Significant improvement of biocompatibility of polypropylene mesh for incisional hernia repair by using poly-ε-caprolactone nanofibers functionalized with thrombocyte-rich solution

Abstract

Incisional hernia is the most common postoperative complication, affecting up to 20% of patients after abdominal surgery. Insertion of a synthetic surgical mesh has become the standard of care in ventral hernia repair. However, the implementation of a mesh does not reduce the risk of recurrence and the onset of hernia recurrence is only delayed by 2–3 years. Nowadays, more than 100 surgical meshes are available on the market, with polypropylene the most widely used for ventral hernia repair. Nonetheless, the ideal mesh does not exist yet; it still needs to be developed. Polycaprolactone nanofibers appear to be a suitable material for different kinds of cells, including fibroblasts, chondrocytes, and mesenchymal stem cells. The aim of the study reported here was to develop a functionalized scaffold for ventral hernia regeneration. We prepared a novel composite scaffold based on a polypropylene surgical mesh functionalized with poly-ε-caprolactone (PCL) nanofibers and adhered thrombocytes as a natural source of growth factors. In extensive in vitro tests, we proved the biocompatibility of PCL nanofibers with adhered thrombocytes deposited on a polypropylene mesh. Compared with polypropylene mesh alone, this composite scaffold provided better adhesion, growth, metabolic activity, proliferation, and viability of mouse fibroblasts in all tests and was even better than a polypropylene mesh functionalized with PCL nanofibers. The gradual release of growth factors from biocompatible nanofiber-modified scaffolds seems to be a promising approach in tissue engineering and regenerative medicine.

Collagen‐inducing biologization of prosthetic material for hernia repair: Polypropylene meshes coated with polyP/collagen

“…In our studies we used MC3T3‐E1 cells to assess the inducibility of SDF‐1. The functional studies with 3T3 fibroblasts showed that they have only a very little propensity to attach to the untreated meshes, as already described earlier . However, they readily and extensively attach to the meshes after coating with polyP/collagen.…”

“…It is self‐explanatory that the mechanical properties and the mechanical compatibility between the respective hernia meshes and the tissue layers are crucial for the success of hernia operations and are important determinators in avoiding postoperative complications and hernia recurrences. Hybrid materials, composed of a resistant durable mesh surrounded by biocompatible and biodegradable material might be the solution …”

“…Hybrid materials, composed of a resistant durable mesh surrounded by biocompatible and biodegradable material might be the solution. 13 Based on the observation that blood platelets accumulate in close association with freshly implanted hernia meshes, it was found that addition of autologous plateletrich plasma accelerates the integration of the meshes. 14 In the search for applicable and (potentially) routinely usable of hybrid meshes, provided with the benefits of blood platelets extracts, it has been proposed to include proregenerative growth factors and chemokines into the meshes.…”

Platelet-functionalized three-dimensional poly-ε-caprolactone fibrous scaffold prepared using centrifugal spinning for delivery of growth factors

“…Alfa granules of platelets contain a wide range of growth factors, including PDGF, TGF-β, PDAF, VEGF, EGF, PDEGF, ECGF and IGF. 9 It has been reported that the use of platelets is beneficial for healing of bone, 10 cartilage, 11 tendon, 12 hernia 13 and skin 14 defects. One of the main advantages of using platelets as a source of growth factor is the possibility of autologous use, which reduces the immune reaction.…”

“…11 Platelets adhered effectively to nanofibers, and the released growth factors enhanced the adhesion and proliferation of chondrocytes. The system of electrospun PCL nanofibers with adhered platelets was also tested in a study by Plencner et al 13 The nanofibrous samples with adhered platelets were tested with fibroblast as a potential chirurgical mesh. The study showed that the platelets improved the properties of PCL nanofibers.…”