of metal determination 30 parts per billion [ppb]).

• 

  Fig. 2 Comparison of materials without/with antibacterial layer by electron microscope. Sample identification: BM, Bard Mesh (C.R. Bard Davol Inc.); BSM, Bard Soft Mesh (C.R. Bard Davol Inc.); PM, Premilene Mesh (B. Braun); PHM, Parietex Hydrophilic 3-Dimensional Mesh (Medtronic); DE, DynaMesh Endolap (FEG Textiltechnik).

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  Fig. 3 Example of elemental analysis in graphs of Bard Mesh (C.R. Bard Davol Inc.) samples.

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  Fig. 4 Measurement of the thickness of the antimicrobial layer (scanning electron microscope) and visual evaluation of the degree of disruption after mechanical handling. Premilene Mesh (B. Braun): 84.49 nm.

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  Fig. 5 Measurement of the thickness of the antimicrobial layer (scanning electron microscope) and visual evaluation of the degree of disruption after mechanical handling. Parietex Hydrophilic 3-Dimensional Mesh (Medtronic): 98.42 nm.

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