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Abstract: Surgical meshes have been employed in the management of a variety of pathological conditions including hernia, pelvic floor dysfunctions, periodontal guided bone regeneration, wound healing and more recently for breast plastic surgery after mastectomy. These common pathologies affect a wide portion of the worldwide population; therefore, an effective and enhanced treatment is crucial to ameliorate patients’ living conditions both from medical and aesthetic points of view. At present, non-absorbable synthetic polymers are the most widely used class of biomaterials for the manufacturing of mesh implants for hernia, pelvic floor dysfunctions and guided bone regeneration, with polypropylene and poly tetrafluoroethylene being the most common. Biological prostheses, such as surgical grafts, have been employed mainly for breast plastic surgery and wound healing applications. Despite the advantages of mesh implants to the treatment of these conditions, there are still many drawbacks, mainly related to the arising of a huge number of post-operative complications, among which infections are the most common. Developing a mesh that could appropriately integrate with the native tissue, promote its healing and constructive remodelling, is the key aim of ongoing research in the area of surgical mesh implants. To this end, the adoption of new biomaterials including absorbable and natural polymers, the use of drugs and advanced manufacturing technologies, such as 3D printing and electrospinning, are under investigation to address the previously mentioned challenges and improve the outcomes of future clinical practice. The aim of this work is to review the key advantages and disadvantages related to the use of surgical meshes, the main issues characterizing each clinical procedure and the future directions in terms of both novel manufacturing technologies and latest regulatory considerations.

英国阿尔斯特大学Mancuso等 | 用于药物输送和组织工程应用的下一代外科网片：材料、设计和新兴制造技术

本综述论文聚焦用于药物输送和组织工程应用的外科手术网片相关研究，包括其材料、设计和制造方法。外科网片已被用于治疗各种病理状况，包括疝气、盆底功能障碍、牙周引导骨再生、伤口愈合以及乳房切除术后的乳房整形手术。这些常见病状影响着全世界大部分人口；从医学和美学的角度来看，有效和强化的治疗对于改善患者的生活条件至关重要。目前，不可吸收的合成聚合物是用于制造疝气、盆底功能障碍和引导骨再生网状植入物的最广泛使用的一类生物材料，其中聚丙烯和聚四氟乙烯是最常见的。生物假体，例如外科移植物，主要用于乳房整形手术和伤口愈合应用。尽管网状植入物在治疗这些病症方面具有优势，但仍存在许多弊端，主要与术后并发症的产生有关，其中感染最为常见。开发一种可以与天然组织适当结合、促进其愈合和建设性重塑的网状物，是外科网状植入物领域现阶段的主要研究目标。为此，人们正在研究采用包括可吸收和天然聚合物在内的新生物材料，使用药物和先进制造技术，如 3D 打印和静电纺丝，以解决前面提到的挑战并改善未来临床实践的结果。本文回顾了使用外科网片相关的主要优点和缺点，表征每个临床程序的主要问题以及新制造技术和最新监管政策方面的未来方向。