Multifunctional hernia repair biopatch: Development, characterization, in vitro and in vivo evaluation

Incisional hernia, a prevalent postoperative complication, is characterized by the protrusion of organs or tissues through damaged abdominal wall. Predisposing factors for hernias include obesity, wound infections, immunosuppression, and comorbidities. However, hernia patches currently in use, including the commercial polypropylene (PP) patch, still have limitations in providing the mechanical and biological properties necessary for abdominal wall regeneration. In this study, three dimensional (3D) printing and coaxial electrospinning methods were combined to create a multifunctional double layered hernia repair biopatch to overcome these limitations. The double-layer design of the biopatch serves a multifunctional role in addressing incisional hernia models, with 3D printed ciprofloxacin (CIP) loaded polycaprolactone (PCL)/gelatin (Ge) scaffold (3DCIP) layer and coaxially electrospun PCL/Ge/kappa-carrageenan (kappa-C) nanofiber (NF) layers. While 3DCIP layers provides temporary mechanical reinforcement to the damaged abdominal wall, prevention of adhesions to internal organs, and reduction of surgical site infections, NF layer serves as tissue regeneration and fast wound healing. The developed multifunctional hernia biopatches underwent comprehensive physical and chemical characterization, followed by in vitro and in vivo evaluations. These evaluations included comparisons with a commercial PP patch, which was used as the control in the experiments. The study successfully fabricated multifunctional hernia biopatches with excellent antibacterial properties, high mechanical robustness, and strong biocompatibility.