Abstract
Polypropylene (PP) large pore size nets have been most widely used implants for hernia repair. Nevertheless, the growth of bacteria within PP mesh pores after operation is a major reason of hernia recurrence. Secondly, pre-operative prophylaxis during mesh implantation has failed due to the hydrophobic nature of PP meshes. Herein, chitosan cross-linked and levofloxacin HCl incorporated, antimicrobial PP mesh devices were prepared using citric acid as a bio-based and green cross-linking agent. The inert PP mesh fibers were surface activated using O2 plasma treatment at low pressure. Then, chitosan of different molecular weights (low and medium weight) were cross-linked with O2 plasma activated surfaces using citric acid. Scanning electron microscopy (SEM), energy dispersive X-ray (EDX) spectroscopy, and Fourier transform infrared (FTIR) spectroscopy confirmed that chitosan was cross-linked with O2 plasma-treated PP mesh surfaces and formed a thin layer of chitosan and levofloxacin HCl on the PP mesh surfaces. Moreover, antimicrobial properties of chitosan and levofloxacin HCl-coated PP meshes were investigated using an agar plate release method. The coated PP meshes demonstrated excellent antimicrobial inhibition zone up to 10 mm. Thus, modified PP meshes demonstrated sustained antimicrobial properties for six continuous days against Staphylococcus aureus (SA) and Escherichia coli (EC) bacteria.
Highlights
Light weight polypropylene (PP) mesh implantation for hernia repair has been performed to reinforce damaged tissues of the abdominal wall [1]
A thin layer of chitosan and levofloxacin HCl was observed on the surfaces of the PP meshes
Chitosan was cross-linked with PP meshes using citric acid monohydrate, as shown in the reaction scheme (Figure 2)
Summary
Light weight polypropylene (PP) mesh implantation for hernia repair has been performed to reinforce damaged tissues of the abdominal wall [1]. Chitosan is commonly used in biomedical devices because of its excellent antimicrobial properties against gram-positive and gram-negative bacteria. Levofloxacin HCl is a soluble drug commonly used for infection prevention with suitable release properties and it is capable of inhibiting both types (gram-negative and gram-positive) of bacteria [33]. A simple textile based one bath padding method was selected to incorporate a chitosan and levofloxacin HCl coating onto oxygen plasma-treated meshes using citric acid.
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