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, Inma Garcia-Romero, Brendan Gilmore, Luca Casettari, Eneko Larrañeta, Dimitrios Lamprou

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Abstract

Pelvic Organ Prolapse (POP) or Stress Urinary Incontinence (SUI) are two very common disorders affecting 30-40% of women worldwide. Current strategies to repair or improve these medical conditions are non-surgical options such as physiotherapy, or surgical options such as the use surgical vaginal meshes. The use of the latter has caused some complications such as chronic pain, infection or mesh rupture. Accordingly, a novel approach that does not show such problems is required. Additive manufacturing (AM) technology, also known as 3D-printing was employed to manufacture these new vaginal meshes. For this purpose, thermoplastic polyurethane (TPU) filaments containing levofloxacin (LFX) in various concentrations (e.g., 0, 0.25, 0.5, and 1%) were produced by an extrusion process. The extruded filaments were used in a fused deposition modeling (FDM) 3D printer to print the abovementioned vaginal meshes. The printed meshes were fully characterized trough different test/analysis such as fracture force studies, attenuated total reflection-Fourier transform infrared, thermal analysis, scanning electron microscopy, X-ray microcomputer tomography (μCT) analysis, release studies in phosphate-buffered saline, and microbiology studies. The results showed that LFX was uniformly distributed within the TPU matrix, regardless the concentration tested. The mechanical properties showed that poly(propylene) (PP) is a tougher material with 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.
Original languageEnglish
Article number63
Number of pages15
JournalPharmaceutics
Volume12
Issue number1
DOIs
Publication statusPublished - 13 Jan 2020

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Polyurethanes
Levofloxacin
Elasticity
Pharmaceutical Preparations
Surgical Mesh
X Ray Tomography
Pelvic Organ Prolapse
Stress Urinary Incontinence
Microcomputers
Fourier Analysis
Microbiology
Infection
Chronic Pain
Electron Scanning Microscopy
Staphylococcus aureus
Rupture
Hot Temperature
Phosphates
Escherichia coli
Technology

Keywords

  • 3D Printing
  • fused deposition modeling
  • extrusion
  • vaginal meshes
  • drug release
  • anti-infective devices
  • pelvic organ prolapse
  • stress urinary incontinence

Cite this

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title = "3D printing of drug-loaded thermoplastic polyurethane meshes: A potential material for soft tissue reinforcement in vaginal surgery",
abstract = "Pelvic Organ Prolapse (POP) or Stress Urinary Incontinence (SUI) are two very common disorders affecting 30-40{\%} of women worldwide. Current strategies to repair or improve these medical conditions are non-surgical options such as physiotherapy, or surgical options such as the use surgical vaginal meshes. The use of the latter has caused some complications such as chronic pain, infection or mesh rupture. Accordingly, a novel approach that does not show such problems is required. Additive manufacturing (AM) technology, also known as 3D-printing was employed to manufacture these new vaginal meshes. For this purpose, thermoplastic polyurethane (TPU) filaments containing levofloxacin (LFX) in various concentrations (e.g., 0, 0.25, 0.5, and 1{\%}) were produced by an extrusion process. The extruded filaments were used in a fused deposition modeling (FDM) 3D printer to print the abovementioned vaginal meshes. The printed meshes were fully characterized trough different test/analysis such as fracture force studies, attenuated total reflection-Fourier transform infrared, thermal analysis, scanning electron microscopy, X-ray microcomputer tomography (μCT) analysis, release studies in phosphate-buffered saline, and microbiology studies. The results showed that LFX was uniformly distributed within the TPU matrix, regardless the concentration tested. The mechanical properties showed that poly(propylene) (PP) is a tougher material with 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.",
keywords = "3D Printing, fused deposition modeling, extrusion, vaginal meshes, drug release, anti-infective devices, pelvic organ prolapse, stress urinary incontinence",
author = "{Dominguez Robles}, Juan and Caterina Mancinelli and Elena Mancuso and Inma Garcia-Romero and Brendan Gilmore and Luca Casettari and Eneko Larra{\~n}eta and Dimitrios Lamprou",
year = "2020",
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language = "English",
volume = "12",
journal = "Pharmaceutics",
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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, Inma

AU - Gilmore, Brendan

AU - Casettari, Luca

AU - Larrañeta, Eneko

AU - Lamprou, Dimitrios

PY - 2020/1/13

Y1 - 2020/1/13

N2 - Pelvic Organ Prolapse (POP) or Stress Urinary Incontinence (SUI) are two very common disorders affecting 30-40% of women worldwide. Current strategies to repair or improve these medical conditions are non-surgical options such as physiotherapy, or surgical options such as the use surgical vaginal meshes. The use of the latter has caused some complications such as chronic pain, infection or mesh rupture. Accordingly, a novel approach that does not show such problems is required. Additive manufacturing (AM) technology, also known as 3D-printing was employed to manufacture these new vaginal meshes. For this purpose, thermoplastic polyurethane (TPU) filaments containing levofloxacin (LFX) in various concentrations (e.g., 0, 0.25, 0.5, and 1%) were produced by an extrusion process. The extruded filaments were used in a fused deposition modeling (FDM) 3D printer to print the abovementioned vaginal meshes. The printed meshes were fully characterized trough different test/analysis such as fracture force studies, attenuated total reflection-Fourier transform infrared, thermal analysis, scanning electron microscopy, X-ray microcomputer tomography (μCT) analysis, release studies in phosphate-buffered saline, and microbiology studies. The results showed that LFX was uniformly distributed within the TPU matrix, regardless the concentration tested. The mechanical properties showed that poly(propylene) (PP) is a tougher material with 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.

AB - Pelvic Organ Prolapse (POP) or Stress Urinary Incontinence (SUI) are two very common disorders affecting 30-40% of women worldwide. Current strategies to repair or improve these medical conditions are non-surgical options such as physiotherapy, or surgical options such as the use surgical vaginal meshes. The use of the latter has caused some complications such as chronic pain, infection or mesh rupture. Accordingly, a novel approach that does not show such problems is required. Additive manufacturing (AM) technology, also known as 3D-printing was employed to manufacture these new vaginal meshes. For this purpose, thermoplastic polyurethane (TPU) filaments containing levofloxacin (LFX) in various concentrations (e.g., 0, 0.25, 0.5, and 1%) were produced by an extrusion process. The extruded filaments were used in a fused deposition modeling (FDM) 3D printer to print the abovementioned vaginal meshes. The printed meshes were fully characterized trough different test/analysis such as fracture force studies, attenuated total reflection-Fourier transform infrared, thermal analysis, scanning electron microscopy, X-ray microcomputer tomography (μCT) analysis, release studies in phosphate-buffered saline, and microbiology studies. The results showed that LFX was uniformly distributed within the TPU matrix, regardless the concentration tested. The mechanical properties showed that poly(propylene) (PP) is a tougher material with 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.

KW - 3D Printing

KW - fused deposition modeling

KW - extrusion

KW - vaginal meshes

KW - drug release

KW - anti-infective devices

KW - pelvic organ prolapse

KW - stress urinary incontinence

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DO - 10.3390/pharmaceutics12010063

M3 - Article

VL - 12

JO - Pharmaceutics

JF - Pharmaceutics

SN - 1999-4923

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