Antibacterial Polylactic-co-glycolic Acid Braided Threads Using Plasma and Coating Modifications for Acupoint Catgut Embedding Therapy Applications

Polylactic-co-glycolic acid (PLGA) thread is frequently used for acupoint catgut embedding therapy (ACET), but the poor hydrophilicity and biocompatibility largely limited its wider applications. The aim of this study is to functionalize the PLGA braided thread and improve its cell adhesion property. The PLGA strands are first processed into threads on a circular braiding machine, and then, antibacterial treatment was introduced with and without oxygen plasma treatments. Afterward, functional characterizations such as antibacterial activity (Staphylococcus aureus and Escherichia coli), cytotoxicity, cell attachment and cell morphology, histological observation, and biodegradation experiments of threads were measured. Moreover, tensile properties and flexibility of the threads were determined to evaluate their mechanical properties. The modified threads showed rougher surfaces than those of the unmodified ones from SEM observations, and the weights and fiber diameters of the threads increased correspondingly, together with the improved surface hydrophilicity. All coated sutures showed durable antimicrobial function and slow drug releasing features for more than 5 days and good cell viability (more than 75%), according to the standard of ISO 10993-5:2009. Besides, cell attachment, tissue growth, and collagen regeneration of plasma-treated samples were greatly improved compared to those of without the plasma treatment. The threads presented slow degradation behavior after the antibacterial treatment. The threads with only plasma-treated revealed a promising prospect for clinical applications.