Features of In Vitro Degradation and Physical Properties of a Biopolymer and In Vivo Tissue Reactions in Comparison with Polypropylene

The use of animal models in preclinical investigations for the development of a surgical mesh for pelvic organ prolapse

“…Not placed under tension, which may affect results USA Bickhaus et al [ 8 ] Mesh B: lightweight, knitted PP mesh 1.5-mm pores Rat (SD) Lightweight PP meshes with 1.5-mm pore size Vagina and proximal vs distal lumbar vertebrae Comparison between sham operation only (control), mesh sutured only on the vagina (vaginal mesh), sacrocolpopexy without tension, and sacrocolpopexy with tension 90 Attachment of prolapse mesh resulted in an increased histological inflammatory response independent of tension Ovariectomy to cancel hormonal effects on outcomes USA Bickhaus et al [ 9 ] Rat (Wistar) Mesh A: biodegradable polymer 65% polycaprolactone and 35% polytrimethylene carbonate Inter-fascial space between dorsal muscles (back) Each rat had two meshes placed at the back, experimental and PP mesh, each 1 × 1 cm 90 and 180 Mesh A degraded by 9% over 6 months, noted to be too fast to allow tissue regeneration. More fibrosis noted with biopolymer matrix, which is ideal for managing POP Biodegradable polymer not suitable for long-term prolapse support Russia Eisenakh et al [ 10 ] Mesh B: PP mesh Rat (SD) Gynemesh® Vagina Ovariectomy performed 1 week prior to mesh implantation. PP mesh seeded with human umbilical cord-derived stem cells 7, 28 and 84 At 12 weeks, better outcomes with stem cells seeded PP mesh with host response and tissue regeneration Testing stem cells coating on larger animals would provide more accurate results China Deng et al [ 11 ] Rat (SD) Mesh A: novel polycarbonate material based on fourfold hydrogen bonding ureidopyrimidinone Abdominal wall Abdominal wall was reconstructed with mesh in the rat hernia model 2, 7, 14, 28 and 90 Results showed th...…”

“…However, this prevents investigation of efficacy. The small size of rats also imposes limitations on the level of tension that can be applied when investigating pelvic mesh, thereby restricting the scope of investigations [ 10 ]. Although the rat model cannot be used to test treatment efficacy, it is readily available for toxicology and biocompatibility.…”

Polypropylene Pelvic Mesh: What Went Wrong and What Will Be of the Future?

“…This section will only mention the novel devices that have reached preclinical animal trials for the application of pelvic surgery. Polycaprolactone (PCL) has the greatest volume of published research regarding application with animal studies showing promising results [ 53 , 54 , 55 , 56 , 57 ], including further experimental studies combining PCL with stem cells to augment the results [ 58 , 59 ]. Biodegradable PCL has also been included in experimental studies, although results found that degradation of the mesh occurred faster than tissue regeneration, hence, the higher risks of implant failure [ 60 ].…”