Tailor‐Made 3D Printed Meshes of Alginate‐Waterborne Polyurethane as Suitable Implants for Hernia Repair

Abstract

Hernia injuries are the main condition where mesh implants are needed to provide a suitable reinforcement of the damaged tissue. Mesh implants made of polypropylene (PP) are widely used for this application, however complications related to lack of flexibility, elasticity, and mesh infection have been reported. The development of mesh implants from safer materials adaptable to patient necessities can suppose an alternative for conventional PP meshes. In this work, personalized mesh implants made of alginate and waterborne-polyurethane (A-WBPU) are developed using 3D printing technology. For that purpose, five waterborne polyurethane ink formulations with different amounts of alginate are developed and rheologically characterized. All ink formulations are 3D printed showing good printability, manufacturing surgical mesh implants with suitable morphological characteristics customizable to patient injury through computer-aided design (CAD) mesh model adaptation. A calcium chloride (CaCl 2 ) coating is applied after 3D printing as mesh reinforcement. Mechanical analysis revealed that CaCl 2 coated meshes containing 6 wt % of alginate in their formulation are the most suitable to be used as implants for small and groin hernias under physiological tensile strength value of 16 N cm −1 , and presenting proper elasticity to cover physiological corporal movements (42.57 %). Moreover, an antibiotic-loaded A-WBPU formulation suitable for 3D printing of meshes are developed as strategy to avoid possible mesh infection.

A Review of Advanced Abdominal Wall Hernia Patch Materials

“…This approach avoids biomechanical errors and complications caused by infection, leading to a higher rate of successful AWR. [21,202] The generation of a sequence of two dimensions (2D) images using computer software based on a 3D model is originally carried out. Subsequently, the material is layer by layer deposited onto the baseplate in 3D printer, in accordance with the sequential 2D images, ultimately "printing" the 3D object (Figure 5A).…”

“…The mesh model is established by means of computer-aided design (CAD) software to ensure that the final 3D object has the appropriate morphological characteristics. [21] This workflow can be used to design a customized 3D AWHPMs that matches the injured or damaged area of the patient, restoring the biocharacteristics and biomechanical function of the AW after implantation. For instance, Zhang et al [80] printed a novel PLA/TPU/ADM mesh with three dissimilar topological structures namely, square, circular, and diamond-shaped micropores (Figure 5B(ii)).…”

“…[153] These techniques are frequently employed for the direct or indirect production of patches with bio-multifunctional properties. [21,189] Specifically, patches fabricated through Schiff base cross-linking (Figure 10A(i)) demonstrate good hydrocoagulability, biocompatibility, adjustability, [133] sustainability, and the ability to mimic the biological environment. [219] Hu et al [133] have synthesized a biological multifunctional hydrogel patch by means of the coupling of carboxymethyl chitosan (CMCS) with 4-arm-poly (ethylene glycol) aldehyde (4-arm-PEG-CHO).…”

“…[14][15][16][17][18][19][20] CRLs detached from the structure of PP/CRLs under specific conditions can be by oneself recreated as state-of-the-art AWH-PMs. Recently, there has been a drive to progress more biomultifunctional AWHPMs, where CRLs-molded AWHPMs can be broadly classified into three distinct categories: [21][22][23][24] 1) fiberbased structures, AWHPMs of including different forms such as membranes, scaffolds, and so on; 2) gel-and hydrogel-based families; and 3) drug-encapsulated species. These advanced struc- ture patches are considered as examples of alternative AWHPMs that exhibit significant biomimetic characteristics, [16,25] being tailorable, and extracellular matrix-like (ECM-like).…”

Waterborne Polyurethane-Urea-Based Composite Inks for 3D Printing with Enhanced Properties

“…13,24 However, the rheological behavior of WBPUU dispersions is often inadequate to be used in DIW 3D printing; thus, they need to be modulated by addition of other components. 7,24 As previously stated, natural polymers can result in inks with excellent rheological properties. Thus, inks prepared with a mix of WBPPU and a natural polymer could benefit from the mechanical properties of the former and the rheological properties of the latter.…”