| BackgroundAbdominal wall hernia is a common surgical complication,of which abdominal wall defect caused by abdominal incision is the most common.Since the hernia cannot heal itself,it will lead to the progressive aggravation of the disease.Tension-free repair with stent implantation is the most effective cure method at present.Synthetic polymer mesh has been unanimously recognized in the surgical field due to its excellent mechanical strength and controllable quality.Polypropylene mesh is currently the most commonly used abdominal wall repair material in clinical use.However,its implantation will cause foreign body reactions,such as chronic inflammation,adhesion of abdominal contents and other problems.At present,the surface chemical modification or biopolymer modification of polypropylene mesh can reduce the inflammatory reaction.However,the preparation of most of the patches reported at present is complex and cannot be directly applied to the preparation of clinical surgery site as required.In addition,there is a high risk of local infection in patch implantationand repair surgery,and antibiotics should be used for a long time to prevent postoperative infection.Achieving the balance between the hydrolytic stability of hydrogel crosslinked networks and the long-term reversible release of antibiotic molecules has always been a challenge for tissue engineering.Therefore,this topic intends to prepare a gel network with high stability and long release of antibiotics as a hernia composite repair patch,which is expected to become a potential clinical application prospect of abdominal wall defect repair material.ObjectiveBased on the network cross-linking method of stable acyl hydrazone bond and the dynamic reversible imine bond drug coupling method,the anti-adhesion and anti-infection composite repair patch was constructed,and its repair effect on abdominal wall defect was studied.Method1.The chemical structure of p-π conjugated bond was designed,and in situ mixing hyaluronic acid carbohydrazide(HA-CDH)and hyaluronic acid acetaldehyde(HA-Acet-CHO)in polypropylene mesh was used to construct a hydrogel layer with ultra stable hydrazone bond.The prepared materials were characterized,and the biocompatibility and anti cell adhesion of the hydrogel layer were tested.2.Based on the high stability of the gel network body,the anti adhesion and anti infection hernia composite repair patch was prepared by coupling gentamicin with fatty aldehyde group modified in the side chain of the gel network.The release of gentamicin,antibacterial activity in vitro and anti-adhesion in vivo of the composite patch were tested respectively.3.Hernia composite repair patch was transplanted to the site of abdominal wall defect to study its repair and reconstruction effect on abdominal wall defect in vivo.Result1.The prepared hydrogel layer has good elastic mechanical properties,short gel forming time,good cell biocompatibility,and shows good anti cell adhesion.2.The composite patch can release gentamicin slowly and stably for a long time,and has a long and stable antibacterial effect in vitro experiments,and has the effect of anti-adhesion of abdominal contents in vivo.3.After 7,14 and 28 days of transplantation of the hernia composite repair patch into the abdominal wall defect,the degree of inflammation was reduced,the area of scar fibrosis was reduced,and the blood vessels were regenerated,and the effect of skeletal muscle regeneration was good.ConclusionBased on the improvement of polypropylene mesh widely used in clinic,this paper developed a new type of composite repair patch for hernia.The results show that it has anti-adhesion,antibacterial,anti-inflammatory and good repair effect for abdominal wall defect. |
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