Silk Fibroin-Decorin Engineered Biologics to Repair Musculofascial Defects

The use of synthetic mesh (e.g., polypropylene [PP] mesh) and biologic (e.g., porcine acellular dermal matrix (PADM)) for the repair of abdominal wall musculofascial has limitations associated with an increased risk of complications and finite properties, respectively. Silk fibroin (SF)-based scaffolds are fabricated with decorin blends (SFD) to create a matrix platform with the desired structure-property function to be translated to the clinic to address patient-specific needs. PADM and SFD composites with SFD or PADM facing the peritoneal cavity were tested in an in vivo incisional ventral hernia repair model using female Hartley guinea pigs. At week 4, gross observation of adhesion grade and strength showed that the SFD, PADM, and composites resulted in fewer and weaker adhesions than did PP mesh (p < 0.05). Mechanical properties at the musculofascial-implant interface in the SFD group were similar to those of the native abdominal wall. SFD group exhibited homogeneous three-dimensional cell infiltration, vascularization, and tissue remodeling in implants. In conclusion, SFD promotes musculofascial regeneration.