The study aims to design and evaluate biodegradable nanofibrous mesh as an alternative to commercially available non-degradable mesh in the treatment of prolapse and incontinence.

This study included both manufacturing optimisation, in-vitro and in-vivo experimental components to evaluate biodegradable nanofibrous mesh.
Biodegradable nanofibrous mesh was manufactured through electrospinning technique using polycaprolactone (PCL), citric acid modified polyethylene glycol (PEGC) and zinc oxide (ZnO). The formulation was optimised through series of mechanical properties analysis and invitro testing using L929 cell lines and adipose derived mesenchymal stem cells.
The optimised mesh formulation was taken up for in-vivo studies using female New Zealand White rabbit model. The mesh was implanted on both subcutaneous tissue of the abdominal wall and submucosal layer of anterior vaginal wall for 30 and 90 days. At the end of the study, clinical pathology analysis, histopathology (H&E, Masson trichrome, Sirius red and α-SMA) and gene expression studies (TNF-α, TGF-β, IL-6 and IL-10) were performed.
Simultaneously, mesh strip was placed transversally on the subcutaneous tissue of rabbit abdomen for 90 days. At the end of the study, mesh tissue complex was harvested and tested for its mechanical properties.

Nanofiber mesh of PCL:PEGC:ZnO ratios ranging from 1:0.1:0.001 to 1:0.1:0.01 was manufactured through electrospinning technique. Out of these mesh formulations, PCL:PEGC:ZnO ratios 1:0.1:0.001 supported cellular proliferation, collagen production in-vitro and also possessed mechanical properties similar to vaginal wall of pelvic floor (mechanical design criteria) even after terminal gamma sterilization in comparison to commercially available polypropylene mesh. In-vivo studies showed multifocal collagen deposition on commercially available polypropylene mesh, whereas nanofibrous mesh presented with multifocal and diffuse collagen deposition and bridging fibrosis. The fibrosis result was also corroborated by positive expression of α-SMA on nanofibrous mesh. Also, gene expression studies revealed higher TNF-α and IL-6 in polypropylene mesh than in nanofibrous mesh.
The mechanical conducted on the explanted mesh strip tissue complex revealed that nanofibrous mesh maintained mechanical design criteria.

Synthetic surgical made of polypropylene used in the repair of prolapse and incontinence induced mild inflammatory, supported tissue ingrowth and fibrosis around the monofilament. Meanwhile, in nanofibrous mesh, tissue infiltration was observed throughout the mesh with no inflammation, supporting uniform collagen deposition and bridging fibrosis.
The mechanical properties on the mesh strip tissue explant confirmed the presence of uniform collagen deposition and fibrosis on a biodegradable nanofibrous mesh. They acted as a three-dimensional reinforcement to the biodegradable nanofibrous mesh which will eventually provide complete support to pelvic organs upon nanofibrous mesh degradation.

Based on the in-vivo experiments, biodegradable nanofibrous mesh of PCL:PEGC:ZnO ratio 1:0.1:0.001 can be a suitable alternative to existing commercially available polypropylene mesh in the treatment for incontinence and prolapse repair.

Preethi Arul Murugan and Jayesh Bellare 2025 Biomed. Mater. 20 025013