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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.

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INTRODUCTION: The aim of this work was the evaluation of surface modification in surgery of normally used hernia implants and thus improving their antimicrobial properties. The modification consisted of applying hybrid nanolayers with immobilized antiseptic substances (metal cations of Ag, Cu, and Zn) by sol-gel method which ensures prolonged effect of these substances and thus enables a greater resistance of the implant towards infection. In this work, attention is drawn to the issue of applying hybrid nanolayers, activation of mesh surfaces by physical plasma modification or ultraviolet C (UV C) radiation, and influence of these modifications on the mechanical properties of the final meshes. Next work will continue concentrating on the issue of antimicrobial efficacy and eventual toxicity of the prepared layers. MATERIALS AND METHODS: Present-day materials of the most commonly used types of implants for reconstruction of the abdominal wall in surgery (polypropylene, polyester, polyvinylidenefluoride) were tested. Optimum conditions of application of nanolayers by sol-gel method and their thermal stabilization were examined first. Surface modification was verified by scanning electron microscope. The surface of implants was first activated for better adhesion by plasma treatment or UV radiation after preliminary tests. Maximum strength and ductility after activation and hybrid nanolayer modification were objectively measured on a universal Testometric tensile testing machine. RESULTS: The results of surface activation of the meshes (by both plasma treatment or UV C radiation) provided similar and satisfactory results, and particular conditions differed based on the type of material of the mesh. Usage of antimicrobial sol AD30 diluted by isopropyl alcohol in 1:1 proportion appear to be optimal. All tested cases of meshes activated by plasma treatment or UV C radiation and with applied nanolayer concluded in a slight reduction of mechanical properties in modified meshes in comparison with the original ones. However, a slight reduction of test values was not of clinical importance. CONCLUSION: It was verified that surface modification of implants by sol-gel method is effective and technically possible, providing hopeful results.

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BACKGROUND: Healthcare-acquired infections by pathogenic microorganisms including viruses represent significant health concern worldwide. Next to direct transmission from person-to-person also indirect transmission from contaminated surfaces is well documented and important route of infections. Here, we tested antiviral properties of hybrid coating containing silver, copper and zinc cations that was previously shown to be effective against pathogenic bacteria including methicillin-resistant Staphylococcus aureus. Hybrid coatings containing silver, copper and zinc cations were prepared through radical polymerization via sol-gel method and applied on glass slides or into the wells of polymethylmethacrylate plates. A 10 µl droplet of several viruses such as human immunodeficiency virus type 1 (HIV-1), influenza, dengue virus, herpes simplex virus, and coxsackievirus was added to coated and uncoated slides or plates, incubated usually from 5 to 240 min and followed by titer determination of recovered virus. RESULTS: Scanning electron microscopy analysis showed better adhesion of coatings on glass surfaces, which resulted in 99.5-100 % HIV-1 titer reduction (3.1 ± 0.8 log10TCID50, n = 3) already after 20 min of exposure to coatings, than on coated polymethylmethacrylate plates with 75-100 % (1.7 ± 1.1 log10TCID50, n = 3) and 98-100 % (2.3 ± 0.5 log10TCID50, n = 3) HIV-1 titer reduction after 20 and 120 min of exposure, respectively. Slower virucidal kinetics was observed with other enveloped viruses, where 240 min exposure to coated slides lead to 97 % (dengue), 100 % (herpes simplex) and 77 % (influenza) reduction in virus titers. Interestingly, only marginal reduction in viral titer after 240 min of exposure was noticed for non-enveloped coxsackie B3 virus. CONCLUSIONS: Our hybrid coatings showed virucidal activity against HIV and other enveloped viruses thus providing further findings towards development of broad-spectrum antimicrobial coating suitable for surfaces in healthcare settings.

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Epidemics spread many types of pathogenic bacterial strains, especially strains of MRSA (Methicillin-resistant Staphylococcus aureus), which are being increasingly reported in many geographical areas [1]. This is becoming to be a serious global problem, particularly in hospitals. Not only are antibiotics proving to be increasingly ineffective but also the bacteria responsible for more than 70% of hospital-acquired bacterial infections are resistant to at least one of the drugs commonly used to treat them. In this study, hybrid coating A1 and nanocomposite hybrid coating A2 based on TMSPM (3-(trimethoxysilyl)propyl methacrylate, MMA (methyl methacrylate), TEOS (tetraethyl orthosilicate) and IPTI (titanium isopropoxide) containing silver and copper ions with or without nanoparticles of titanium dioxide were prepared by the sol-gel method. They were deposited on glass, poly(methyl methacrylate) and cotton using dip-coating or spin-coating, and then cured at 150 °C for 3 h or, in the case of poly(methyl methacrylate), at 100 °C for 4.5 h. The morphology and microstructure of these hybrid coatings were examined by SEM. The abrasion resistance was tested using a washability tester and found to depend heavily on the curing temperature. Seven types of bacterial strains were used to determine the profile of antibacterial activity, namely Escherichia coli, Staphylococcus aureus, Methicillin-resistant Staphylococcus aureus - MRSA (CCM 4223), MRSA-2 (CCM 7112), Acinetobacter baumanii, Pseudomonas aeruginosa, and Proteus vulgaris (according to ALE-G18, CSNI). All the samples were tested by irradiating with either a UV-A or a daylight fluorescent lamp. All types of hybrid coating A1 and nanocomposite hybrid coating A2 were found to possess an excellent antibacterial effect, including against the pathogenic bacterial strains of MRSA, which present a dangerous threat on a global scale.

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