PURPOSE: Incisional hernia is a common postoperative complication following abdominal surgery. Despite the use of synthetic meshes, recurrence rates remain high. This study aimed to develop and evaluate a biodegradable, aligned microfibrous scaffold to support wound healing and strengthen abdominal wall repair. METHODS: Scaffolds were fabricated from poly(ε-caprolactone) (PCL) using a controlled fiber-drawing technique to produce highly aligned microfibers with reproducible thickness and architecture. Their biocompatibility was examined in vitro using fibroblasts through adhesion and proliferation assays. For in vivo evaluation, the scaffolds were implanted over standardized abdominal wall incisions in rabbits. After six weeks, the regenerated tissue was harvested for mechanical testing to determine tensile strength and elasticity, while histological and immunohistochemical analyses assessed collagen type I deposition and neovascularization within the scaffold area. RESULTS: The aligned PCL scaffold promoted strong cell attachment and proliferation in vitro. In vivo, its application significantly increased tensile modulus compared with control wounds. Histological analysis revealed denser and more organized collagen deposition and a higher microvessel density in the scaffold-treated group, indicating enhanced tissue remodeling and vascular integration. CONCLUSION: The aligned PCL microfibrous scaffold improved the mechanical and biological quality of the abdominal wall healing in vivo. These results suggest its potential for reducing the formation of incisional hernias and are suitable for further testing leading to use in clinical practice.

Department of Chemistry Faculty of Sciences Humanities and Education Technical University of Liberec Liberec Czech Republic

Department of Histology and Embryology and Biomedical Centre Faculty of Medicine in Pilsen Charles University Pilsen Czech Republic

Department of Natural Sciences Faculty of Biomedical Engineering Czech Technical University Kladno Czech Republic

Department of Tissue Engineering Institute of Experimental Medicine The Czech Academy of Sciences Prague Czech Republic

Faculty of Mechanical Engineering Technical University of Liberec Liberec Czech Republic

Institute of Experimental Medicine Prague 4 Videnska 1083 14220 Czech Republic

Technical University of Liberec Studentská 1402 2 461 17 Liberec Czech Republic

Zobrazit více v PubMed

Le Huu Nho R, Mege D, Ouaïssi M et al (2012) Incidence and prevention of ventral incisional hernia. J Visc Surg 149:e3–e14. 10.1016/J.JVISCSURG.2012.05.004 PubMed DOI

Dietz UA, Menzel S, Lock J, Wiegering A (2018) The treatment of incisional hernia. Dtsch Arztebl Int 115:31. 10.3238/ARZTEBL.2018.0031 PubMed DOI PMC

Zhu L-M, Schuster P, Klinge U (2015) Mesh implants: an overview of crucial mesh parameters. World J Gastrointest Surg 7:226. 10.4240/WJGS.V7.I10.226 PubMed DOI PMC

van Silfhout L, Leenders LAM, Heisterkamp J, Ibelings MS (2021) Recurrent incisional hernia repair: surgical outcomes in correlation with body-mass index. Hernia 25:77–83. 10.1007/S10029-020-02320-5 PubMed DOI

Köckerling F (2019) Recurrent incisional hernia repair—an overview. Front Surg 6:26. 10.3389/FSURG.2019.00026 PubMed DOI PMC

Burger JWA, Lange JF, Halm JA et al (2005) Incisional hernia: early complication of abdominal surgery. World J Surg 29:1608–1613. 10.1007/S00268-005-7929-3 PubMed DOI

Walming S, Angenete E, Block M et al (2017) Retrospective review of risk factors for surgical wound dehiscence and incisional hernia. BMC Surg 17:1–6. 10.1186/S12893-017-0207-0 PubMed DOI PMC

Hornby ST, McDermott FD, Coleman M et al (2015) Female gender and diabetes mellitus increase the risk of recurrence after laparoscopic incisional hernia repair. Ann R Coll Surg Engl 97:115–119. 10.1308/003588414X14055925058751 PubMed DOI PMC

Wilson RB, Farooque Y (2022) Risks and prevention of surgical site infection after hernia mesh repair and the predictive utility of ACS-NSQIP. J Gastrointest Surg 26:950–964. 10.1007/S11605-022-05248-6 PubMed DOI PMC

Moussavian MR, Schuld J, Dauer D et al (2010) Long term follow up for incisional hernia after severe secondary peritonitis-incidence and risk factors. Am J Surg 200:229–234. 10.1016/J.AMJSURG.2009.08.043 PubMed DOI

Smith CT, Katz MG, Foley D et al (2015) Incidence and risk factors of incisional hernia formation following abdominal organ transplantation. Surg Endosc 29:398–404. 10.1007/S00464-014-3682-8/METRICS PubMed DOI PMC

Al-Bustami IS, Clements T, Ferguson D et al (2024) Biosynthetic mesh in hernia repair: A systematic review and meta-analysis. Int J Abdom Wall Hernia Surg 7:55–66. 10.4103/IJAWHS.IJAWHS_99_23 DOI

Liu X, Xu H, Zhang M, Yu DG (2021) Electrospun medicated nanofibers for wound healing. Rev Membr (Basel) 11:770. 10.3390/MEMBRANES11100770 PubMed DOI PMC

Memic A, Abudula T, Mohammed HS et al (2019) Latest progress in electrospun nanofibers for wound healing applications. ACS Appl Bio Mater 2:952–969. 10.1021/ACSABM.8B00637/ASSET/IMAGES/MEDIUM/MT-2018-006373_0011.GIF. PubMed DOI

Plencner M, East B, Tonar Z et al (2014) Abdominal closure reinforcement by using polypropylene mesh functionalized with poly-ε-caprolactone nanofibers and growth factors for prevention of incisional hernia formation. Int J Nanomed 9:3263–3277. 10.2147/IJN.S63095 PubMed DOI PMC

Molnár K, Voniatis C, Fehér D et al (2018) Biocompatibility study of poly(Vinyl alcohol)-based electrospun scaffold for hernia repair. Express Polym Lett 12:676–687. 10.3144/EXPRESSPOLYMLETT.2018.58 DOI

Afewerki S, Bassous N, Harb SV et al (2021) Engineering multifunctional bactericidal nanofibers for abdominal hernia repair. Communications Biology 2021 4:1–14. 10.1038/s42003-021-01758-2 PubMed PMC

Hall Barrientos IJ, Paladino E, Brozio S et al (2017) Fabrication and characterisation of drug-loaded electrospun polymeric nanofibers for controlled release in hernia repair. Int J Pharm 517:329–337. 10.1016/J.IJPHARM.2016.12.022 PubMed DOI

Plencner M, Prosecká E, Rampichová M et al (2015) Significant improvement of biocompatibility of polypropylene mesh for incisional hernia repair by using poly-ε-caprolactone nanofibers functionalized with thrombocyte-rich solution. Int J Nanomed 10:2635. 10.2147/IJN.S77816 PubMed DOI PMC

Boys CV (1887) On the production, properties, and some suggested uses of the finest threads. Proc Phys Soc Lond 9:8–19. 10.1088/1478-7814/9/1/303 DOI

Xing X, Wang Y, Li B (2008) Nanofibers drawing and nanodevices assembly in poly(trimethylene terephthalate). Opt Express 16:10815. 10.1364/OE.16.010815 PubMed DOI

Ondarçuhu T, Joachim C (1998) Drawing a single nanofibre over hundreds of microns. Europhys Lett 42:215–220. 10.1209/EPL/I1998-00233-9 DOI

Yuan H, Cambron SD, Keynton RS (2015) Prescribed 3-D direct writing of suspended Micron/Sub-micron scale fiber structures via a robotic dispensing system. 10.3791/52834. J Vis Exp 2015: PubMed PMC

Yarin AL, Pourdeyhimi B, Ramakrishna S (2013) Fundamentals and applications of micro and nanofibers. Fundamentals Appl Micro Nanofibers 9781107060296:1–443. 10.1017/CBO9781107446830 DOI

Li D, Wang Y, Xia Y (2003) Electrospinning of polymeric and ceramic nanofibers as uniaxially aligned arrays. Nano Lett 3:1167–1171. 10.1021/NL0344256 DOI

Nain AS, Amon C, Sitti M (2005) Polymer Micro/Nanofiber Fabrication using Micro/Nanopipettes. 2005 5th IEEE Conference on Nanotechnology 1:366–369. 10.1109/NANO.2005.1500772

Nain AS, Wong JC, Amon C, Sitti M (2006) Drawing suspended polymer micro-/nanofibers using glass micropipettes. Appl Phys Lett. 10.1063/1.2372694 DOI

Nain AS, Amon C, Sitti M (2006) Proximal probes based nanorobotic drawing of polymer micro/nanofibers. IEEE Trans Nanotechnol 5:499–510. 10.1109/TNANO.2006.880453 DOI

McKinley GH, Sridhar T (2002) Filament-stretching rheometry of complex fluids. Annu Rev Fluid Mech 34:375–415. 10.1146/ANNUREV.FLUID.34.083001.125207/1 DOI

Vacanti JP, Morse MA, Saltzman WM et al (1988) Selective cell transplantation using bioabsorbable artificial polymers as matrices. J Pediatr Surg 23:3–9. 10.1016/S0022-3468(88)80529-3 PubMed DOI

Kocova J (1970) Overall staining of connective tissue and the muscular layer of vessels. Folia Morphol (Warsz) 18:293–295 PubMed

Kolinko Y, Malečková A, Kochová P et al (2022) Using virtual microscopy for the development of sampling strategies in quantitative histology and design-based stereology. Anat Histol Embryol 51:3–22. 10.1111/AHE.12765 PubMed DOI

Gundersen HJG (1977) Notes on the estimation of the numerical density of arbitrary profiles: the edge effect. J Microsc 111:219–223. 10.1111/J.1365-2818.1977.TB00062.X DOI

Tokarev A, Asheghali D, Griffiths IM et al (2015) Touch- and brush-spinning of nanofibers. Adv Mater 27:6526–6532. 10.1002/ADMA.201502768 PubMed DOI

Rampichová M, Buzgo M, Míčková A et al (2017) Platelet-functionalized three-dimensional poly-ε-caprolactone fibrous scaffold prepared using centrifugal spinning for delivery of growth factors. Int J Nanomed 12:347–361. 10.2147/IJN.S120206 PubMed DOI PMC

Zander NE (2015) Formation of melt and solution spun polycaprolactone fibers by centrifugal spinning. J Appl Polym Sci. 10.1002/APP.41269 DOI

Badrossamay MR, Balachandran K, Capulli AK et al (2014) Engineering hybrid polymer-protein super-aligned nanofibers via rotary jet spinning. Biomaterials 35:3188–3197. 10.1016/J.BIOMATERIALS.2013.12.072 PubMed DOI

Chen M, Patra PK, Warner SB, Bhowmick S (2007) Role of fiber diameter in adhesion and proliferation of NIH 3T3 fibroblast on electrospun polycaprolactone scaffolds. Tissue Eng 13:579–587. 10.1089/TEN.2006.0205 PubMed DOI

Buzgo M, Plencner M, Rampichova M et al (2019) Poly-ε-caprolactone and polyvinyl alcohol electrospun wound dressings: adhesion properties and wound management of skin defects in rabbits. Regen Med 14:423–445. 10.2217/RME-2018-0072 PubMed DOI

Kim JI, Hwang TI, Aguilar LE et al (2016) A Controlled Design of Aligned and Random Nanofibers for 3D Bi-functionalized Nerve Conduits Fabricated via a Novel Electrospinning Set-up. Scientific Reports 6(1):1–12. 10.1038/srep23761 PubMed DOI PMC

Li X, Wang X, Yao D et al (2018) Effects of aligned and random fibers with different diameter on cell behaviors. Colloids Surf B Biointerfaces 171:461–467. 10.1016/J.COLSURFB.2018.07.045 PubMed DOI

Tonnesen MG, Feng X, Clark RAF (2000) Angiogenesis in wound healing. J Invest Dermatol Symp Proc 5:40–46. 10.1046/J.1087-0024.2000.00014.X PubMed DOI

DiPietro LA (2016) Angiogenesis and wound repair: when enough is enough. J Leukoc Biol 100:979–984. 10.1189/JLB.4MR0316-102R PubMed DOI PMC

Dulmovits BM, Herman IM (2012) Microvascular remodeling and wound healing: a role for pericytes. Int J Biochem Cell Biol 44:1800. 10.1016/J.BIOCEL.2012.06.031 PubMed DOI PMC

Mathew-Steiner SS, Roy S, Sen CK (2021) Collagen in wound healing. Bioengineering. 10.3390/BIOENGINEERING8050063 PubMed DOI PMC

Kobayashi M, Lei NY, Wang Q et al (2015) Orthogonally oriented scaffolds with aligned fibers for engineering intestinal smooth muscle. Biomaterials 61:75. 10.1016/J.BIOMATERIALS.2015.05.023 PubMed DOI PMC

Ricketts SA, Sibbons PD, Green CJ (1999) Quantitative analysis of the development of experimentally induced post surgical adhesions: a microstereological study. Int J Exp Pathol 80:325–334. 10.1046/J.1365-2613.1999.00127.X PubMed DOI PMC

Herrick SE, Wilm B (2021) Post-surgical peritoneal scarring and key molecular mechanisms. Biomolecules 11:692. 10.3390/BIOM11050692 PubMed DOI PMC