Antibacterial Biopolymer Gel Coating on Meshes Used for Abdominal Hernia Repair Promotes Effective Wound Repair in the Presence of Infection

Prosthetic mesh infection is a devastating complication of abdominal hernia repair which impairs natural healing in the implant area, leading to increased rates of patient morbidity, mortality, and prolonged hospitalization. This preclinical study was designed to assess the effects on abdominal wall...

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Bibliographic Details
Published in:Polymers 2021-07, Vol.13 (14), p.2371
Main Authors: Benito-Martínez, Selma, Pérez-Köhler, Bárbara, Rodríguez, Marta, García-Moreno, Francisca, Gómez-Gil, Verónica, Pascual, Gemma, Bellón, Juan Manuel
Format: Article
Language:English
Subjects:
Abdomen
Angiogenesis
Antiinfectives and antibacterials
Biopolymers
Chlorhexidine
Collagen
Cytokines
Finite element method
Gels
Gene expression
Growth factors
Hernias
Laboratory animals
Matrix metalloproteinases
Microorganisms
Prostheses
Proteins
Rabbits
Scanning electron microscopy
Skin
Staphylococcus infections
Surgery
Surgical outcomes
Surgical techniques
Transplants & implants
Vascular endothelial growth factor
Wound healing
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Summary:Prosthetic mesh infection is a devastating complication of abdominal hernia repair which impairs natural healing in the implant area, leading to increased rates of patient morbidity, mortality, and prolonged hospitalization. This preclinical study was designed to assess the effects on abdominal wall tissue repair of coating meshes with a chlorhexidine or rifampicin-carboxymethylcellulose biopolymer gel in a Staphylococcus aureus (S. aureus) infection model. Partial abdominal wall defects were created in New Zealand white rabbits (n = 20). Four study groups were established according to whether the meshes were coated or not with each of the antibacterial gels. Three groups were inoculated with S. aureus and finally repaired with lightweight polypropylene mesh. Fourteen days after surgery, implanted meshes were recovered for analysis of the gene and protein expression of collagens, macrophage phenotypes, and mRNA expression of vascular endothelial growth factor (VEGF) and matrix metalloproteinases (MMPs). Compared to uncoated meshes, those coated with either biopolymer gel showed higher collagen 1/3 messenger RNA and collagen I protein expression, relatively increased VEGF mRNA expression, a significantly reduced macrophage response, and lower relative amounts of MMPs mRNAs. Our findings suggest that following mesh implant these coatings may help improving abdominal wall tissue repair in the presence of infection.
ISSN:2073-4360
2073-4360
DOI:10.3390/polym13142371