Next-generation surgical meshes for drug delivery and tissue engineering applications: materials, design and emerging manufacturing technologies

Abstract

Surgical meshes have been employed in the management of a variety of pathological conditions including hernia, pelvic floor dysfunctions, periodontal guided bone regeneration, wound healing and more recently for breast plastic surgery after mastectomy. These common pathologies affect a wide portion of the worldwide population; therefore, an effective and enhanced treatment is crucial to ameliorate patients’ living conditions both from medical and aesthetic points of view. At present, non-absorbable synthetic polymers are the most widely used class of biomaterials for the manufacturing of mesh implants for hernia, pelvic floor dysfunctions and guided bone regeneration, with polypropylene and poly tetrafluoroethylene being the most common. Biological prostheses, such as surgical grafts, have been employed mainly for breast plastic surgery and wound healing applications. Despite the advantages of mesh implants to the treatment of these conditions, there are still many drawbacks, mainly related to the arising of a huge number of post-operative complications, among which infections are the most common. Developing a mesh that could appropriately integrate with the native tissue, promote its healing and constructive remodelling, is the key aim of ongoing research in the area of surgical mesh implants. To this end, the adoption of new biomaterials including absorbable and natural polymers, the use of drugs and advanced manufacturing technologies, such as 3D printing and electrospinning, are under investigation to address the previously mentioned challenges and improve the outcomes of future clinical practice. The aim of this work is to review the key advantages and disadvantages related to the use of surgical meshes, the main issues characterizing each clinical procedure and the future directions in terms of both novel manufacturing technologies and latest regulatory considerations. Graphic abstract

3D bioprinted scaffolds for diabetic wound-healing applications

“…The 3D printing method was first demonstrated in the 1980s, and since then, the field of 3D printing (3DP) and bioprinting has grown rapidly in recent years due to technological developments and greater understanding on the capabilities using these technologies, particularly in the development of scaffolds for tissue engineering applications [6]. In the fabrication of 3D (bio)printed scaffolds, the user is firstly required to design a scaffold using computeraided design (CAD).…”

The Role of Mesh Implants in Surgical Treatment of Parastomal Hernia

“…Post-operative infection and recurrence are the primary problems associated with hernia repair [4]. The formation of peritoneal adhesions between the abdominal viscera and the mesh is another cause for concern and is the most crucial parameter for parastomal hernia repair.…”

Antimicrobial Meshes for Hernia Repair: Current Progress and Perspectives

“…In the future, other fabrication techniques such as 3D printing could be employed to develop surgical meshes that are individually tailored to each patient's needs and that would present improved antibacterial drug release properties [87][88][89].…”