Foreign Body Reaction Associated with PET and PET-Chitosan Electrospun Nanofibrous Abdominal MeshesReport as inadecuate

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Electrospun materials have been widely explored for biomedical applications because of their advantageous characteristics, i.e., tridimensional nanofibrous structure with high surface-to-volume ratio, high porosity, and pore interconnectivity. Furthermore, considering the similarities between the nanofiber networks and the extracellular matrix ECM, as well as the accepted role of changes in ECM for hernia repair, electrospun polymer fiber assemblies have emerged as potential materials for incisional hernia repair. In this work, we describe the application of electrospun non-absorbable mats based on polyethylene terephthalate PET in the repair of abdominal defects, comparing the performance of these meshes with that of a commercial polypropylene mesh and a multifilament PET mesh. PET and PET-chitosan electrospun meshes revealed good performance during incisional hernia surgery, post-operative period, and no evidence of intestinal adhesion was found. The electrospun meshes were flexible with high suture retention, showing tensile strengths of 3 MPa and breaking strains of 8–33%. Nevertheless, a significant foreign body reaction FBR was observed in animals treated with the nanofibrous materials. Animals implanted with PET and PET-chitosan electrospun meshes fiber diameter of 0.71±0.28 µm and 3.01±0.72 µm, respectively showed, respectively, foreign body granuloma formation, averaging 4.2-fold and 7.4-fold greater than the control commercial mesh group Marlex. Many foreign body giant cells FBGC involving nanofiber pieces were also found in the PET and PET-chitosan groups 11.9 and 19.3 times more FBGC than control, respectively. In contrast, no important FBR was observed for PET microfibers fiber diameter = 18.9±0.21 µm. Therefore, we suggest that the reduced dimension and the high surface-to-volume ratio of the electrospun fibers caused the FBR reaction, pointing out the need for further studies to elucidate the mechanisms underlying interactions between cells-tissues and nanofibrous materials in order to gain a better understanding of the implantation risks associated with nanostructured biomaterials.

Author: Beatriz Veleirinho , Daniela S. Coelho, Paulo F. Dias, Marcelo Maraschin, Rúbia Pinto, Eduardo Cargnin-Ferreira, Ana Peixoto, Jo



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