Advances in Innovative Surgical Implant Manufacturing for Hernia Repair and Soft Tissue Reconstruction.

Abstract

Abdominal wall hernias occur in a high percentage of the general population, making prosthetic hernia repair one of the most common surgical procedures. Despite the significant development of surgical techniques and the improvement of surgical meshes, complications still burden the health of patients, as well as the health system. The successful integration of the mesh plays a crucial role in the minimizing the complications associated with hernia meshes. Regenerative medicine focuses on the development of new treatments and applications to heal tissues and organs in order to restore their function. It uses scaffolds that provide physical support and a suitable environment for accelerating repair and proliferation and promoting the regeneration of damaged tissue. Platelet-rich plasma and stem cells are essential tools in regenerative medicine since they have shown efficacy in multiple fields. The main risk factor negatively affecting the survival of any cell type, including stem cells on a prosthetic material, is ischemia. Without the minimum required supply of oxygen, growth factors, and cytokines, it is impossible for cells to successfully proliferate and differentiate. The addition of PRP to a surgical mesh is hypothesized to increase neoangiogenesis in the area, acting as a reservoir of growth factors that will create the right conditions for the proliferation and differentiation of these cells. The aim of the present review is to record experimental studies that have been published where a scaffold or a hernia mesh is coated with PRP, stem cells, or a combination of them for hernia repair and soft tissue reconstruction.