I-Corps: Drug-eluting Sutures

在许多应用中，药物洗脱缝合可以预防感染并最终挽救生命。该团队最初的目标应用是宫颈环扎术（缝合线），从妊娠晚期开始，通过增强母亲虚弱（无能）的宫颈的强度来预防早产。尽管用环扎术关闭了子宫颈，但已知会发生毁灭性的感染，细菌会通过子宫颈迁移并感染胎儿。通常使用口服抗菌剂或阴道托来预防感染。然而，口服途径可能对健康的胃细菌产生不利影响，两种方法都依赖于患者的依从性。通过将局部药物输送到胎儿足月所需的整整三个月时间，这项新技术可以取代目前的治疗方法。在所有外科和创伤性伤口中，有3%的患者会发生感染，平均需要住院6.5天，仅在美国就增加了350亿至400亿美元的费用。虽然口服抗生素在预防感染方面具有既定的功效，但它们具有固有的风险。相反，在这项工作中开发的技术直接从缝合处提供最小有效剂量的强大广谱抗菌药物，最大限度地减少副作用。此外，从缝合线处施用抗菌药物可确保患者100%遵守药物治疗方案。在项目结束时，该团队将有一个编织的原型缝线，该缝线已经过更彻底的药物释放和强度检查，并已在南卡罗来纳医科大学进行了初步的体内动物试验。该团队还将对该技术的潜在商业化做出决定。

There are many applications where a drug-eluting suture can prevent infection and ultimately save lives. The team's initial target application is a cervical cerclage (suture), which is utilized to prevent premature birth by bolstering the strength of a mother's weak (incompetent) cervix from the beginning of their third trimester. Despite closing the cervix with a cerclage, devastating infections are known to occur from bacteria that migrate through the cervix and infect the fetus. Typically oral antimicrobials or vaginal pessaries are prescribed to prevent infection. However, the oral route may adversely affect healthy stomach bacteria, and both methods rely on patient compliance. By incorporating a localized drug delivery for the full three month duration needed to bring the fetus to term this new technology can usurp current treatments. In 3% of all surgical and traumatic wounds a patient develops an infection, necessitating an average 6.5-day hospital stay, adding $35-40 billion in expenses in the United States alone. While orally-administered antibiotics have an established efficacy towards preventing infection, they come with inherent risks. Instead, the technology developed in this effort delivers the minimally-effective dose of a powerful broad-spectrum antimicrobial directly from a suture, minimizing side effects. Further, administration of the antimicrobial from the suture ensures 100% patient compliance with the drug regimen. At the end of the project, the team will have a woven, prototype suture that has been examined more thoroughly for drug release and strength and has gone through preliminary in vivo animal trials at the Medical University of South Carolina. The team will also have a go/no go decision with regard to potential commercialization of the technology.