Polycaprolactone Mesh Research Articles

Medical- and Non-Medical-Grade Polycaprolactone Mesh Printing for Prolapse Repair: Establishment of Melt Electrowriting Prototype Parameters

Pelvic organ prolapse (POP) occurs due to inadequate support of female pelvic organs and is often treated with synthetic implants. However, complications like infections, mesh shrinkage, and tissue erosion can arise due to biomechanical incompatibilities with native tissue. This study aimed to optimize the melt electrowriting process using medical-grade biodegradable Poly(ε-caprolactone) (PCL) with a pellet extruder to print meshes that mimic the mechanical properties of vaginal tissue. Square and diagonal mesh designs with filament diameters of 80 µm, 160 µm, and 240 µm were produced and evaluated through mechanical testing, comparing them to a commercial mesh and sheep vaginal tissue. The results showed that when comparing medical-grade with non-medical-grade square meshes, there was a 54% difference in the Secant modulus, with the non-medical-grade meshes falling short of matching the properties of vaginal tissue. The square-shaped medical-grade PCL mesh closely approximated vaginal tissue, showing only a 13.7% higher Secant modulus and a maximum stress of 0.29 MPa, indicating strong performance. Although the diagonal-shaped mesh exhibited a 14% stress difference, its larger Secant modulus discrepancy of 45% rendered it less suitable. In contrast, the commercial mesh was significantly stiffer, measuring 77.5% higher than vaginal tissue. The diagonal-shaped mesh may better match the stress–strain characteristics of vaginal tissue, but the square-shaped mesh offers stronger support due to its higher stress–strain curve. Overall, meshes printed with medical-grade PCL show superior performance compared to non-medical-grade meshes, suggesting that they are a promising avenue for future advancements in the field of POP repair.

Assessing the Viability of Polycaprolactone Mesh in Bilateral Orbital Floor Reconstruction: Insights From Le Fort II Fracture Cases.

This study aims to evaluate the effectiveness of pure polycaprolactone (PCL) mesh in reconstructing complex bilateral orbital floor fractures associated with Le Fort II fractures. PCL mesh is traditionally viewed as less suitable for severe fractures due to its perceived weakness. This study challenges that perception by demonstrating the utility of PCL mesh in high-severity cases. Two patients with Le Fort II fractures and bilateral orbital floor fractures underwent orbital reconstruction using a 3D-printed PCL mesh. The mesh was molded and inserted through subciliary or transconjunctival incisions. Orbital volumes were analyzed preoperatively and postoperatively using CT scans and a 3D Analysis program. Both cases demonstrated significant correction of orbital volume differences postoperatively, leading to improved symmetry and successful reconstruction. For case 1, the preoperative orbital volume difference of 3.2cc was reduced to 1.1cc postoperatively. For case 2, the preoperative orbital volume difference of 1.18cc was reduced to 0.4cc postoperatively. The PCL mesh provided adequate structural support and facilitated effective tissue integration. Despite the radiolucency of the PCL mesh on CT scans, volumetric analysis confirmed stable and balanced orbital volumes. Pure PCL mesh is a viable alternative for orbital floor reconstruction in severe craniofacial fractures, offering a balance of structural support and biocompatibility. To validate these findings, further research with larger samples and long-term follow-up is recommended.

In Vitro and In Vivo Drug Release from a Nano-Hydroxyapatite Reinforced Resorbable Nanofibrous Scaffold for Treating Female Pelvic Organ Prolapse.

Pelvic prolapse stands as a substantial medical concern, notably impacting a significant segment of the population, predominantly women. This condition, characterized by the descent of pelvic organs, such as the uterus, bladder, or rectum, from their normal positions, can lead to a range of distressing symptoms, including pelvic pressure, urinary incontinence, and discomfort during intercourse. Clinical challenges abound in the treatment landscape of pelvic prolapse, stemming from its multifactorial etiology and the diverse array of symptoms experienced by affected individuals. Current treatment options, while offering relief to some extent, often fall short in addressing the full spectrum of symptoms and may pose risks of complications or recurrence. Consequently, there exists a palpable need for innovative solutions that can provide more effective, durable, and patient-tailored interventions for pelvic prolapse. We manufactured an integrated polycaprolactone (PCL) mesh, reinforced with nano-hydroxyapatite (nHA), along with drug-eluting poly(lactic-co-glycolic acid) (PLGA) nanofibers for a prolapse scaffold. This aims to offer a promising avenue for enhanced treatment outcomes and improved quality of life for individuals grappling with pelvic prolapse. Solution extrusion additive manufacturing and electrospinning methods were utilized to prepare the nHA filled PCL mesh and drug-incorporated PLGA nanofibers, respectively. The pharmaceuticals employed included metronidazole, ketorolac, bleomycin, and estrone. Properties of fabricated resorbable scaffolds were assessed. The in vitro release characteristics of various pharmaceuticals from the meshes/nanofibers were evaluated. Furthermore, the in vivo drug elution pattern was also estimated on a rat model. The empirical data show that nHA reinforced PCL mesh exhibited superior mechanical strength to virgin PCL mesh. Electrospun resorbable nanofibers possessed diameters ranging from 85 to 540 nm, and released effective metronidazole, ketorolac, bleomycin, and estradiol, respectively, for 9, 30, 3, and over 30 days in vitro. Further, the mesh/nanofiber scaffolds also liberated high drug levels at the target site for more than 28 days in vivo, while the drug concentrations in blood remained low. This discovery suggests that resorbable scaffold can serve as a viable option for treating female pelvic organ prolapse.

Controlled Calcium Oxalate Crystals Obtained by Electrocrystallization on Electrospun Polycaprolactone Fibers Loaded with Zarzaparrilla ( Herreria stellata ).

Calcium oxalate (CaOx) is known to grow on organic matrices and is often associated with the formation of kidney stones. Therefore, it is crucial to understand the nucleation and growth mechanisms. This study investigates the role of electrospun polycaprolactone (PCL)-loaded zarzaparrilla (ZP) (Herreria stellata) in the electrocrystallization (EC) of CaOx. Electrospinning (ES) was used to prepare PCL meshes with random (R) and aligned (A) fiber orientations. CaOx particles were grown directly on conductive tin indium oxide (ITO) glass modified with electrospun ZP-loaded PCL meshes by EC. The CaOx crystals after EC were measured by chronopotentiometry (CP), optical microscopy (OM), scanning electron microscopy (SEM), and X-ray diffraction (XRD), which showed that the ZP additive and PCL fiber orientations are key factors for CaOx nucleation.

Novel Bioresorbable Drug-Eluting Mesh Scaffold for Therapy of Muscle Injury.

A novel bioresorbable drug-eluting polycaprolactone (PCL) mesh scaffold was developed, utilizing a solvent-cast additive manufacturing technique, to promote therapy of muscle injury. The degradation rate and mechanical properties strength of the PCL mesh were characterized after immersion in a buffer solution for different times. The in vitro release characteristics of vancomycin, ceftazidime, and lidocaine from the prepared mesh were evaluated using a high-performance liquid chromatography (HPLC) assay. In addition, the in vivo efficacy of PCL meshes for the repair of muscle injury was investigated on a rat model with histological examinations. It was found that the additively manufactured PCL meshes degraded by 13% after submission in buffered solution for four months. All PCL meshes with different pore sizes exhibited greater strength than rat muscle and survived through 10,000 cyclic loadings. Furthermore, the meshes could offer a sustained release of antibiotics and analgesics for more than 3 days in vitro. The results of this study suggest that drug-loaded PCL mesh exhibits superior ability to pure PCL mesh in terms of effectively promoting muscle repair in rat models. The histological assay also showed adequate biocompatibility of the resorbable meshes. The additively manufactured biodegradable drug-eluting meshes may be adopted in the future in humans for the therapy of muscle injuries.

Technology platform for facile handling of 3D hydrogel cell culture scaffolds

Hydrogels are used extensively as cell-culture scaffolds for both 2D and 3D cell cultures due to their biocompatibility and the ease in which their mechanical and biological properties can be tailored to mimic natural tissue. The challenge when working with hydrogel-based scaffolds is in their handling, as hydrogels that mimic e.g. brain tissue, are both fragile and brittle when prepared as thin (sub-mm) membranes. Here, we describe a method for facile handling of thin hydrogel cell culture scaffolds by molding them onto a polycaprolactone (PCL) mesh support attached to a commonly used Transwell set-up in which the original membrane has been removed. In addition to demonstrating the assembly of this set-up, we also show some applications for this type of biological membrane. A polyethylene glycol (PEG)-gelatin hydrogel supports cell adhesion, and the structures can be used for biological barrier models comprising either one or multiple hydrogel layers. Here, we demonstrate the formation of a tight layer of an epithelial cell model comprising MDCK cells cultured over 9 days by following the build-up of the transepithelial electrical resistances. Second, by integrating a pure PEG hydrogel into the PCL mesh, significant swelling is induced, which leads to the formation of a non-adherent biological scaffold with a large curvature that is useful for spheroid formation. In conclusion, we demonstrate the development of a handling platform for hydrogel cell culture scaffolds for easy integration with conventional measurement techniques and miniaturized organs-on-chip systems.

Engineering bone-forming biohybrid sheets through the integration of melt electrowritten membranes and cartilaginous microspheroids.

Bone fractures are one of the most common traumatic large-organ injuries and although many fractures can heal on their own, 2-12% of fractures are slow healing or do not heal (non-unions). Autologous grafts are currently used for treatment of non-unions but are associated with limited healthy bone tissue. Tissue engineered cell-based products have promise for an alternative treatment method. It was previously demonstrated that cartilaginous microspheroids of periosteum-derived cells could be assembled into scaffold-free constructs and heal murine critically-sized long bone defects (non-unions). However, the handleability of such scaffold-free implants can be compromised when scaling-up. In this work, cartilaginous spheroids were combined with melt electrowritten (MEW) meshes to create an engineered cell-based implant, able to induce in vivo bone formation. MEW polycaprolactone meshes were tailored to contain pores (116±28µm) of a size that captured microspheroids (180±15µm). Periosteum-derived microspheroids pre-cultured for 4 days, were seeded on MEW meshes and gene expression analysis demonstrated up-regulation of chondrogenic (SOX9, COL2) and prehypertrophic (VEGF) gene markers after 14 days, creating a biohybrid sheet. When implanted subcutaneously (4 weeks), the biohybrid sheets mineralized (23±3% MV/TV) and formed bone and bone marrow. Bone formation was also observed when implanted in a murine critically-sized long bone defect, though a high variation between samples was detected. The high versatility of this biofabrication approach lies in the possibility to tailor the scaffolds to shape and dimensions corresponding to the large bone defects and the individual patient using robust bone forming building blocks. These strategies are instrumental in the development of personalized regenerative therapies with predictive clinical outcomes. STATEMENT OF SIGNIFICANCE: Successful treatments for healing of large long bone defects are still limited and 2-12% of fractures do not heal properly. We combined a novel biofabrication technique: melt electrowriting (MEW), with robust biology: bone forming cartilaginous spheroids to create biohybrid sheets able to form bone upon implantation. MEW enabled the fabrication of scaffolds with micrometer-sized fibers in defined patterns which allowed the capturing of and merging with cartilaginous spheroids which had the potency to mature into bone via the developmental process of endochondral ossification. The present study contributes to the rapidly growing field of "Biofabrication with Spheroid and Organoid Materials'' and demonstrates design considerations that are of great importance for biofabrication of functional tissues through the assembly of cellular spheroids.

Vertical and horizontal ridge augmentation using customized three-dimensionally printed polycaprolactone mesh in atrophic posterior maxillae: a case report.

Polycaprolactone has exhibited expediency as a biomaterial for bone regenerative procedures preclinically. The present report of the two clinical cases in the posterior maxilla is the first to describe clinical application of a customized 3D printed polycaprolactone mesh for alveolar ridge augmentation. Two patients needing extensive ridge augmentation procedures for dental implant therapy were selected. Polycaprolactone meshes were virtually designed, 3D printed and applied in combination with a xenogeneic bone substitute. Cone-beam computed tomography was taken pre-operatively, immediately after the surgery, and 1.5 to 2 years after the delivery of implant prostheses. The serial cone-beam computed tomography images were superimposed to measure the augmented height and width at 1 mm increments from the implant platform to 3 mm apically. After 2 years, the mean [maximum, minimum] bone gain was 6.05 [8.64, 2.85] mm vertically and 7.77 [10.03, 6.18] mm horizontally at 1 mm below the implant platform. From immediately postoperative to 2 years, there was 14 % reduction of augmented ridged height and 24 % reduction of augmented width at 1 mm below the platform. All implants placed in augmented sites were successfully maintained until 2 years. The customized Polycaprolactone mesh might be a viable material for ridge augmentation in the atrophic posterior maxilla. This needs to be confirmed through randomized controlled clinical trials in future studies.

Precise Printing of Microfiber Scaffold with Gelatin Methacryloyl (GelMA)/Polyethylene Oxide (PEO) Bioink.

Gelatin methacryloyl scaffolds with microscale fiber structures own great significance because they can effectively mimic the extracellular matrix environment. Compared with extruding bioprinting, electrospinning technology is more suitable for establishing accurate hydrogel microfibers. However, electrospinning accurate gelatin methacryloyl microfiber remains a big challenge restricted by its bad spinnability. In this paper, polyethylene oxide, which owns promising spinnability, is added into gelatin methacryloyl hydrogel precursor to improve the spinnability of gelatin methacryloyl bioink. A three-dimensional motion platform for electrospinning is designed and built and the spinning process of microfibers under far-electric-field and near-electric-field conditions is systematically studied, respectively. As a result, scaffolds consisted of unordered and ordered microfibers are successfully fabricated under far-electric-field and near-electric field, respectively. In vitro culture experiments of human umbilical vein endothelial cells are carried out using the prepared gelatin methacryloyl microfiber scaffolds. The results show that the cells can easily attach to the microfibers and grow well. Moreover, the gelatin methacryloyl/ polyethylene oxide microfiber scaffold was directly spun on the polycaprolactone mesh scaffold printed by fused modeling printing method. The results showed that the macroscopic ordered and microscopic disordered microfiber scaffold could be successfully established, which could lead to directed cell growth. We believe that this method can effectively solve the problem of hydrogel spinnability and be a powerful tool for various biomedical engineering methods in the future.

Wedge resection combined with 3D-printed polycaprolactone mesh for caudal septal deviation

BackgroundBiocompatibility and stability of three-dimensional printed polycaprolactone mesh grafts for nasal surgery are proven in both animal and human models. However, their safety and durability as batten grafts for caudal septal deviation has not been documented. This study was designed to investigate the efficacy and safety of three-dimensional printed polycaprolactone mesh batten graft in septoplasty using the wedge resection technique for the correction of caudal septal deviation.MethodsThis retrospective study reviewed the medical records of 20 patients aged ≥ 18 years with caudal septal deviation who underwent septoplasty with wedge resection and three-dimensional printed polycaprolactone mesh graft from a tertiary medical center in South Korea, between December 1, 2019 and May 31, 2021. Those without nasal obstruction before surgery or with a short follow-up period (< 28 days) were excluded from the survey analysis.ResultsOf the 20 patients (mean age, 48.0 [range, 19–65] years), 17 (85.0%) were male, and three (15.0%) were female. A significant change was noted in the mean nasal obstruction symptom evaluation score (68.2 vs. 15.0, P < .001) in the 17 patients included in the analysis. Postoperative endoscopic evaluation revealed a straight septum in 19/20 (95.0%) patients, and no complications were noted in the postoperative follow-up period of up to 364 days.ConclusionsThe three-dimensional printed polycaprolactone nasal mesh is safe and provides adequate support to resist the intrinsic memory of the cartilage of the caudal septum. In addition to nasal surgeries, it has great potential as a graft in other reconstructive surgeries.Trial registration Retrospectively registered.

Effectiveness of Absorbable Plates for the Treatment of Nasal Septal Cartilage Fractures.

Nasal bone fractures are the most common type of facial fracture. Nasal bone fractures often occur in combination with septal cartilage fractures, because the nasal septal cartilage acts as a vertical strut and provides structural support for the nose and bilateral nasal airway. However, the treatment for nasal septal cartilage fracture remains controversial, and if untreated, nasal septal cartilage fracture can lead to various complications, such as nasal obstruction and posttraumatic nasal and septal deformity. This study aimed to evaluate the effectiveness and safety of our procedure in which septal cartilage fractures were treated with septoplasty using an absorbable plate as an internal splint. Between January 2017 and November 2020, 21 patients with nasal septal cartilage fractures were treated with septoplasty using an absorbable plate as an internal splint. The severity of the septal cartilage fracture was graded from 0 to 3 according to the computed tomography septal grading system. The numeric graded scale of nasal septal cartilage fracture was evaluated preoperatively and 6 months postoperatively using a computed tomography scan. Of 21 patients with septal cartilage fractures, 12 were treated with a polycaprolactone (PCL) mesh plate, and 9 were treated with a polydioxanone (PDS) plate. In the PDS plate group, the preoperative numeric scale of nasal septal cartilage fracture was 2.50 (2.00-3.00), whereas the postoperative numeric scale was 1.00 (1.00-1.25, P = 0.023). In the PCL mesh plate group, the preoperative numeric scale of nasal septal cartilage fracture was 2.00 (2.00-3.00), whereas the postoperative numeric scale was 1.00 (1.00-1.50, P = 0.034). The effectiveness of the PCL mesh plate and that of the PDS plate group according to the septal grading scale were 1.45 (SD, 0.522) and 1.18 (SD, 0.603), respectively. However, these differences were not statistically significant. Our study shows that septoplasty using absorbable plates provides satisfactory and safe clinical outcomes in patients with nasal septal cartilage fractures.

Stimuli-responsive nanoparticle-nanofiber hybrids for drug delivery and photodynamic therapy

Hybrid nanomaterials possess integrated multi-components to syncretize various properties and functions within a single entity. Owing to this synergistic effect, they promise efficient anti-cancer therapy. In line with this target, we produced stimuli-responsive nanoparticle-nanofiber hybrids (NNHs) via embedding photoresponsive natural melanin nanoparticles (MNPs) within a biocompatible polycaprolactone (PCL) nanofiber matrix. Electrospinning was performed to produce monolithic and core–shell structured NNHs using a single and a coaxial nozzle. The NNHs were upgraded to drug delivery systems by model hydrophilic drug-ampicillin (amp)-loading. The drug release results showed that monolithic PCL meshes displayed a burst release, whereas nanohybrid formation with MNPs improved the release profile toward Fickian diffusion. Core-shell NNH presented a more sustained drug release profile than its MNP-free replica and monolithic NNH because its encapsulating shell layer hindered the diffusion of the drug. The photodynamic therapy accompanied by UV-A-irradiation on monolithic and core–shell NNHs yielded up to 34 % and 37 % malignant melanoma cell death. Moreover, this study proved the potency of MNPs-enhanced NNHs in drug delivery and photodynamic therapy applications. Even so, more efforts should be concerted to unlock unknown features of the NNHs, which have the power to advance emerging areas, including but not limited to material science, biosensing, and theranostics.

Three-Dimensional Printed Polycaprolactone Mesh in Pediatric Cranial Vault Remodeling Surgery.

The surgical management of craniosynostosis has greatly evolved with improvements in both technology and understanding of the disease process. Some drawbacks remain regarding bone regeneration within the surgical bony gaps. Generally, bony gaps improve in the 12 to 24 months after surgery, but some gaps may remain for longer and cause deformity and/or require additional bony reconstruction. These considerations make tissue-engineered bone very attractive. Novel 3-dimensional printed bioresorbable mesh implants made of Polycaprolactone (PCL) can be used to fill the surgical bony defects. The authors seek to investigate how the use of a 3-dimensional printed biodegradable PCL mesh applied to bony defects in cranial vault surgery affects bone healing. Case series analysis of 8 pediatric patients who have undergone surgical intervention using PCL mesh implants for reconstruction of bony defects during craniosynostosis correction surgery. Radiological evaluation of 3 patients at random time points between 9 and 12 months postoperative revealed persistent bony gaps in areas where PCL mesh was laid. One patient who underwent a subsequent cranial vault surgery at 9 months was found to have less bone regeneration in the defect area where PCL mesh was used when compared with an adjacent area where a particulate bone graft was used. Based on our experience, the use of PCL mesh on its own did not augment bone regeneration. It is possible that a greater amount of time or increased vascularization of the scaffold is required, which supports the concept of regenerative matching axial vascularization or the further addition of osteogenic factors to increase the rate of bone formation.

Electrospun nanofiber mesh with connective tissue growth factor and mesenchymal stem cells for pelvic floor repair: Long-term study.

Pelvic organ prolapse (POP) affects many women, with an estimated lifetime risk of surgical intervention of 18.7%. There is a need for alternative approaches as the use of synthetic nondegradable mesh was stopped due to severe adverse events, and as current methods for pelvic floor repair have high POP recurrence rates. Thus, we hypothesized that electrospun degradable meshes with stem cells and growth factor were safe and durable for the long term in elderly rats. In an abdominal repair model, electrospun polycaprolactone (PCL) meshes coated with connective tissue growth factor (CTGF)/PEG-fibrinogen (PF) and rat mesenchymal stem cells were implanted in elderly female rats and removed after in average 53 weeks (53-week group). Collagen amount and production were quantified by qPCR and Western blotting. Moreover, histological appearance and biomechanical properties were evaluated. Results were compared with previous results of young rats with identical mesh implanted for 24 weeks (24-week group). The 53-week group differed from the 24-week group in terms of (1) reduced collagen III, (2) strong reduction in foreign body response, and (3) altered histological appearance. We found comparable biomechanical properties, aside from higher, not significant, mean tissue stiffness in the 53-week group. Lastly, we identified mesh components 53 weeks after implantation. This study provides new insights into future POP repair in postmenopausal women by showing how CTGF/PF-coated electrospun PCL meshes with stem cells exhibit sufficient support, biocompatibility, and no mesh-related complications long term in an abdominal repair model in elderly rats.

Electrospun Polycaprolactone (PCL) Degradation: An In Vitro and In Vivo Study.

Polycaprolactone (PCL) is widely used in tissue engineering due to its interesting properties, namely biocompatibility, biodegradability, elastic nature, availability, cost efficacy, and the approval of health authorities such as the American Food and Drug Administration (FDA). The PCL degradation rate is not the most adequate for specific applications such as skin regeneration due to the hydrophobic nature of bulk PCL. However, PCL electrospun fiber meshes, due to their low diameters resulting in high surface area, are expected to exhibit a fast degradation rate. In this work, in vitro and in vivo degradation studies were performed over 90 days to evaluate the potential of electrospun PCL as a wound dressing. Enzymatic and hydrolytic degradation studies in vitro, performed in a static medium, demonstrated the influence of lipase, which promoted a rate of degradation of 97% for PCL meshes. In an in vivo scenario, the degradation was slower, although the samples were not rejected, and were well-integrated in the surrounding tissues inside the subcutaneous pockets specifically created.

Long-Term Outcomes of Secondary Nasal Tip Plasty After Degradation of a Polycaprolactone (PCL) Mesh.

In secondary nasal tip plasty, it is often difficult to harvest appropriate septal extension grafts for sufficient tip projection. Therefore, studies using numerous alloplastic materials in rhinoplasty have been reported. This study aimed to evaluate the nasal tip change over time after tip plasty using a PCL mesh. We conducted a retrospective study of 86 Asian patients who received secondary tip plasty by septal extension grafting with a PCL mesh as a batten graft. Patient demographics and surgical outcomes were examined. The outcome variables were nasolabial angle, nasofrontal angle and Goode ratio. Measurements were performed with photographs obtained at short-term (postoperative 4-6 months) and long-term (more than postoperative 24 months) follow-ups. Aesthetic outcomes and safety were assessed using the Global Aesthetic Improvement Scale. Among 86 patients, 56 had a long-term follow-up. The mean age was 33.33 years, and the male-to-female ratio was 17.44:82.56. The nasolabial and nasofrontal angles did not change significantly between the short-term and long-term follow-ups. The Goode ratio, which is a useful tool to evaluate nasal projection, was decreased by 5.00%. Nevertheless, all patients were satisfied, and the long-term aesthetic outcomes were improved in 54 (96.4%) patients. There were two cases (2.33%) of complications, including one infection and one case of PCL-mesh protrusion. The present study demonstrated the usefulness and safety of PCL meshes when used in septal extension grafts as batten grafts. Although biodegradation seems to affect the nasal projection, PCL is still useful in secondary tip plasty along with other alloplastic materials. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Development and in vitro investigation of a biodegradable mesh for the treatment of stress urinary incontinence

Introduction and hypothesisThe use of polypropylene (PP) mesh for stress urinary incontinence (SUI) surgery has declined because of safety concerns. The aim of this study is to evaluate a biodegradable polycaprolactone (PCL) mesh and a PCL composite mesh tissue engineered with human uterine fibroblasts (HUFs) for SUI surgery by comparing mechanical properties and in vitro biocompatibility to commercially available PP and porcine dermis (PD).MethodsThe mechanical properties of four scaffold materials were evaluated: PCL, PCL-collagen-hyaluronic acid composite, acellular porcine dermal collagen (PD) (Pelvicol™) and polypropylene (Gynecare TVT™ Exact®). HUFs were seeded on separate scaffolds. After 7 and 14 days scaffolds were assessed for metabolic activity and cell proliferation using Alamar Blue, Live/Dead and PicoGreen assays. Soluble collagen production was evaluated using a Sircol assay.ResultsPCL and the composite scaffold reached ultimate tensile strength (UTS) values closest to healthy pelvic floor tissue (PCL = 1.19 MPa; composite = 1.13 MPa; pelvic floor = 0.79 MPa; Lei et al. Int Urogynecol J Pelvic Floor Dysfunct. 18(6):603-7, 2007). Cells on PCL showed significantly greater cell viability than PP at day 7 (p < 0.0001). At D14 the composite scaffold showed significantly greater cell viability than PP (p = 0.0006). PCL was the best performing scaffold for soluble collagen production at day 14 (106.1 μg versus 13.04 μg for PP, p = 0.0173).ConclusionsWe have designed a biodegradable PCL mesh and a composite mesh which demonstrate better biocompatibility than PP and mechanical properties closer to that of healthy pelvic floor tissue. This in vitro study provides promising evidence that these two implants should be evaluated in animal and human trials.

Glutathione Immobilized Polycaprolactone Nanofiber Mesh as a Dermal Drug Delivery Mechanism for Wound Healing in a Diabetic Patient

Glutathione (GSH) is an anti-inflammatory and antioxidant biomolecule. Polycaprolactone (PCL) nanofiber mesh (NFM) is capable of the attachment and release of biomolecules for prolonged periods and has the potential as a transdermal drug delivery system during wound healing for a diabetic patient. Our earlier study found that high levels of sugar in diabetic male mice were significantly decreased by daily doses of glutathione administered on the mice. Furthermore, oxidative stress found in diabetic male mice led to the total depletion of glutathione levels in the body’s organs (pancreas, spleen, epididymis, and testis). The objective of this study was to attach GSH with PCL NFM for the controlled release of GSH biomolecules for long periods of time from the fiber mesh into a diabetic body. This study produced PCL NFM using an electrospun technique and tested it on mice to evaluate its efficiency as a dermal drug delivery mechanism. This study dissolved GSH (2.5 mg/mL) with phosphate-buffered saline (PBS) and glutaraldehyde (GLU) solution to create GSH-PBS and GSH-GLU complexes. Each complex was used to soak PCL NFM for 24 h and dried to create PCL-GSH-PBS and PCL-GSH-GLU meshes. Fiber morphology, degradation, fibroblast cell proliferation, cytotoxicity, and GSH release activities from each mesh were compared. Fibroblast cell adhesion and cytotoxicity tests found excellent biocompatibility of both GSH-immobilized PCL meshes and no degradation until 20 days of the study period. The disk diffusion method was conducted to test the antibacterial properties of the sample groups. Release tests confirmed that the attachment of GSH with PCL by GSH-GLU complex resulted in a steady release of GSH compared to the fast release of GSH from PCL-GSH-PBS mesh. The disk diffusion test confirmed that PCL-GSH-GLU has antibacterial properties. The above results conclude that GSH-GLU immobilized PCL NFM can be a suitable candidate for a transdermal anti-oxidative and anti-bacterial drug delivery system such as bandage, skin graft for wound healing application in a diabetic patient.

Development of 3D Printed Biodegradable Mesh with Antimicrobial Properties for Pelvic Organ Prolapse.

To address the increasing demand for safe and effective treatment options for pelvic organ prolapse (POP) due to the worldwide ban of the traditional polypropylene meshes, this study introduced degradable polycaprolactone (PCL)/polyethylene glycol (PEG) composite meshes fabricated with melt-electrowriting (MEW). Two PCL/PEG mesh groups: 90:10 and 75:25 (PCL:PEG, wt%) were fabricated and characterized for their degradation rate and mechanical properties, with PCL meshes used as a control. The PCL/PEG composites showed controllable degradation rates by adjusting the PEG content and produced mechanical properties, such as maximal forces, that were higher than PCL alone. The antibacterial properties of the meshes were elicited by coating them with a commonly used antibiotic: azithromycin. Two dosage levels were used for the coating: 0.5 mg and 1 mg per mesh, and both dosage levels were found to be effective in suppressing the growth of S. aureus bacteria. The biocompatibility of the meshes was assessed using human immortalized adipose derived mesenchymal stem cells (hMSC). In vitro assays were used to assess the cell viability (LIVE/DEAD assay), cell metabolic activity (alamarBlue assay) and cell morphology on the meshes (fluorescent and electron microscopy). The cell attachment was found to decrease with increased PEG content. The freshly drug-coated meshes showed signs of cytotoxicity during the cell study process. However, when pre-released for 14 days in phosphate buffered saline, the initial delay in cell attachment on the drug-coated mesh groups showed full recovery at the 14-day cell culture time point. These results indicated that the PCL/PEG meshes with antibiotics coating will be an effective anti-infectious device when first implanted into the patients, and, after about 2 weeks of drug release, the mesh will be supporting cell attachment and proliferation. These meshes demonstrated a potential effective treatment option for POP that may circumvent the issues related to the traditional polypropylene meshes.

Dissection Manual for Open Rhinoseptoplasty in a Silicone Nose Model

Open rhinoseptoplasty has been widely performed in the field of otorhinolaryngology. However, from the perspective of beginners, rhinoseptoplasty is a hard-to-learn surgery that involves a relatively steep learning curve. Therefore, practical guidance is essential to enhance the skills needed for excellent surgical outcomes. Here, we provide a step-wise dissection manual using a commercialized silicone nose model designed for rhinoseptoplasty. The contents include general approaches with regard to transcolumellar inverted V incision, flap elevation, osteotomy, septoplasty, modification of the lower lateral cartilage for tip surgery, and dorsal augmentation using silicone implants. In addition, we introduce novel techniques such as dorsal augmentation using a ready-made mold with tissue glue applied to diced cartilage and polycaprolactone mesh for rhinoseptoplasty. The present study also provides photos of individual surgical procedures using a silicone nose model for actual guidance. The authors expect that this manual will help beginning rhinoseptoplasty surgeons improve their confidence.