title: Anti-inflammatory coatings of hernia repair meshes: A pilot study.
abstract: The current prevalence of postoperative chronic pain from hernioplasty procedures employing polymer mesh is close to 30%. Most of the researchers agree that oxidative stress, resulting from the release of oxidants and enzymes during acute inflammatory response, is a key factor in the development of posthernioplasty complications. This results in both the decrease of the biomechanical properties and stiffening of the polymer fibers of the mesh, leading to chronic pain. Moreover, enhanced activity of inflammatory cells can lead to an excessive deposition of connective tissue around the implant. In this study polypropylene hernia repair meshes coated with vitamin E (α-tocopherol), a known antioxidant, were prepared and characterized. The absorption isotherm of vitamin E on the mesh was characterized and a release profile study yielded a promising results, showing sustained release of the drug over a 10-day period. An animal study was conducted, and histological analysis five weeks after implantation exhibited a reduced host tissue response for a modified mesh as compared to a plain mesh, as evidenced by a higher mature collagen to immature collagen ratio, as well as lower level of fatty infiltrates, neovascularization and fibrosis in the case of modified mesh. These results support the use of α-tocopherol as a potential coating in attempt to reduce the extent of postoperative inflammation, and thereby improve long-term outcomes of hernioplasty. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 589-597, 2018.
authors.affiliation: Department of Bioengineering, Clemson University, 301 Rhodes Hall, Clemson, South Carolina, 29634.
authors.forename: Dmitry
authors.initials: D
authors.lastname: Gil
authors.affiliation: Department of Bioengineering, Clemson University, 301 Rhodes Hall, Clemson, South Carolina, 29634.
authors.forename: James
authors.initials: J
authors.lastname: Rex
authors.affiliation: The Hernia Center, Department of Surgery, Greenville Health System, 2104 Woodruff rd. Greenville, South Carolina, 29607.
authors.forename: William
authors.initials: W
authors.lastname: Cobb
authors.affiliation: Department of Bioengineering, Clemson University, 301 Rhodes Hall, Clemson, South Carolina, 29634.|Institute for Biological Interfaces of Engineering, Clemson University, 301 Rhodes Hall, Clemson, South Carolina, 29634.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Reukov
authors.affiliation: Department of Bioengineering, Clemson University, 301 Rhodes Hall, Clemson, South Carolina, 29634.
authors.forename: Alexey
authors.initials: A
authors.lastname: Vertegel
mesh_terms: D000818:Animals; D000975:Antioxidants / Q000737:chemistry / Q000494:pharmacology*; D020099:Coated Materials, Biocompatible / Q000737:chemistry / Q000494:pharmacology*; D059685:Herniorrhaphy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D023421:Models, Animal; D010865:Pilot Projects; D011126:Polypropylenes / Q000737:chemistry / Q000494:pharmacology; D011817:Rabbits; D017568:Rectus Abdominis / Q000187:drug effects / Q000601:surgery; D013526:Surgical Mesh / Q000009:adverse effects*; D014810:Vitamin E / Q000737:chemistry / Q000494:pharmacology*; D014945:Wound Healing / Q000187:drug effects
chemical_list: D000975:Antioxidants; D020099:Coated Materials, Biocompatible; D011126:Polypropylenes; D014810:Vitamin E
keywords: anti-inflammatory coating; hernia; histology; oxidative stress; tocopherol