Double-Action Disinfection with Silk Fibroin Gauze: Reliable Therapeutics to Prevent Infectious Complications

Surgical site infections, which represent the most frequently encountered cause of mortality in infectious complications, impede normal recovery and degrade the hopeful prognosis of patients. To prevent such infections, this study aims to establish an innovative therapeutic method, double-action disinfection, realized using a silk fibroin gauze. The ideal requirement for double-action disinfection is the co-exhibition of an adhered occlusive barrier and elution-based biochemical activity in a single material. To this end, the intrinsic structure of the silk fibroin gauze is designed as a type I conformation. Thus, the silk fibroin gauze exhibits an adhesive force (shear stress ≈ 51.8 kPa) larger than that of commercial tissue adhesives. Simultaneously, the drug-elution rate from the silk fibroin gauze is 3.46 mg cm-3 min-1/2, enabling dosage comparable to that of existing drug-eluting therapeutic strategies. The silk fibroin gauze promotes double-action disinfection of the exploratory laparotomy site and prevents surgical-site-infection-associated complications in vivo, leading to the hopeful prognosis of the inflammatory disease without surgical site infection. Furthermore, synergy with antibiotics significantly alleviates the effect of severe disease, which demonstrates the clinical potential of the proposed therapeutic method.