Biomechanical, Topological and Chemical Features That Influence the Implant Success of an Urogynecological Mesh: A Review

Maria, Carmelo De; Santoro, Vito; Vozzi, Giovanni

doi:10.1155/2016/1267521

Cited by 9 publications

(9 citation statements)

References 36 publications

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“…After demonstrating the antimicrobial activity of PAR-loaded HA hydrogels, we evaluated the possibility to associate them to medical materials used for clinical applications. We selected a nonwoven fabric used for wound cleaning and dressing (hydrophilic gauze made of 70% viscose and 30% polyester) and a polypropylene (PP) mesh used for treatment of urogynecological pathologies 42 (Figure 7A−C). HA hydrogels were successfully deposited onto both materials and showed antibacterial activity similar to HA hydrogel discs (Figure S8) after loading with PAR.…”

Section: ■ Materials and Methodsmentioning

confidence: 99%

Polyanionic Hydrogels as Reservoirs for Polycationic Antibiotic Substitutes Providing Prolonged Antibacterial Activity

Gribova

Boulmedais

Dupret‐Bories

et al. 2020

ACS Appl. Mater. Interfaces

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Implantation of biomedical devices is often followed by bacterial infections that may seriously affect implant functionalities and lead to their failure. In the context of bacterial resistance to antibiotics, which is a growing problem worldwide, new strategies that are able to overcome these problems are needed. In this work, we introduce a new formulation of hyaluronic acid (HA)-based antimicrobial material: HA hydrogels loaded with polyarginine (PAR), a polycationic antibiotic substitute. The loading is possible through electrostatic interactions between negatively charged HA and positively charged PAR. Such hydrogels absorb high quantities of PAR, which are then gradually released from the hydrogel. This original system provides a long-lasting antibacterial effect on an in vitro model of repetitive infection, thus demonstrating a strong potential to fight multiple rounds of infections that are resistant to antibiotic treatment. In addition, HA-PAR hydrogels could be deposited onto/into medical devices such as wound dressings and mesh prostheses used in clinical applications. Finally, we performed first in vivo tests of hydrogel-coated mesh materials to verify their biocompatibility in a rat model, which show no difference between control HA hydrogel and PAR-loaded hydrogel in terms of inflammation.

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Section: ■ Materials and Methodsmentioning

confidence: 99%

Polyanionic Hydrogels as Reservoirs for Polycationic Antibiotic Substitutes Providing Prolonged Antibacterial Activity

Gribova

Boulmedais

Dupret‐Bories

et al. 2020

ACS Appl. Mater. Interfaces

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“…Prior to the worldwide ban, the commercially available pelvic meshes were generally created via knitting or weaving techniques [11,12]. These polypropylene meshes were designed to exhibit high tensile strength to support the pelvis.…”

Section: Introductionmentioning

confidence: 99%

Development of 3D Printed Biodegradable Mesh with Antimicrobial Properties for Pelvic Organ Prolapse

et al. 2022

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To address the increasing demand for safe and effective treatment options for pelvic organ prolapse (POP) due to the worldwide ban of the traditional polypropylene meshes, this study introduced degradable polycaprolactone (PCL)/polyethylene glycol (PEG) composite meshes fabricated with melt-electrowriting (MEW). Two PCL/PEG mesh groups: 90:10 and 75:25 (PCL:PEG, wt%) were fabricated and characterized for their degradation rate and mechanical properties, with PCL meshes used as a control. The PCL/PEG composites showed controllable degradation rates by adjusting the PEG content and produced mechanical properties, such as maximal forces, that were higher than PCL alone. The antibacterial properties of the meshes were elicited by coating them with a commonly used antibiotic: azithromycin. Two dosage levels were used for the coating: 0.5 mg and 1 mg per mesh, and both dosage levels were found to be effective in suppressing the growth of S. aureus bacteria. The biocompatibility of the meshes was assessed using human immortalized adipose derived mesenchymal stem cells (hMSC). In vitro assays were used to assess the cell viability (LIVE/DEAD assay), cell metabolic activity (alamarBlue assay) and cell morphology on the meshes (confocal and electron microscopy). The cell attachment was found to decrease with increased PEG content. The freshly drug-coated meshes showed signs of cytotoxicity during the cell study process. However, when pre-released for 14 days in phosphate buffered saline, the initial delay in cell attachment on the drug-coated mesh groups showed full recovery at the 14-day cell culture time point. These results indicated that the PCL/PEG meshes with antibiotics coating will be an effective anti-infectious device when first implanted into the patients, and, after about 2 weeks of drug release, the mesh will be supporting cell attachment and proliferation. These meshes demonstrated a potential effective treatment option for POP that may circumvent the issues related to the traditional polypropylene meshes.

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“…Overall, there were 6 synthetic transvaginal prolapse mesh products with MDRs, 4 currently available sacrocolpopexy products, and 10 currently available midurethral slings (Table 2), with 34,485 total reports. Characteristics and textile properties of available mesh products are listed in Table 1 16–19 . Among the 20 products, there were 164 unique patient complaints, spanning multiple organ systems.…”

Section: Resultsmentioning

confidence: 99%

“…Characteristics and textile properties of available mesh products are listed in Table 1. [16][17][18][19] Among the 20 products, there were 164 unique patient complaints, spanning multiple organ systems. The most frequent patient problems were the same for all mesh product groups: "unspecified injury," pain, erosion, and infection.…”

Section: Resultsmentioning

confidence: 99%

Complications Reported to the Food and Drug Administration: A Cross-sectional Comparison of Urogynecologic Meshes

Sassani¹,

Moalli²,

Bradley³

2022

Female Pelvic Med Reconstr Surg

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ImportanceThe U.S. Food and Drug Administration uses the Manufacturer and User Facility Device Experience database to evaluate the safety of urogynecologic meshes; however, reports on individual meshes have not been characterized.ObjectiveThe aim of the study was to compare complications among available urogynecologic meshes reported to the Manufacturer and User Facility Device Experience database.Study DesignThis study is a cross-sectional analysis of medical device reports (MDRs) of urogynecologic mesh from January 2004 to March 2019, using the Reed Tech Navigator (LexisNexis), which codes MDRs. The percentage of reports containing specific complaints (not an adverse event rate) were compared with χ2 tests with Dunn-Sidak correction. Correlations with time on market, mesh weight, stiffness, and porosity were determined.ResultsThe 34,485 reports examined included 6 transvaginal meshes, 4 sacrocolpopexy meshes, and 10 midurethral slings. Most reported events were pain, erosion, and infection. For transvaginal prolapse, less than 10% of Uphold Lite (Boston Scientific) reports contained pain or erosion versus greater than 90% of Prolift/Prolift+M (Ethicon, P < 0.001). For sacrocolpopexy mesh, greater than 90% of Gynemesh (Ethicon; Prolift in vaginal form) reports included erosion and pain versus less than 60% for Artisyn (Ethicon), Restorelle (Colpoplast), and Upsylon (Boston Scientific, P < 0.0001). For slings, Gynecare TVT Obturator had the highest proportion of erosion and pain complaints. Heavier sling meshes had more reports. When Ascend (Caldera Medical), an outlier with only 5 reports, was excluded, transvaginal mesh stiffness correlated strongly with number of reports. For transvaginal meshes, number of reports correlated with time on market (ρ = 0.8, P = 0.04).ConclusionsIndividual meshes have different properties with different complication profiles, which should inform mesh development and use. Gynemesh MDRs included pain and erosion more frequently than others. Comprehensive registries are needed.

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Biomechanical, Topological and Chemical Features That Influence the Implant Success of an Urogynecological Mesh: A Review

Cited by 9 publications

References 36 publications

Polyanionic Hydrogels as Reservoirs for Polycationic Antibiotic Substitutes Providing Prolonged Antibacterial Activity

Polyanionic Hydrogels as Reservoirs for Polycationic Antibiotic Substitutes Providing Prolonged Antibacterial Activity

Development of 3D Printed Biodegradable Mesh with Antimicrobial Properties for Pelvic Organ Prolapse

Complications Reported to the Food and Drug Administration: A Cross-sectional Comparison of Urogynecologic Meshes

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