Early and late effects of absorbable poly(vinyl alcohol) hernia mesh to tissue reconstruction

Abstract

Hernia is a defect of the abdominal wall. Treatment is principally surgical mesh implantation. Non-degradable surgical meshes produce numerous complications and sideeffects such as inflammatory response, mesh migration and chronic pain. In contrast, the biodegradable, poly (vinyl alcohol) (PVA) based polymers have excellent chemical, mechanical and biological properties and after their degradation no chronic pain can be expected. The toxicology of PVA solution and fibers was investigated with Human dermal fibroblast-Adult cell line. Implantation tests were observed on long-term contact (rat) and large animal (swine) models. To measure the adhesion formation, Diamond and Vandendael score were used. Macroscopical and histological responses were graded from the samples. In vitro examination showed that PVA solution and fibers are biocompatible for the cells. According to the implantation tests, all samples were integrated into the surrounding tissue, and there was no foreign body reaction. The average number of adhesions was found on the non-absorbable suture line. The biocompatibility of the PVA nanofiber mesh was demonstrated. It has a non-adhesive, non-toxic and good quality structure which has the potential to be an alternative solution for the part of the hernia mesh.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Assessment of mesh shrinkage using fibroblast-populated collagen matrices: a proof of concept for in vitro hernia mesh testing

“…Using cell culture techniques to test hernia meshes in vitro has been explored a number of times in the literature. Similar to our work, Fehér et al [ 28 ] used HDF cells to test hernia meshes by seeding them directly onto different products. Whilst the study was able to stain the cells and assess their morphology, cellular function was not assessed.…”

Designing Double‐Layer Multimaterial Composite Patch Scaffold with Adhesion Resistance for Hernia Repair

“…This phenomenon is due to the fact that PVA acts as a physical barrier in vivo and will effectively block tissue contact between the two sides, while creating a beneficial environment for the recovery of the defect by preventing scar formation that usually occurs at the early stage. [ 64 ] Figure 6F shows the tissue area covered by each patch after 4 weeks of implantation. The tissue area covered by PCL patch was 7.60 cm 2 , the tissue area covered by PCL–PVA patch was 2.85 cm 2 , and the tissue area covered by composite patch was 7.25 cm 2 .…”

Fabrication of Mechanically Enhanced, Suturable, Fibrous Hydrogel Membranes

“…A hernia is defined as a protrusion of an internal organ through the cavity it normally resides in [ 7 , 8 , 9 ]. Hernias most commonly occur in the abdominal region where visceral tissues, typically intestines, due to several causes, can eventually bulge through the abdominal wall.…”

“…PVA is known for several successful biomedical applications, including drug capsule components, contact lenses, drug carrier systems, and others [ 18 , 19 , 20 , 21 , 22 , 23 ]. PVA has been investigated before as a potential hernia mesh [ 9 , 16 ] due to its favourable anti-adhesive properties, but unfortunately, due to its poor mechanical performance, it has been put aside while researchers concentrated on other applications.…”