Doctor of Philosophy, Case Western Reserve University, 2021, Biomedical Engineering
Post-surgical adhesions are internal scars that pathologically adhere together adjacent tissues/organs/biomaterials. They pose a tremendous but frequently underestimated burden across many surgical disciplines, being especially prevalent following abdominal surgery. Peritoneal adhesions can cause discomfort, intestinal obstructions, infertility, and increased morbidity/mortality of subsequent surgery. Once formed, treatments for adhesions tend to be risky and ineffective, so prophylactic strategies are desirable. Implantation of meshes, such as in hernia repair, often exacerbates peritoneal adhesions. Knitted polypropylene (PP) meshes are the most common hernioplasty devices, but are notoriously adhesiogenic owing to material and structural characteristics that promote incorporation, such as hydrophobicity and reticular construction. The ideal strategy to prevent mesh adhesions entails adhering a smooth, continuous, hydrophilic barrier material on the mesh visceral face to mitigate tissue attachment processes. Prior studies developed polymerized cyclodextrin (pCD) materials having unique capabilities for sustained, multi-window drug release, and suggested that these hydrophilic polymers passively resist cell attachment. In several animal species, pCD could deliver antibiotics for weeks to successfully resolve mesh infection, another hernioplasty complication for which only suboptimal solutions exist. In the present work, pCD materials were explored toward application as novel adhesion barriers for PP surgical meshes. First, nonthermal plasma activation was assessed as a strategy to improve PP-pCD bonding, as PP is generally unreceptive to coatings. Plasma introduced hydroxyls onto PP, enhancing PP-pCD adherence. Second, protein adsorption, bacterial attachment, and fibroblast viability/attachment upon pCD-coated and bare PP materials were evaluated. These events play roles in mesh adhesion, infection, and biocompatibility. pCD decreased protein adsorption and bacter (open full item for complete abstract)
Committee: Horst von Recum PhD (Advisor); Jeffrey Capadona PhD (Committee Chair); Kathleen Derwin PhD (Committee Member); Guang Zhou PhD (Committee Member); Michael Rosen MD (Committee Member)
Subjects: Biomedical Engineering