A versatile hernia mesh for abdominal wall reconstruction with fibrosis suppression and non-invasive monitoring capabilities.

Abstract

Postoperative recurrence after incisional hernia repair remains a significant clinical challenge, with mesh contraction from the fibrotic foreign body response as an important contributing factor. Meanwhile, the inherent radiolucency of standard polypropylene (PP) meshes hinders postoperative imaging assessment. To address this, we developed a versatile mesh, SB431542@MPDA-PP, by functionalizing a medical-grade PP mesh with mesoporous polydopamine (MPDA) nanoparticles for localized drug delivery and intrinsic photoacoustic (PA) imaging. The mesh achieved high encapsulation loading (97.13%) and sustained release of SB431542, a TGF-β receptor inhibitor. It suppressed TGF-β1 secretion, epithelial-mesenchymal transition (EMT), and pro-fibrotic responses in human peritoneal mesothelial cells in vitro. In a rat model, the mesh reduced contraction by approximately 47.4% at 3 months compared to standard PP, with attenuated collagen deposition and a favorable collagen I/III ratio. Mechanistically, SB431542 release inhibited the TGF-β1/Smad axis, reversed EMT, and suppressed myofibroblast activation. Furthermore, the MPDA coating enabled clear, non-invasive PA visualization (>96% compliance). This integrated platform simultaneously mitigates fibrosis and enables postoperative surveillance, offering a promising strategy to improve hernia repair outcomes.