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Enhancing the antimicrobial efficacy of polyester hernia meshes via layer-by-layer chitosan surface modification

Ali D, Rukhsar S, Sanbhal N, Tagar S, Peerzada MA, Sanbhal MA, Khan HA

Hernia : the journal of hernias and abdominal wall surgery, 2026

Abstract

Background: Polyester (PET)-based meshes are widely employed in hernia repair due to their superior mechanical properties and biocompatibility. However, their multifilament nature promotes bacterial adhesion and biofilm formation, increasing the risk of postoperative infections and recurrence.

Method: In this research, polyethylene terephthalate (PET) mesh was functionalized with chitosan using layer-by-layer coating in chitosan and citric acid layers. The PET meshes were soaked in chitosan and citric acid for 5 times and 10 times layer by layer to see the weight variance of both coated meshes. Moreover, chitosan coated PET meshes were loaded with levofloxacin for antibacterial properties.

Results: The functionalized PET meshes were thoroughly characterized using scanning electron microscopy (SEM), energy dispersive X-ray (EDX) spectroscopy, and Fourier transform infrared (FTIR) spectroscopy. SEM images confirmed the uniform deposition of the chitosan coating on the PET meshes. While EDX revealed the presence of deposited chitosan and levofloxacin HCL. The FTIR confirmed the successful cross-linking of chitosan with PET mesh. The antimicrobial efficacy of the coated meshes was assessed against Staphylococcus aureus and Escherichia coli using the agar diffusion method. The results demonstrated excellent antimicrobial activity, with minimum inhibition zones up to 10 mm. The antibacterial levofloxacin demonstrated the release performance of a soluble drug and inhibited…

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