Prosthetic meshes for hernia repair: State of art, classification, biomaterials, antimicrobial approaches, and fabrication methods

Abstract

Worldwide, hernia repair represents one of the most frequent surgical procedures encompassing a global market valued at several billion dollars. This type of surgery usually requires the implantation of a mesh that needs the appropriate chemical, physical and biological properties for the type of repair. This review thus presents a description of the types of hernias, current hernia repair methods, and the state of the art of prosthetic meshes for hernia repair providing the most important meshes used in clinical practice by surgeons working in this area classified according to their biological or chemical nature, morphology and whether bioabsorbable or not. We emphasise the importance of surgical site infection in herniatology, how to deal with this microbial problem, and we go further into the future research lines on the production of advanced antimicrobial meshes to improve hernia repair and prevent microbial infections, including multidrug-resistant strains. A great deal of progress has been made in this biomedical field in the last decade. However, we are still far from an ideal antimicrobial mesh that can also provide excellent integration to the abdominal wall, mechanical performance, low visceral adhesion and minimal inflammatory or foreign body reactions, among many other problems.

Latest Trends on the Attenuation of Systemic Foreign Body Response and Infectious Complications of Synthetic Hernia Meshes

“…14 Among them, the common nonabsorbable materials are polypropylene (PP), polyester (PET), expanded polytetrafluoroethylene (ePTFE). 15 Absorbable mesh materials include poly(4-hydroxybutyrate), poly(glycolic acid), and carboxy cellulose (poly(glycolic acid), poly(lactic acid−glycolic acid)). Biologic meshes (animal-derived meshes) are generally made up of tissues derived from autologous human tissues and heterologous cattle and pigs.…”

“…Meshes for clinical hernioplasty can be categorized as nonabsorbable prostheses, partially absorbable prostheses, and absorbable prostheses . Among them, the common nonabsorbable materials are polypropylene (PP), polyester (PET), expanded polytetrafluoroethylene (ePTFE) . Absorbable mesh materials include poly­(4-hydroxybutyrate), poly­(glycolic acid), and carboxy cellulose (poly­(glycolic acid), poly­(lactic acid–glycolic acid)).…”

Antimicrobial Meshes for Hernia Repair: Current Progress and Perspectives

“…Nowadays, there is a broad spectrum of synthetic prosthetic biomaterials (absorbable, non-absorbable) or biological meshes (xenografts and allografts) that hernia treatment may benefit from, which have been the subject of some reviews in recent years [1,3,[9][10][11][12][13][14][15].…”

Engineering Three-Dimensional-Printed Bioactive Polylactic Acid Alginate Composite Scaffolds with Antibacterial and In Vivo Osteoinductive Capacity

“…Poly­(lactic acid) (PLA) is an aliphatic polyester that can be sustainably synthesized from natural resources, and the balance of mechanical properties with biodegradation has led to its use in the production of bioabsorbable surgical sutures, screws, drug delivery systems, and scaffolds for guided tissue regeneration. − The ability to use three-dimensional (3D) printing techniques to construct PLA scaffolds with reproducible interconnected porous architectures over porogen-leaching techniques, , emulsion templating, electrospinning, , and combinations of several of these techniques , are certainly an advantage. However, one of the most economical and simplest techniques is fused deposition modeling (FDM), which only uses the biomaterial without any cells, , in which the polymer thread is wound around a bobbin and extruded from a nozzle heated to the polymer melt temperature .…”