Abdominal closure reinforcement by using polypropylene mesh functionalized with poly-Ԑ-caprolactone nanofibers and growth factors for prevention of incisional hernia formation

Abstract

Incisional hernia affects up to 20% of patients after abdominal surgery. Unlike other types of hernia, its prognosis is poor, and patients suffer from recurrence within 10 years of the operation. Currently used hernia-repair meshes do not guarantee success, but only extend the recurrence-free period by about 5 years. Most of them are nonresorbable, and these implants can lead to many complications that are in some cases life-threatening. Electrospun nanofibers of various polymers have been used as tissue scaffolds and have been explored extensively in the last decade, due to their low cost and good biocompatibility. Their architecture mimics the natural extracellular matrix. We tested a biodegradable polyester poly-ε-caprolactone in the form of nanofibers as a scaffold for fascia healing in an abdominal closure-reinforcement model for prevention of incisional hernia formation. Both in vitro tests and an experiment on a rabbit model showed promising results.

Significant improvement of biocompatibility of polypropylene mesh for incisional hernia repair by using poly-ε-caprolactone nanofibers functionalized with thrombocyte-rich solution

“…51 Previous studies have mentioned various drug-delivery systems based on a PCL composite scaffold successfully used for hernia regeneration. 29,44,45 PCL nanofibers were used in our study as a carrier of GFs gradually released from platelets adhered to the nanofiber surface, with the aim of using the material in hernia regeneration. The use of this system enabled us to avoid the complications caused by a burst release of high doses of GFs.…”

“…Our previous study proved the suitability of a composite scaffold based on PCL nanofibers deposited on a PP mesh for hernia regeneration in rabbits. 29 A histological and biomechanical evaluation revealed PCL nanofibers had better healing capacity than conventional PP mesh for preventing hernia formation. 29 In the present study, we tested a new composite scaffold based on a PP surgical mesh, PCL nanofibers, and adhered thrombocytes.…”

“…29 A histological and biomechanical evaluation revealed PCL nanofibers had better healing capacity than conventional PP mesh for preventing hernia formation. 29 In the present study, we tested a new composite scaffold based on a PP surgical mesh, PCL nanofibers, and adhered thrombocytes. We evaluated the effect of released GFs from thrombocytes and the effect of PCL nanofiber functionalization on 3T3 fibroblast proliferation in vitro.…”

“…20 Nanofibers can be produced from materials that are biocompatible and biodegradable, such as poly-ε-caprolactone (PCL), 21 poly(lactic-co-glycolic) acid (PLGA), 21 and chitosan. 22 PCL has frequently been chosen for electrospinning, because it is a US Food and Drug Administration (FDA)-approved material and has been shown to support the attachment and growth of chondrocytes, 23 osteoblasts, 24,25 smooth muscle cells, 26 fibroblasts, 24,[27][28][29] myoblasts, 30 and mesenchymal stem cells (MSCs). 31 PCL appears to be a suitable material for scaffold preparation for reparative surgery.…”

Development and Characterization of Novel Electrospun Meshes for Hernia Repair

“…Furthermore, these films are often used as adhesion barrier layers and have no direct interaction with the hernia site [5]. Conversely, it has been demonstrated that resorbable nanofiber layers in direct contact with the hernia site promote collagen deposition and remodeling, and yield better mechanical properties at the wound interface compared to polypropylene mesh alone [21]. This suggests that if the adhesion barrier layer was made from nanofibers instead of a film, there would be a significantly lower inflammatory response.…”