Mechanical Characterization and Azithromycin Coating of Melt Electrowritten Polycaprolactone Mesh Implants for Prolapse Repair

Pelvic organ prolapse (POP) cases have been rising, affecting women’s quality of life. Severe cases often require surgical mesh implants, which can cause complications like tissue erosion and infection, leading the FDA to ban transvaginal meshes for POP. To address this, polycaprolactone (PCL) mesh implants, produced via melt electrowriting (MEW), were evaluated mechanically and coated with azithromycin, an antibiotic for genitourinary infections. Uniaxial tensile and cyclic tests assessed the long-term behavior of the meshes over 100 cycles. The results show that while all PCL meshes had similar behavior, those with 1 mm pores sustained higher stress, whereas 1.5 mm pore size meshes had mechanical properties closer to vaginal tissue but remained stiffer. Cyclic tests revealed initial damage and hardening during plastic deformation, with tensile tests confirming increased stiffness, as Young’s modulus rose between 19.2% and 29.3%. Zone inhibition and biofilm assays evaluated azithromycin’s effectiveness against bacterial infection. Even though FTIR analysis could not confirm antibiotic incorporation, the drug coated meshes show inhibitory activity against E. coli biofilm formation and MSSA in its planktonic state. Scanning Electron Microscopy supported these findings. These results suggest that MEW-fabricated PCL meshes coated with azithromycin hold promise as improved implants for POP treatment.