A newly-designed 3D-printed Biomesh effectively minimized postsurgical complications of hernia repair in an animal model.

The condition may develop serious complications, therefore hernia repair may be recommended. Repair consists of surgically implanting a prosthetic mesh to support and reinforce the damaged abdominal wall and facilitate the healing process. However, currently used mesh implants are associated with potentially adverse postsurgical complications.

«Although hernia mesh implants are mechanically strong and support abdominal tissue, making the patient feel comfortable initially, it is a common problem that about three days after surgery the implant can drive inflammation that in two to three weeks will affect organs nearby,» said Dr. Crystal Shin, assistant professor of surgery at Baylor College of Medicine and lead author of this study looking to find a solution to postsurgical hernia complications.

Mesh implants mostly fail because they promote the adhesion of the intestine, liver or other visceral organs to the mesh. As the adhesions grow, the mesh shrinks and hardens, potentially leading to chronic pain, bowel obstruction, bleeding and poor quality of life. Some patients may require a second surgery to repair the unsuccessful first. «Inflammation is also a serious concern,» said Dr. Ghanashyam Acharya, associate professor of surgery at Baylor. «Currently, inflammation is controlled with medication or anti-inflammatory drugs, but these drugs also disturb the healing process because they block the migration of immune cells to the injury site.»

«To address these complications, we developed a non-pharmacological approach by designing a novel mesh that, in addition to providing mechanical support to the injury site, also acts as an inflammation modulating system,» Shin said.

Opposites attract

«A major innovation to our design is the development of a Biomesh that can reduce inflammation and, as a result, minimize tissue adhesion to the mesh that leads to pain and failure of the surgery,» Shin said. Inflammatory mediators called cytokines appear where the mesh is implanted a few days after the surgery. Some of the main cytokines in the implant, IL1-?, IL6 and TNF-?, have a positive surface charge due to the presence of the amino acids lysine and arginine.

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