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

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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\(_{\text{Phys}}\) = 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.

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Acknowledgments

Financial support for this research was provided by the Spanish Ministry of Economy and Competitiveness through research projects DPI2011-27939-C02-01/DPI2011-27939-C02-02, DPI2014-54981-R and DPI2013-44391-P; the Department of Industry and Innovation (Government of Aragon) through the research group Grant T88 (Fondo Social Europeo) and the Instituto de Salud Carlos III (ISCIII) through the CIBER initiative (BIOMIMESH project) and the Platform for Biological Tissue Characterization of CIBER-BBN.

Declaration of interest

None of the authors has a financial or proprietary interest in any material or method mentioned. All the authors read and approved the final manuscript. The authors have no conflicts of interest to disclose.

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Authors and Affiliations

  1. Aragón Institute of Engineering Research (I3A), Mechanical Engineering Department, University of Zaragoza, Zaragoza, Spain

    A. Cordero, B. Hernández-Gascón, B. Calvo & E. Peña

  2. Departament of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Madrid, Spain

    G. Pascual

  3. Departament of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Madrid, Spain

    J. M. Bellón

  4. CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Aragon Health Sciences Institute, Zaragoza, Spain

    A. Cordero, B. Hernández-Gascón, G. Pascual, J. M. Bellón, B. Calvo & E. Peña

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  1. A. Cordero
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  2. B. Hernández-Gascón
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  3. G. Pascual
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  4. J. M. Bellón
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  5. B. Calvo
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  6. E. Peña
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Correspondence to E. Peña.

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Associate Editor Peter McHugh oversaw the review of this article.

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Cordero, A., Hernández-Gascón, B., Pascual, G. et al. Biaxial Mechanical Evaluation of Absorbable and Nonabsorbable Synthetic Surgical Meshes Used for Hernia Repair: Physiological Loads Modify Anisotropy Response. Ann Biomed Eng 44, 2181–2188 (2016). https://doi.org/10.1007/s10439-015-1503-4

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  • DOI: https://doi.org/10.1007/s10439-015-1503-4

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