Shape-memory polyurethane foam integrated with nanofiber technology: synergistic efficacy in reducing the risk of capsular contracture and infection in breast reconstruction applications

Abstract

Implant-based breast reconstruction is frequently complicated by capsular contracture and surgical-site infection. Current mesh materials are unable to effectively address these complications due to inherent limitations. This study introduces a novel dual-layered mesh composed of a shape-memory polyurethane foam (PUF) base and a magnolol-loaded nanofiber (PG-MA) outer layer. The PUF-PG-MA mesh offers mechanical support, sustained antibacterial activity against Staphylococcus aureus, and anti-inflammatory effects by reducing TNF-α and IL-1β levels. In vitro characterization demonstrated a microtextured surface topography (R_a = 11.4 µm), biphasic drug release profile (65.0 ± 4.5% released within 24 hours; 79.9 ± 3.2% by 7 days), excellent shape recovery (>94.5% after cyclic strain), and cytocompatibility (cell viability >80%). Importantly, in an infected breast reconstruction model, PUF-PG-MA resulted in significantly thinner capsules (160.86 ± 96.21 µm) compared to controls (PUF: 257.88 ± 76.27 µm; PUF-PG: 192.34 ± 71.06 µm), demonstrating its dual capacity to suppress infection-induced fibrosis and capsular contracture. This integrated design represents a promising strategy for improving long-term outcomes in breast reconstruction.