Controlled Levofloxacin Release and Antibacterial Properties of β-Cyclodextrins-Grafted Polypropylene Mesh Devices for Hernia Repair.

Mesh infection is a major complication of hernia repair. After knitted mesh implantation, bacteria can grow within textile structures causing infection. In this work, polypropylene (PP) mesh devices were two-step grafted with hexamethylene diisocyanate (HDI) and β⁻cyclodexrins (CD) and then loaded with suitable antimicrobial levofloxacin HCL for hernia mesh-infection prevention. First, oxygen plasma was able to create surface roughness, then HDI was successfully grafted onto PP fiber surfaces. Afterwards, CD was covalently grafted onto the HDI treated PP meshes, and levofloxacin HCL (LVFX) was loaded into the CD cavity of the modified meshes. The modified devices were evaluated for sustained antibiotic properties and drug-release profiles in a phosphate buffer, and sustained drug release was observed between interfaces of meshes and aqueous environment. The antibiotic-loaded PP mesh samples demonstrated sustained antibacterial properties for 7 and 10 days, respectively, against both Gram-negative and Gram-positive bacteria. The CD-captured levofloxacin HCL showed burst release after 6 h but later exhibited sustained release for the next 48 h. Among all samples, the modified mesh LVFX-6 was more stable and showed more sustained drug release and could be employed in future clinical applications.