Innovative Silk Sutures Delivering Tranexamic Acid and Dexamethasone: Haemocompatibility and Potential for Oral Surgery Applications

Background: Postoperative bleeding and inflammation are significant challenges in oral and maxillofacial surgery. Conventional systemic administration of antifibrinolytics and corticosteroids has limitations including side effects and suboptimal local drug concentrations. Drug-eluting sutures represent an innovative strategy for localized, controlled drug delivery. Objective: This study evaluated the haemocompatibility of silk sutures coated with polycaprolactone (PCL) incorporating tranexamic acid (TXA) and dexamethasone (DEX). Methods: Silk sutures were coated with PCL containing TXA and DEX. Haemocompatibility was tested using ASTM F756-17 haemolysis assay with human blood. Haemolysis percentage was calculated and materials were classified as non-haemolytic (5%). Uncoated sutures served as controls. Results: All sutures showed haemolysis values below 2%. Uncoated silk sutures had the lowest haemolysis (0.4%), while drug-coated sutures showed slightly higher values (0.71.4%). The increase was not statistically significant and remained within non-haemolytic limits. Conclusion: PCL-coated silk sutures loaded with TXA and DEX demonstrated excellent haemocompatibility, supporting their potential as safe dual-drug delivery platforms for oral surgical wound management.