Biosynthesis of Zinc Oxide Nanoparticles Using Aqueous Piper betle Leaf Extract and Its Application in Surgical Sutures

Surgical site infection (SSI), mainly caused by Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli), is considered the most frequent complication in a surgical patient. Globally, surgical site infection accounts for 2.5%-41.9% and even higher rates in developing countries. SSI affects not only the patient's health but also the development of society. Like previous reports, a surgical suture increases the hazard of SSI due to its structure. The antibacterial suture is the most effective solution to decrease the SSI. Due to some unique properties, nano-zinc oxide (ZnO NPs) is one of the promising antibacterial agents for coating on the suture. In this study, we aim to synthesize the ZnO NPs using Piper betle leaf extract and used it to coat the suture. The effect of synthesis parameters on the size and morphology of ZnO NPs was studied as well. The UV-Vis spectrum indicated the formation of ZnO NPs with lambda max at around 370 nm. The volume of leaf extract plays a role in controlling the size and morphology of zinc oxide nanoparticles. The average particle size of as-synthesized ZnO NPs was around 112 nm with a hexagonal and spherical shape. Other than that, the results proved that ZnO NPs performed a high antibacterial activity against S. aureus and E. coli with its antibacterial effectiveness up to 5 days. The ZnO NP-coated sutures also exhibited a high performance on bacterial inactivation. With key findings, this study made a tremendous contribution to lowering the burden on medical services in terms of medical treatment cost in developing countries.