Abstract
Background: Biomedical device-associated infections pose major challenges in surgical care, particularly in hernia repair where polypropylene (PP) meshes and sutures are prone to bacterial colonization and biofilm formation. The limitations of antibiotic resistance and toxicity warrants the need of developing innovative antibacterial strategies. Methods: We developed a composite coating of hydroxypropyl methylcellulose (HPMC) and zinc oxide nanorods (ZnO NP) synthesized via thermal decomposition. This coating was applied to PP meshes and sutures to enhance anti-adhesive properties. The study evaluated surface hydrophilicity through water contact angles, estimation of Zn(2+) ions using inductively coupled plasma-mass spectrometry (ICP-MS), and long-term efficacy over six months. Safety was assessed via systemic toxicity studies in murine models. Results: The ZnO NPs exhibited potent antibacterial efficacy, achieving up to 99.999% killing against Klebsiella pneumoniae. When applied as an HPMC-ZnO coating, PP meshes and sutures demonstrated enhanced hydrophilicity, reducing water contact angles by ~41° and facilitating prevention of bacterial adhesion. The coated meshes inhibited bacterial attachment by 83% (Escherichia coli), 60% (Pseudomonas aeruginosa), 99.6% (K. pneumoniae), and 99% (Staphylococcus aureus). Similarly, coated sutures reduced adhesion by 67-96% across these strains. Long-term storage studies showed retained antibiofilm efficacy for up to six months. In vivo assessments indicated negligible systemic toxicity of ZnO NPs in murine models. Conclusions: Collectively, these findings highlight HPMC-ZnO NPs coatings as a safe, durable, and effective strategy to functionalize PP-based meshes and sutures, reducing the risk of surgical site infections and demonstrating the potential for broader biomedical applications.