Polyethersulfone films as promising biomaterials for reducing granuloma formation and preserving tissue compatibility

Granuloma formation often complicates the implantation of foreign materials, causing tissue inflammation and adverse effects. This study assessed the efficacy of polyethersulfone (PES) films in reducing granuloma formation, comparing them to silicone rubber and control groups. Polylactide (PLA) membranes, commonly used for peritendinous anti-adhesion, might degrade and trigger granuloma formation via macrophage-induced foreign body reactions. To address this issue, this study explored PES films, constructed using a PVP pore-forming agent, and investigated the immune mechanisms leading to foreign body reactions. The primary objective was to evaluate PES films' potential in preventing adhesion and granuloma formation around tissues and to elucidate biocompatibility mechanisms. The results showed that PES films are porous, biocompatible, and a promising alternative to PLA membranes. Comprehensive in vitro and in vivo experiments evaluated the biocompatibility of PES films. Cell viability assays performed using L929 cells indicated that PES films maintained excellent cell viability, comparable to the control group, whereas silicone rubber showed a slight reduction. Live/dead assays corroborated high cell viability in the PES film group. Hemocompatibility assessments revealed that PES films, like the control and silicone rubber, did not induce hemolysis. The blood adhesion test indicated lower cell adhesion for PES films compared to silicone rubber. Histological analysis showed reduced granuloma formation in the PES film group, underscoring its potential in minimizing tissue inflammation. These results highlight PES films' promising role in developing biomaterials to reduce granuloma formation and enhance tissue compatibility, providing valuable insights into advancing biocompatible materials for biomedical applications.