3D Printing of Drug-Loaded Thermoplastic Polyurethane Meshes: A Potential Material for Soft Tissue Reinforcement in Vaginal Surgery

Juan Dominguez-Robles, Caterina Mancinelli, Elena Mancuso, Inmaculada Garcia-Romero, Brendan F. Gilmore, Luca Casettari, Eneko Larraneta, Dimitrios Lamprou

Research output: Contribution to journalArticle

Abstract

Current strategies to treat pelvic organ prolapse (POP) or stress urinary incontinence (SUI), include the surgical implantation of vaginal meshes. Recently, there have been multiple reports of issues generated by these meshes conventionally made of poly(propylene). This material is not the ideal candidate, due to its mechanical properties leading to complications such as chronic pain and infection. In the present manuscript, we propose the use of an alternative material, thermoplastic polyurethane (TPU), loaded with an antibiotic in combination with fused deposition modelling (FDM) to prepare safer vaginal meshes. For this purpose, TPU filaments containing levofloxacin (LFX) in various concentrations (e.g., 0.25%, 0.5%, and 1%) were produced by extrusion. These filaments were used to 3D print vaginal meshes. The printed meshes were fully characterized through different tests/analyses such as fracture force studies, attenuated total reflection-Fourier transform infrared, thermal analysis, scanning electron microscopy, X-ray microcomputed tomography (μCT), release studies and microbiology testing. The results showed that LFX was uniformly distributed within the TPU matrix, regardless the concentration loaded. The mechanical properties showed that poly(propylene) (PP) is a tougher material with a lower elasticity than TPU, which seemed to be a more suitable material due to its elasticity. In addition, the printed meshes showed a significant bacteriostatic activity on both Staphylococcus aureus and Escherichia coli cultures, minimising the risk of infection after implanting them. Therefore, the incorporation of LFX to the TPU matrix can be used to prepare anti-infective vaginal meshes with enhanced mechanical properties compared with current PP vaginal meshes
LanguageEnglish
Number of pages15
JournalPharmaceutics
Volume12
Issue number1
DOIs
Publication statusPublished - 13 Jan 2020

Fingerprint

Polyurethanes
Levofloxacin
Pharmaceutical Preparations
Elasticity
Pelvic Organ Prolapse
X-Ray Microtomography
Stress Urinary Incontinence
Manuscripts
Fourier Analysis
Microbiology
Infection
Chronic Pain
Electron Scanning Microscopy
Staphylococcus aureus
Hot Temperature
Three Dimensional Printing
Reinforcement (Psychology)
Escherichia coli
Anti-Bacterial Agents
propylene

Keywords

  • 3d printing
  • fused deposition modeling
  • extrusion
  • vaginal meshes
  • mechanical properties
  • drug release
  • anti-infective devices
  • pelvic organ prolapse
  • stress urinary incontinence

Cite this

Dominguez-Robles, Juan ; Mancinelli, Caterina ; Mancuso, Elena ; Garcia-Romero, Inmaculada ; Gilmore, Brendan F. ; Casettari, Luca ; Larraneta, Eneko ; Lamprou, Dimitrios. / 3D Printing of Drug-Loaded Thermoplastic Polyurethane Meshes: A Potential Material for Soft Tissue Reinforcement in Vaginal Surgery. In: Pharmaceutics. 2020 ; Vol. 12, No. 1.
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abstract = "Current strategies to treat pelvic organ prolapse (POP) or stress urinary incontinence (SUI), include the surgical implantation of vaginal meshes. Recently, there have been multiple reports of issues generated by these meshes conventionally made of poly(propylene). This material is not the ideal candidate, due to its mechanical properties leading to complications such as chronic pain and infection. In the present manuscript, we propose the use of an alternative material, thermoplastic polyurethane (TPU), loaded with an antibiotic in combination with fused deposition modelling (FDM) to prepare safer vaginal meshes. For this purpose, TPU filaments containing levofloxacin (LFX) in various concentrations (e.g., 0.25{\%}, 0.5{\%}, and 1{\%}) were produced by extrusion. These filaments were used to 3D print vaginal meshes. The printed meshes were fully characterized through different tests/analyses such as fracture force studies, attenuated total reflection-Fourier transform infrared, thermal analysis, scanning electron microscopy, X-ray microcomputed tomography (μCT), release studies and microbiology testing. The results showed that LFX was uniformly distributed within the TPU matrix, regardless the concentration loaded. The mechanical properties showed that poly(propylene) (PP) is a tougher material with a lower elasticity than TPU, which seemed to be a more suitable material due to its elasticity. In addition, the printed meshes showed a significant bacteriostatic activity on both Staphylococcus aureus and Escherichia coli cultures, minimising the risk of infection after implanting them. Therefore, the incorporation of LFX to the TPU matrix can be used to prepare anti-infective vaginal meshes with enhanced mechanical properties compared with current PP vaginal meshes",
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Dominguez-Robles, J, Mancinelli, C, Mancuso, E, Garcia-Romero, I, Gilmore, BF, Casettari, L, Larraneta, E & Lamprou, D 2020, '3D Printing of Drug-Loaded Thermoplastic Polyurethane Meshes: A Potential Material for Soft Tissue Reinforcement in Vaginal Surgery', Pharmaceutics, vol. 12, no. 1. https://doi.org/10.3390/pharmaceutics12010063

3D Printing of Drug-Loaded Thermoplastic Polyurethane Meshes: A Potential Material for Soft Tissue Reinforcement in Vaginal Surgery. / Dominguez-Robles, Juan; Mancinelli, Caterina; Mancuso, Elena; Garcia-Romero, Inmaculada; Gilmore, Brendan F.; Casettari, Luca; Larraneta, Eneko; Lamprou, Dimitrios.

In: Pharmaceutics, Vol. 12, No. 1, 13.01.2020.

Research output: Contribution to journalArticle

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T1 - 3D Printing of Drug-Loaded Thermoplastic Polyurethane Meshes: A Potential Material for Soft Tissue Reinforcement in Vaginal Surgery

AU - Dominguez-Robles, Juan

AU - Mancinelli, Caterina

AU - Mancuso, Elena

AU - Garcia-Romero, Inmaculada

AU - Gilmore, Brendan F.

AU - Casettari, Luca

AU - Larraneta, Eneko

AU - Lamprou, Dimitrios

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KW - mechanical properties

KW - drug release

KW - anti-infective devices

KW - pelvic organ prolapse

KW - stress urinary incontinence

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