Characterization and quantification of oxidative stress induced particle debris from polypropylene surgical mesh

Explanted polypropylene (PP) surgical mesh has frequently been reported to show surface alterations, such as cracks and flaking. However, to date the consequence of PP mesh degradation is not clearly understood, particularly its potential to influence the biological host response of surrounding tissues. Of particular concern is a possible host reaction to polypropylene particles released through degradation of surgical mesh in vivo. This concern is driven by previous studies which have postulated that an oxidative stress environment has the potential to etch away particles from the surface of a PP fibers. The release of such particles is of considerable significance as particles in the nano- to micro range have been shown to have the capacity to irritate cells and stimulate the immune system. The authors are not aware of any previous studies that have attempted to characterize, quantify or identify any particles released from PP mesh after exposure to an oxidative stress environment. Characterization of the PP mesh, post oxidative stress exposure, including identification of particles was achieved through application of a range of techniques: low voltage-scanning electron microscopy (LV-SEM), pyrolysis gas chromatography mass spectrometry (Pyr-GCMS), nano-Fourier transform infrared spectroscopy (nano-FTIR), scattering-type, scanning near-field optical microscopy (s-SNOM), atomic force microscopy (AFM), attenuated total reflectance-Fourier transform infrared spectroscopy (ATR-FTIR) and uniaxial tensile testing. The findings of this study indicate that oxidative stress alone is a major factor in the production of PP particle debris. PP debris identified within solution, using Pyr-GCMS, was shown to be in order of the micron scale.