Preparation of antiadhesion polypropylene mesh using bacterial cellulose combined with chitosan hydrogel application in rat abdominal incisional hernia

Abstract

Abstract OBJECTIVE: To develop an antiadhesion polypropylene (PP) mesh by incorporating bacterial cellulose (BC) combined with chitosan (CS) hydrogel and to evaluate its properties using an intraperitoneal mesh repair approach in a rat model of abdominal incisional hernia. MATERIALS AND METHODS: BC was used to prepare hydrogels through cross-linking of CS. The hydrogel was adhered to the surface of a PP mesh using a glue applicator to form an antiadhesion mesh. Forty-eight male rats were randomly divided into four groups of 12 members each: PP, antiadhesion mesh (Sepramesh), BC mesh, and BCCS mesh. Incisional hernia models of the abdominal wall of the rats were created sequentially, and meshes were subsequently inserted. At 7 days postoperation, six rats were randomly selected for euthanasia, and the repaired abdominal wall tissues, adhesions, and mesh were removed for pathological analysis. Similarly, the remaining six rats were euthanized at 14 days postoperation, and their respective abdominal wall tissues, adhesions, and mesh were also excised for pathological examination. RESULTS: BC is combined with CS hydrogel, and the mixture is adhered to the PP mesh using a glue applicator. The mesh adhesion scores in the PP group were consistently high. The adhesion scores of the BC group were better than those of the PP group. There were no statistically significant differences in the indices between the Sepramesh and BCCS groups, and both groups showed lower adhesion grades. Hematoxylin-eosin staining revealed that the natural tissue inflammatory response of the BCCS group was lower, and its prosthetic (mesh) surface inflammatory response was lower than that of the other groups. On the other hand, the inflammatory response in the BCCS group was lower. Masson’s trichrome staining showed that the number of cells formed in the scar plate of the Sepramesh and BCCS groups was significantly lower than that of the other groups, the degree of tissue ingrowth was also better in both groups, and the biocompatibility of the BCCS group was better. CONCLUSION: BC is bonded with CS hydrogel and then adhered to the surface of PP mesh by an applicator to make an antiadhesive mesh. This mesh may reduce intraabdominal adhesions and intraabdominal bacterial colonization while possessing good strength and biocompatibility, thereby contributing to peritoneal repair.