LIPUS-activated piezoelectric sutures exert antibacterial and pro-regenerative effects to promote wound healing

Background Sutures are essential for preventing surgical site infections (SSIs) and promoting wound healing, yet current drug-based antibacterial strategies often fail to sustain long-term efficacy and may induce drug resistance. Objective To develop a drug-free dual-function electroactive (DE) suture with piezoelectric properties, and evaluate its antibacterial and wound-healing performance in vitro and in vivo . Methods DE sutures were fabricated and tested under low-intensity pulsed ultrasound (LIPUS). Antibacterial activity was assessed via ROS generation and bacterial viability assays. In vivo evaluation was performed using rat full thickness incision model with histological and immunohistochemical analyses of inflammation, vascularization, and tissue regeneration. Results LIPUS-activated DE sutures generated ROS that disrupted bacterial membranes, significantly reducing bacterial viability. In vivo , DE sutures attenuated inflammation, promoted angiogenesis, and enhanced tissue regeneration. Multi-strand designs showed improved mechanical and pro-healing performance. Conclusion This piezoelectric-enabled, LIPUS-triggered DE suture provides a drug-free strategy for simultaneous infection control and tissue repair, offering a promising approach in regenerative tissue engineering.