title: Characterizing the ex vivo mechanical properties of synthetic polypropylene surgical mesh.
abstract: The use of synthetic polypropylene mesh for hernia surgical repair and the correction of female pelvic organ prolapse have been controversial due to increasing post-operative complications, including mesh erosion, chronic pain, infection and support failure. These morbidities may be related to a mismatch of mechanical properties between soft tissues and the mesh. The aim of this study was to gain a better understanding of the biomechanical behavior of Prolene polypropylene mesh (Ethicon, Sommerville, NJ, USA), which is widely used for a variety of surgical repair procedures. The stiffness and permanent deformation of Prolene mesh were compared in different directions by performing uniaxial tensile failure tests, cyclic and creep tests at simulated physiological loads in the coursewise (0°), walewise (90°) and the diagonal (45°) directions. Failure tests suggest that the mechanical properties of the mesh is anisotropic; with response at 0° being the most compliant while 90° was the stiffest. Irreversible deformation and viscoelastic behavior were observed in both cyclic and creep tests. The anisotropic property may be relevant to the placement of mesh in surgery to maximize long term mesh performance. The considerable permanent deformation may be associated with an increased risk of post-operative support failure.
authors.affiliation: Auckland Bioengineering Institute, The University of Auckland, Level 6, Uniservices House, 70 Symonds Street, Auckland, New Zealand. Electronic address: xli230@aucklanduni.ac.nz.
authors.forename: Xinxin
authors.initials: X
authors.lastname: Li
authors.affiliation: Auckland Bioengineering Institute, The University of Auckland, Level 6, Uniservices House, 70 Symonds Street, Auckland, New Zealand. Electronic address: j.kruger@auckland.ac.nz.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Kruger
authors.affiliation: Auckland Bioengineering Institute, The University of Auckland, Level 6, Uniservices House, 70 Symonds Street, Auckland, New Zealand. Electronic address: j.jor@auckland.ac.nz.
authors.forename: Jessica W Y
authors.initials: JW
authors.lastname: Jor
authors.affiliation: Department of Obstetrics and Gynecology, Sydney Medical School Nepean, Nepean Hospital, University of Sydney, Penrith, NSW 2750, Australia. Electronic address: vivwlp@yahoo.co.nz.
authors.forename: Vivien
authors.initials: V
authors.lastname: Wong
authors.affiliation: Department of Obstetrics and Gynecology, Sydney Medical School Nepean, Nepean Hospital, University of Sydney, Penrith, NSW 2750, Australia. Electronic address: hpdietz@bigpond.com.
authors.forename: Hans P
authors.initials: HP
authors.lastname: Dietz
authors.affiliation: Auckland Bioengineering Institute, The University of Auckland, Level 6, Uniservices House, 70 Symonds Street, Auckland, New Zealand; Department of Engineering Science, The University of Auckland, Level 3, Uniservices House, 70 Symonds Street, Auckland, New Zealand. Electronic address: martyn.nash@auckland.ac.nz.
authors.forename: Martyn P
authors.initials: MP
authors.lastname: Nash
authors.affiliation: Auckland Bioengineering Institute, The University of Auckland, Level 6, Uniservices House, 70 Symonds Street, Auckland, New Zealand; Department of Engineering Science, The University of Auckland, Level 3, Uniservices House, 70 Symonds Street, Auckland, New Zealand. Electronic address: p.nielsen@auckland.ac.nz.
authors.forename: Poul M F
authors.initials: PM
authors.lastname: Nielsen
mesh_terms: D016880:Anisotropy; D004548:Elasticity; D008422:Materials Testing; D055595:Mechanical Phenomena; D011126:Polypropylenes; D013526:Surgical Mesh; D014783:Viscosity
chemical_list: D011126:Polypropylenes
keywords: Anisotropy; Hernia; Mechanical properties; Polypropylene mesh; Viscoelasticity