I-Corps: Drug-eluting Sutures

在许多应用中，药物洗脱缝线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），用于从妊娠晚期开始通过加强母亲虚弱（不健全）的宫颈力量来预防早产。尽管使用环扎术闭合宫颈，但已知通过宫颈迁移并感染胎儿的细菌会发生毁灭性的感染。通常口服抗菌药物或阴道栓剂用于预防感染。然而，口服途径可能会对健康的胃细菌产生不利影响，这两种方法都依赖于患者的依从性。通过将局部药物输送用于使胎儿足月所需的整整三个月的时间，这种新技术可以取代目前的治疗方法。在所有手术和创伤伤口中，有3%的患者发生感染，平均需要住院6.5天，仅在美国就增加了350 - 400亿美元的费用。虽然口服抗生素具有预防感染的既定功效，但它们具有内在风险。相反，在这项努力中开发的技术直接从缝线中提供最低有效剂量的强效广谱抗菌剂，最大限度地减少副作用。此外，从缝线施用抗菌剂可确保患者100%依从药物方案。在项目结束时，该团队将有一个编织的原型缝线，已经过更彻底的药物释放和强度检查，并在南卡罗来纳州医科大学进行了初步的体内动物试验。该团队还将就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.