Institute of Applied Medical Engineering, Dept. of Biohybrid & Medical Textiles (BioTex), RWTH Aachen University, Germany.
Institute for Pathology at the Düren Hospital, Düren, Germany.
J Mech Behav Biomed Mater. 2021 Jul;119:104490. doi: 10.1016/j.jmbbm.2021.104490. Epub 2021 Mar 23.
Mesh implant has been applied in hernia repair and urogynecological reconstruction. Polypropylene (PP) is now the most widely used material for non-resorbable mesh implants. A degradation phenomenon of PP mesh, which is apparent on the mesh surface as cracking, flaking and peeling, was discovered in the 1990's. This phenomenon of mesh implant has drawn attention because of mesh-related litigations. Polyvinylidene fluoride (PVDF), due to its high biocompatible performance, has been used since 2003 as an alternative material for non-resorbable mesh implants. Till now, no such degradation phenomenon of PVDF mesh has been reported, although limited study on PVDF mesh is available. In this paper, we researched the degradation of PVDF meshes taking the degradation of PP mesh as a reference. The meshes analysed in this study were received from a previous animal experiment. To expose the surface of explanted meshes, a tissue removing method with protease was used and the result of this cleaning process was tested by X-ray Photoelectron Spectroscopy (XPS). The morphological condition of the mesh surface was compared using Scanning Electron Microscopy (SEM) and the chemical condition concerning degradation was analysed through Fourier Transform Infrared Spectroscopy (FTIR). The surface condition of PVDF mesh after 3-, 6-, 12- and 24-month implantation was illustrated and compared with two types of PP meshes. XPS revealed an absence of nitrogen, confirming the successful removal of tissue residues using protease. SEM results presented no notable morphological surface change of the PVDF mesh and progressive surface cracking processes over time of both types of PP meshes. FTIR spectra of the implanted PVDF meshes had no considerable difference from the spectrum of the pristine mesh, while FTIR spectra of both types of PP meshes had extra chemical functional groups (carbonyl (CO) and hydroxyl (-OH) groups) increasing with implantation time, indicating progressive degradation. This study highlights the morphological and chemical stability of the PVDF mesh and demonstrates that the PVDF mesh is more resistant to degradation in comparison to the other two types of PP meshes.
网片植入物已被应用于疝修补和妇泌尿科重建。目前，聚丙烯（PP）是最广泛应用于不可吸收性网片植入物的材料。20 世纪 90 年代发现，PP 网片存在降解现象，表现在网片表面出现开裂、剥落和脱皮等现象。这种网片植入物的降解现象引起了人们的关注，因为它与网片相关的诉讼有关。聚偏二氟乙烯（PVDF）由于其高生物相容性，自 2003 年以来已被用作不可吸收性网片植入物的替代材料。到目前为止，虽然对 PVDF 网片的研究有限，但尚未报道这种降解现象。在本文中，我们以 PP 网片的降解为参考，研究了 PVDF 网片的降解。本研究分析的网片是从以前的动物实验中获得的。为了暴露植入物网片的表面，采用蛋白酶组织去除法，并通过 X 射线光电子能谱（XPS）对清洗效果进行了测试。通过扫描电子显微镜（SEM）比较了网片表面的形态状况，并通过傅里叶变换红外光谱（FTIR）分析了降解相关的化学状况。结果表明，在 3、6、12 和 24 个月的植入后，PVDF 网片的表面状况如图所示，并与两种类型的 PP 网片进行了比较。XPS 显示没有氮的存在，这证实了蛋白酶成功地去除了组织残留。SEM 结果表明，PVDF 网片的表面形态没有明显变化，而两种类型的 PP 网片的表面随着时间的推移出现了渐进的表面开裂过程。植入的 PVDF 网片的 FTIR 光谱与原始网片的光谱没有明显差异，而两种类型的 PP 网片的 FTIR 光谱有额外的化学官能团（羰基（CO）和羟基（-OH）基团）随植入时间的增加而增加，表明其发生了降解。本研究强调了 PVDF 网片的形态和化学稳定性，并表明与另外两种类型的 PP 网片相比，PVDF 网片更能抵抗降解。
