3D‐Bioprinted Inflammation Modulating Polymer Scaffolds for Soft Tissue Repair

Abstract

creates a defect that intra-abdominal contents may protrude through. [1] The most common types of hernias are incisional, inguinal, femoral, umbilical and hiatal hernias. [2] Hernia repair for many defects is performed by the surgical implantation of a prosthetic mesh to firmly support and reinforce the damaged abdominal wall and facilitate the healing process (Figure 1A,B). Each year, over 400 000 incisional hernia repair surgeries are performed with a cost of ≈$15 billion in US healthcare expenditures. [3-5] Prosthetic hernia mesh implants are developed using synthetic, biologic, and coated materials. [6,7] Despite their specific advantages, these mesh implants are not very effective in minimizing potential adverse postsurgical complications. [8] Surgical hernia repair with mesh implants mostly fail due to the formation of visceral adhesions, hardening, and shrinking of the mesh after its implantation. Visceral adhesions are fibrous tissues developed from the underlying serosal membrane of stomach, intestine or colon, that attach to the implanted mesh. [9] These adhesions are mainly composed of collagen and fibroblasts that grow on the mesh and adhere to the nearby tissue, nerves and organs. [10] The mesh shrinks as the adhesions grow and scar tissue hardens, thus forming a hard, fibrous mass that may cause chronic pain, bowel obstruction, enteric fistula, infertility, poor quality of life, and failure of the surgical hernia repair. [11-13] To remove the failed hernia mesh, a complicated surgery needs to be performed, wherein the mesh must be peeled off bladder, stomach, intestine, colon, or a major blood vessel, that may adversely affect the clinical outcomes. [14] To minimize adhesions formation, graft contraction, and foreign body reactions, absorbable and biological meshes have been developed. However, these meshes are not significantly effective because of very high hernia recurrence rates. [15-17] Causative factors for adverse complications arising due to surgical mesh implantation are chronic inflammatory responses, poor mesh-tissue integration, rapid degradation of the materials, surface chemistry and topochemical design of the mesh. [18,19] We herein present the development of an intrinsically inflammation modulating 3D-fabricated biomaterial scaffold (bioscaffold) for soft tissue repair and demonstrate its in vivo efficacy in a rat ventral hernia Development of inflammation modulating polymer scaffolds for soft tissue repair with minimal postsurgical complications is a compelling clinical need. However, the current standard of care soft tissue repair meshes for hernia repair is highly inflammatory and initiates a dysregulated inflammatory process causing visceral adhesions and postsurgical complications. Herein, the development of an inflammation modulating biomaterial scaffold (bioscaffold) for soft tissue repair is presented. The bioscaffold design is based on the idea that, if the excess proinflammatory cytokines are sequestered from the site of injury by the surgical implantation of a bioscaffold,...

Peritoneum‐Inspired Janus Porous Hydrogel with Anti‐Deformation, Anti‐Adhesion, and Pro‐Healing Characteristics for Abdominal Wall Defect Treatment

“…Note that the soaking medium was PBS buffer in refs. [25,60,61,63,64,68], normal saline in refs. [62,66,67], and water in ref.…”

“…anti-adhesion and adhesion behaviors, which is difficult to simultaneously achieve based on a single patch. [20] On the one hand, anti-adhesion barriers have been widely developed based on the tissue-adhesive surfaces by various methods, such as constructing dense physical surfaces, [21,22] superhydrophobic surfaces, [23,24] negatively charged surfaces, [25,26] and so on. On the other, bioengineered patches have been widely developed to promote adhesion and proliferation of soft tissues by diverse approaches of surface modification, including loose extracellular-matrix-like surfaces, [27][28][29][30][31][32] moderately hydrophilic surfaces, [33,34] and positively charged surfaces.…”

Microfluidic 3D printing polyhydroxyalkanoates-based bionic skin for wound healing

“…In this study, the mechanical properties of P34HB/PCL microfibers and scaffolds were evaluated using a universal mechanical testing machine (figure 3(a)). The composite scaffold exhibited good flexibility to stretch, twist, fold and rapidly return to its initial shape after the external force was removed (figure 3(b), figure S6, and movie S2, support information) [41]. Figure 3(c) showed that the tensile strengths of single P34HB/PCL non-porous and porous microfibers were 2.99 MPa and 1.25 MPa, and the elongation at break was 224.1% and 215.6%, respectively.…”

New Insights into the Application of 3D-Printing Technology in Hernia Repair

“…The latest breakthrough in devices for tissue engineering of hernia defects consists of scaffolds able to modulate the inflammatory response that follows hernia repair. Shin et al manufactured inflammation-modulating PLA scaffolds crosslinked with phosphate with the physiological ability to trap inflammatory cytokines [89]. The main objective pursued was to mitigate the proinflammatory environment in the abdominal wall that usually stimulates adhesion formation in intraperitoneal mesh repairs.…”