Macro/nano topological modification of a silk fibroin mesh with mimicked extracellular matrix structure and excellent biocompatibility.

Synthetic surgical meshes have been widely used for repairing hernias, but their performance, such as nonabsorbability and insufficient mechanical strength, requires further improvement due to postsurgical complications, including chronic pain and inflammation. In this work, naturally derived and bioresorbable silk fibroin meshes (SFM) with three knit patterns were optimized and modified by a combination of regenerated silk fibroin (RSF) and polydopamine (PDA), to endow SFM with a mimicked extracellular matrix (ECM) structure and excellent biocompatibility. Our study confirmed that the modified meshes (SFM@PDA-RSF) exhibited ECM-like structure and good structural stability. Tensile testing results revealed that the SFM substrate played a dominant role in mechanical properties, and SFM@PDA-RSF showed high tensile strength (49.58 N cm^-1 transversely, 68.42 N cm^-1 longitudinally), which could afford sufficient mechanical support for abdominal wall hernia (AWH) repair (16 N cm^-1). Moreover, SFM@PDA-RSF was found to be significantly antioxidant, non-hemolytic, and favorable for cell adhesion and growth, showing great potential for effective hernia repair.