Abstract
Electrospun materials have been widely explored for biomedical applications because of their advantageous characteristics, i.e., tridimensional nanofibrous structure with high surface-to-volume ratio, high porosity, and pore interconnectivity. Furthermore, considering the similarities between the nanofiber networks and the extracellular matrix (ECM), as well as the accepted role of changes in ECM for hernia repair, electrospun polymer fiber assemblies have emerged as potential materials for incisional hernia repair. In this work, we describe the application of electrospun non-absorbable mats based on poly(ethylene terephthalate) (PET) in the repair of abdominal defects, comparing the performance of these meshes with that of a commercial polypropylene mesh and a multifilament PET mesh. PET and PET/chitosan electrospun meshes revealed good performance during incisional hernia surgery, post-operative period, and no evidence of intestinal adhesion was found. The electrospun meshes were flexible with high suture retention, showing tensile strengths of 3 MPa and breaking strains of 8–33%. Nevertheless, a significant foreign body reaction (FBR) was observed in animals treated with the nanofibrous materials. Animals implanted with PET and PET/chitosan electrospun meshes (fiber diameter of 0.71±0.28 µm and 3.01±0.72 µm, respectively) showed, respectively, foreign body granuloma formation, averaging 4.2-fold and 7.4-fold greater than the control commercial mesh group (Marlex). Many foreign body giant cells (FBGC) involving nanofiber pieces were also found in the PET and PET/chitosan groups (11.9 and 19.3 times more FBGC than control, respectively). In contrast, no important FBR was observed for PET microfibers (fiber diameter = 18.9±0.21 µm). Therefore, we suggest that the reduced dimension and the high surface-to-volume ratio of the electrospun fibers caused the FBR reaction, pointing out the need for further studies to elucidate the mechanisms underlying interactions between cells/tissues and nanofibrous materials in order to gain a better understanding of the implantation risks associated with nanostructured biomaterials.
Highlights
Electrospinning has attracted the interest of researchers from many fields as a versatile technique to produce nanofibers from synthetic and naturally derived polymers
We describe the application of three electrospun nonabsorbable mats, including poly(ethylene terephthalate) (PET), PET/ chitosan (PET/C) and double-layered mesh (DL), in the repair of abdominal defects, comparing the performance of these nanofibrous meshes with that of a commercial polypropylene mesh (Marlex) and a multifilament microfibrous PET mesh
Compared to PET/C, PET mesh showed superior mechanical properties with a higher tensile strength (3.1760.23 MPa compared to 2.8960.27 MPa), Young’s modulus (120610 compared to 70610 MPa), and elongation (32.865.7% compared to 8.261.3%)
Summary
Electrospinning has attracted the interest of researchers from many fields as a versatile technique to produce nanofibers from synthetic and naturally derived polymers. With typical diameters ranging from 10 nm to a few micrometers, these fibers are usually collected continuously as nonwoven fibrous mats. These mats usually show a tridimensional nanostructure with high surface-tovolume ratio, high porosity, and interconnectivity, and they have demonstrated high potential for biomedical applications, such as tissue engineering scaffolds, vascular grafts, and drug delivery systems [1,2,3]. Our research group has been exploring the potential of electrospinning for different applications [4]. The promising results obtained in vitro prompted us to test these nondegradable electrospun mats as abdominal meshes for incisional hernia repair
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