Biaxial Mechanical Evaluation of Absorbable and Nonabsorbable Synthetic Surgical Meshes Used for Hernia Repair: Physiological Loads Modify Anisotropy Response

Abstract

The aim of this study was to obtain information about the mechanical properties of six meshes commonly used for hernia repair (Surgipro(®), Optilene(®), Infinit(®), DynaMesh(®), Ultrapro™ and TIGR(®)) by planar biaxial tests. Stress-stretch behavior and equibiaxial stiffness were evaluated, and the anisotropy was determined by testing. In particular, equibiaxial test (equal simultaneous loading in both directions) and biaxial test (half of the load in one direction following the Laplace law) were selected as a representation of physiologically relevant loads. The majority of the meshes displayed values in the range of 8 and 18 (N/mm) in each direction for equibiaxial stiffness (tangent modulus under equibiaxial load state in both directions), while a few achieved 28 and 50 (N/mm) (Infinit (®) and TIGR (®)). Only the Surgipro (®) mesh exhibited planar isotropy, with similar mechanical properties regardless of the direction of loading, and an anisotropy ratio of 1.18. Optilene (®), DynaMesh (®), Ultrapro (®) and TIGR (®) exhibited moderate anisotropy with ratios of 1.82, 1.84, 2.17 and 1.47, respectively. The Infinit (®) scaffold exhibited very high anisotropy with a ratio of 3.37. These trends in material anisotropic response changed during the physiological state in the human abdominal wall, i.e. T:0.5T test, which the meshes were loaded in one direction with half the load used in the other direction. The Surgipro (®) mesh increased its anisotropic response (Anis[Formula: see text] = 0.478) and the materials that demonstrated moderate and high anisotropic responses during multiaxial testing presented a quasi-isotropic response, especially the Infinit(®) mesh that decreased its anisotropic response from 3.369 to 1.292.

A novel method for evaluating the tensile behavior isotropy of surgical meshes based on the analysis of the polar graph of tensile properties using image processing method

“…1 Several studies have revealed that hernia treatment with mesh leads to a lower recurrence rate. 2 The advantages and disadvantages of different mesh materials have been evaluated to create modern polymeric meshes in a historical duration. 3 As a perfect prosthesis, the mesh should have crucial functional properties: safety, sterilization ability, biocompatibility, enough strength, suitable pore size, adequate porosity, structural stability, and good formability.…”

“…11 A surgical mesh’s mechanical response has to define because an anisotropic mesh’s random orientation can lead to inconsistent surgical outcomes. 2…”

“…11 A surgical mesh's mechanical response has to define because an anisotropic mesh's random orientation can lead to inconsistent surgical outcomes. 2 Saberski et al investigated the anisotropy of synthetic surgical meshes. Results showed that most investigated meshes have anisotropic tensile behavior.…”

Between Prolene®, Ultrapro® and Bard Soft® Meshes Which Presents the Best Performance in the Repair of the Abdominal Wall?

“…Once implanted in the recipient wall, the incorporation with tissue lining should imitate the biomechanical properties of the healthy abdominal wall. Studies have shown that the permanence of the high-weight mesh causes persistent inflammatory reaction at the mesh-tissue interface for months, and even years after implantation 7 .…”

Changes of Free Amino Acids in Skeletal Muscle and Serum after Exercise Injury

“…In recent years, many studies have found that adult skeletal muscle has certain repair potential after injury. Studies have shown that the physiological repair process of skeletal muscle injury can be divided into three stages [3]: the first stage is the formation of hematoma at the site of muscle injury. In the second stage, the satellite cells around the injured muscle were activated, and the fibroblasts restored the connective tissue skeleton.…”