Toward the New Generation of Surgical Meshes with 4D Response: Soft, Dynamic, and Adaptable

Abstract

Herein, a facile approach toward transforming a 2D polypropylene flexible mesh material into a 4D dynamic system is presented. The versatile platform, composed by a substrate of knitted fibers of isotactic polypropylene (iPP) mesh and a coating of thermosensitive poly(N‐isopropylacrylamide‐co‐N,N’‐methylene bis(acrylamide) (PNIPAAm‐co‐MBA) hydrogel, covalently bonded to the mesh surface, after cold‐plasma surface treatment and radical polymerization, is intended to undergo variations in its geometry via its reversible folding/unfolding behavior. The study is the first to trace the 3D movement of a flat surgical mesh, intended to repair hernia defects, under temperature and humidity control. An infrared thermographic camera and an optical microscope are used to evaluate the macroscopic and microscopic structure stimulus response. The presence of the PP substrate and the distribution of the gel surrounding the PP threads, affect both the PNIPAAM gel expansion/contraction as well as the time of folding/unfolding response. Furthermore, PP‐g‐PNIPAAm meshes show an increase in the bursting strength of ≈16% with respect to the uncoated mesh, offering a strongest and adaptable system for its future implantation in human body. The findings reported offer unprecedented application possibilities in the biomedical field.

Rapid synthesis of biocompatible bilayer hydrogels via frontal polymerization

“…We noted that the cut surfaces could heal by themselves at the ambient temperature without any external stimulation, and the healed samples could sustain vigorous stretching (Figure 5A,B). We attribute the self‐healing behavior of bilayer hydrogels to hydrogen bonding 36,37,43 . The G‐1 and G‐2 hydrogels are rich in suspended functional groups such as carbonyl groups (CO), amino groups (‐NH 2 ), and sulfonic acid groups (‐SO 3 H) ( G‐1 ) or hydroxyl groups (‐OH) ( G‐2 ), which form hydrogen bonding across the interface, to produce self‐healing phenomena when the two parts of the hydrogels bring into touch.…”

“…We attribute the self-healing behavior of bilayer hydrogels to hydrogen bonding. 36,37,43 The G-1 and G-2 hydrogels are rich in suspended functional groups such as carbonyl groups (C O), amino groups (-NH 2 ), and sulfonic acid groups (-SO 3 H) (G-1) or hydroxyl groups (-OH) (G-2), which form hydrogen bonding across the interface, to produce self-healing phenomena when the two parts of the hydrogels bring into touch. The proposal of hydrogen bonds for auto-healing was confirmed by micro-IR spectroscopic analysis (Figure 5C,D).…”

A review of smart electrospun fibers toward textiles

“…In addition, recently, some scientists reported a facile way to fabricate surgical mesh with 4D response by coating a copolymer of N,N′‐methylene bis(acrylamide) (MBA) crosslinked P(NIPAM) on a cold-plasma treated surface of PP fibers in a knitted fabric [ 80 ]. The resultant coated knitted fabric showed a 4D response upon temperature change, which may indicate one of the new generations of surgical meshes.…”

In vivosoft tissue reinforcement with bacterial nanocellulose

“…glueing). 7,8 Besides, multi-component grafts have been advocated as a well-suited strategy to isolate the PP mesh from the viscera by adding an additional layer of a synthetic 9,10 or natural biomaterial 11,12 that acts as an anti-adherent barrier. Despite recent advances, clinicians and manufacturers are still pursuing an optimal mesh to improve the clinical outcome and the costeffectiveness ratio of hernioplasty procedures by leveraging the selection of materials, porous structure, mechanical resistance, anti-adhesive properties, biocompatibility, long term mechanical stability, tissue integration and conformability.…”