Promotion of Hernia Repair with High-Strength, Flexible, and Bioresorbable Silk Fibroin Mesh in a Large Abdominal Hernia Model

The use of synthetic surgical meshes for abdominal hernia repair presents numerous challenges due to insufficient mechanical strength, nonabsorbability, and implant rigidity that leads to complications including chronic inflammatory reactions and adhesions. In this study, a naturally derived, high-strength, flexible, and bioresorbable silk fibroin mesh was developed by knitted textile engineering and biochemical manipulation. The mechanical properties of the mesh were optimized with the trial of different surface coating methods (thermal or chemical treatment) and 12 different knit patterns. Our silk fibroin mesh showed sufficient tensile strength (67.83 N longitudinally and 62.44 N vertically) which afforded the high mechanical strength required for abdominal hernia repair (16 N). Compared to the commonly used commercial nonabsorbable and absorbable synthetic meshes (Prolene mesh and Ultrapro mesh, respectively), the developed silk fibroin mesh showed advantages over other meshes, including lower elongat...