Antibiotic-Coated Melt Electrowritten Polycaprolactone Meshes: Fabrication and In Vitro Antibacterial Evaluation

Abstract

In recent years, pelvic organ prolapse (POP) cases have been rising, affecting women’s quality of life. Synthetic surgical transvaginal meshes used for POP treatment were withdrawn from the United States market in 2019 due to high risks, including infection, vaginal mesh erosion, and POP reoccurrence. Biodegradable mesh implants with three-dimensional printing technology have emerged as an innovative alternative. In this study, polycaprolactone (PCL) meshes for POP repair were fabricated using melt electrospinning writing (MEW) and mechanically evaluated through uniaxial tensile tests. Following this, they were coated with antibiotics—azithromycin, gentamicin sulfate, and ciprofloxacin—commonly used for genitourinary tract infections. Zone inhibition and biofilm assays evaluated antibiotic effectiveness in preventing mesh infections by Escherichia coli, and methicillin-susceptible (MSSA) and methicillin-resistant (MRSA) Staphylococcus aureus. The meshes presented a mechanical behavior closer to vaginal tissue than commercially available meshes. Fourier transform infrared analysis confirmed antibiotic incorporation. Ciprofloxacin demonstrated antibacterial activity against MRSA, with a 92% reduction in metabolic activity and a 99% biomass reduction. Gentamicin and ciprofloxacin displayed inhibitory activity against MSSA and E. coli. Scanning electron microscopy images support these conclusions. This methodology may offer a more effective, patient-friendly solution for POP repair, improving healing and the quality of life for affected women.