Abdominal PP meshes coated with functional core-sheath biodegradable nanofibers with anticoagulant and antibacterial properties

Abstract

Abdominal hernia repair is a common surgical procedure, involving in most cases the use of textile meshes providing a mechanical barrier to consolidate the damaged surrounding tissues and prevent the resurgence of the hernia. However, in more than half cases postoperative complications such as adhesions and infections occur at the surface of the mesh, leading to chronic pain for the patient and requiring the removal of the implant. One of the most promising strategies to reduce the risk of postoperative adhesions and infections is to add a physical barrier between the mesh and the abdominal walls. In this study, we propose a strategy to develop functional hernia meshes possessing anticoagulant and antibacterial activities depending on the side of the implant. Two bioactive polymers were synthetized: a polysulfonate (poly(2-acrylamido-2-methylpropane sulfonic acid), PAMPS) one for anticoagulant activity and a polymer bearing ternary amines (poly((2-tert-butylamino) ethyl methacrylate), PTBAEMA) for antibacterial activity. These polymers were used to produce core-sheath nanofibers thanks to coaxial electrospinning with poly(ɛ-caprolactone) (PCL) as core and the bioactive polymer as sheath. The electrospinning parameters were optimized in order to obtain defect-free nanofibrous coatings onto the mesh with improved stability in water. The core-sheath structure was investigated as well as the presence of the functional groups at the surface. The in vitro cytocompatibility, anticoagulant activity and antibacterial activity were evaluated and highlighted the high potential of these coatings for the simultaneous prevention of postoperative adhesions and infections.