Self-reinforced silk nanofibrils networks enable ultrafine fibroin monofilament sutures applied in minimally invasive surgery

Superfine recycled regenerated silk fibroin (RRSF) monofilament sutures are designed to minimize surgical incisions, prevent scar formation, and facilitate precise suturing in cosmetic and plastic surgeries. However, balancing fineness and strength remains a challenge because the RRSF extraction process disrupts the hierarchical structure of natural silk fibers, leading to suboptimal mechanical properties. This study employed mechanical peeling and grinding to exfoliate β-sheets-rich silk fibroin nanofibrils (SFNF), which served as homologous reinforcing materials uniformly dispersed in the RRSF spinning system. Water-soluble, biocompatible polyvinyl alcohol (PVA) was introduced to enhance ductility. The fiber underwent extensive water immersion stretching to produce ultrafine fibers and foster a highly oriented internal self-reinforcing SFNF network structure. Monofilament surgical sutures were successfully fabricated following surface coating with chitosan. Our results showed that with 0.1 wt% SFNF and a stretching multiplier of 2.5, the tensile strength of the fibers increased by 33 % compared to those without SFNF. Fluorescence staining confirmed the presence of highly oriented SFNF networks within the fibers. Mechanical simulations validated the pronounced reinforcement effect of this network structure. The sutures, measuring 39.38 μm in diameter and exhibiting a tensile strength of 0.31 N, met USP standards for 9-0 surgical sutures, making them suitable for microsurgery. Additionally, they demonstrated antibacterial properties, biocompatibility, and degraded at a rate of 43.09 % within 30 days. In animal trials, the sutures facilitated wound closure, reduced inflammatory responses, and minimized scar formation.