Anisotropic evaluation of synthetic surgical meshes

E. R. Saberski, Sean Orenstein, Y. W. Novitsky

Research output: Contribution to journalArticle

57 Citations (Scopus)

Abstract

Introduction: The material properties of meshes used in hernia repair contribute to the overall mechanical behavior of the repair. The anisotropic potential of synthetic meshes, representing a difference in material properties (e.g., elasticity) in different material axes, is not well defined to date. Haphazard orientation of anisotropic mesh material can contribute to inconsistent surgical outcomes. We aimed to characterize and compare anisotropic properties of commonly used synthetic meshes. Methods: Six different polypropylene (Trelex®, ProLite™, Ultrapro™), polyester (Parietex™), and PTFE-based (Dualmesh®, Infinit) synthetic meshes were selected. Longitudinal and transverse axes were defined for each mesh, and samples were cut in each axis orientation. Samples underwent uniaxial tensile testing, from which the elastic modulus (E) in each axis was determined. The degree of anisotropy (λ) was calculated as a logarithmic expression of the ratio between the elastic modulus in each axis. Results: Five of six meshes displayed significant anisotropic behavior. Ultrapro™ and Infinit exhibited approximately 12- and 20-fold differences between perpendicular axes, respectively. Trelex®, ProLite™, and Parietex™ were 2.3-2.4 times. Dualmesh® was the least anisotropic mesh, without marked difference between the axes. Conclusion: Anisotropy of synthetic meshes has been underappreciated. In this study, we found striking differences between elastic properties of perpendicular axes for most commonly used synthetic meshes. Indiscriminate orientation of anisotropic mesh may adversely affect hernia repairs. Proper labeling of all implants by manufacturers should be mandatory. Understanding the specific anisotropic behavior of synthetic meshes should allow surgeons to employ rational implant orientation to maximize outcomes of hernia repair.

Original languageEnglish (US)
Pages (from-to)47-52
Number of pages6
JournalHernia
Volume15
Issue number1
DOIs
StatePublished - Feb 2011
Externally publishedYes

Fingerprint

Surgical Mesh
Herniorrhaphy
Elastic Modulus
Anisotropy
Polyesters
Polypropylenes
Elasticity
Polytetrafluoroethylene
parietex

Keywords

  • Anisotropy
  • Biomechanical test
  • Hernia
  • Mesh
  • Synthetic

ASJC Scopus subject areas

  • Surgery

Cite this

Anisotropic evaluation of synthetic surgical meshes. / Saberski, E. R.; Orenstein, Sean; Novitsky, Y. W.

In: Hernia, Vol. 15, No. 1, 02.2011, p. 47-52.

Research output: Contribution to journalArticle

Saberski, E. R. ; Orenstein, Sean ; Novitsky, Y. W. / Anisotropic evaluation of synthetic surgical meshes. In: Hernia. 2011 ; Vol. 15, No. 1. pp. 47-52.
@article{dd7863d71b114f978493faa692a25089,
title = "Anisotropic evaluation of synthetic surgical meshes",
abstract = "Introduction: The material properties of meshes used in hernia repair contribute to the overall mechanical behavior of the repair. The anisotropic potential of synthetic meshes, representing a difference in material properties (e.g., elasticity) in different material axes, is not well defined to date. Haphazard orientation of anisotropic mesh material can contribute to inconsistent surgical outcomes. We aimed to characterize and compare anisotropic properties of commonly used synthetic meshes. Methods: Six different polypropylene (Trelex{\circledR}, ProLite™, Ultrapro™), polyester (Parietex™), and PTFE-based (Dualmesh{\circledR}, Infinit) synthetic meshes were selected. Longitudinal and transverse axes were defined for each mesh, and samples were cut in each axis orientation. Samples underwent uniaxial tensile testing, from which the elastic modulus (E) in each axis was determined. The degree of anisotropy (λ) was calculated as a logarithmic expression of the ratio between the elastic modulus in each axis. Results: Five of six meshes displayed significant anisotropic behavior. Ultrapro™ and Infinit exhibited approximately 12- and 20-fold differences between perpendicular axes, respectively. Trelex{\circledR}, ProLite™, and Parietex™ were 2.3-2.4 times. Dualmesh{\circledR} was the least anisotropic mesh, without marked difference between the axes. Conclusion: Anisotropy of synthetic meshes has been underappreciated. In this study, we found striking differences between elastic properties of perpendicular axes for most commonly used synthetic meshes. Indiscriminate orientation of anisotropic mesh may adversely affect hernia repairs. Proper labeling of all implants by manufacturers should be mandatory. Understanding the specific anisotropic behavior of synthetic meshes should allow surgeons to employ rational implant orientation to maximize outcomes of hernia repair.",
keywords = "Anisotropy, Biomechanical test, Hernia, Mesh, Synthetic",
author = "Saberski, {E. R.} and Sean Orenstein and Novitsky, {Y. W.}",
year = "2011",
month = "2",
doi = "10.1007/s10029-010-0731-7",
language = "English (US)",
volume = "15",
pages = "47--52",
journal = "Hernia : the journal of hernias and abdominal wall surgery",
issn = "1265-4906",
publisher = "Springer Paris",
number = "1",

}

TY - JOUR

T1 - Anisotropic evaluation of synthetic surgical meshes

AU - Saberski, E. R.

AU - Orenstein, Sean

AU - Novitsky, Y. W.

PY - 2011/2

Y1 - 2011/2

N2 - Introduction: The material properties of meshes used in hernia repair contribute to the overall mechanical behavior of the repair. The anisotropic potential of synthetic meshes, representing a difference in material properties (e.g., elasticity) in different material axes, is not well defined to date. Haphazard orientation of anisotropic mesh material can contribute to inconsistent surgical outcomes. We aimed to characterize and compare anisotropic properties of commonly used synthetic meshes. Methods: Six different polypropylene (Trelex®, ProLite™, Ultrapro™), polyester (Parietex™), and PTFE-based (Dualmesh®, Infinit) synthetic meshes were selected. Longitudinal and transverse axes were defined for each mesh, and samples were cut in each axis orientation. Samples underwent uniaxial tensile testing, from which the elastic modulus (E) in each axis was determined. The degree of anisotropy (λ) was calculated as a logarithmic expression of the ratio between the elastic modulus in each axis. Results: Five of six meshes displayed significant anisotropic behavior. Ultrapro™ and Infinit exhibited approximately 12- and 20-fold differences between perpendicular axes, respectively. Trelex®, ProLite™, and Parietex™ were 2.3-2.4 times. Dualmesh® was the least anisotropic mesh, without marked difference between the axes. Conclusion: Anisotropy of synthetic meshes has been underappreciated. In this study, we found striking differences between elastic properties of perpendicular axes for most commonly used synthetic meshes. Indiscriminate orientation of anisotropic mesh may adversely affect hernia repairs. Proper labeling of all implants by manufacturers should be mandatory. Understanding the specific anisotropic behavior of synthetic meshes should allow surgeons to employ rational implant orientation to maximize outcomes of hernia repair.

AB - Introduction: The material properties of meshes used in hernia repair contribute to the overall mechanical behavior of the repair. The anisotropic potential of synthetic meshes, representing a difference in material properties (e.g., elasticity) in different material axes, is not well defined to date. Haphazard orientation of anisotropic mesh material can contribute to inconsistent surgical outcomes. We aimed to characterize and compare anisotropic properties of commonly used synthetic meshes. Methods: Six different polypropylene (Trelex®, ProLite™, Ultrapro™), polyester (Parietex™), and PTFE-based (Dualmesh®, Infinit) synthetic meshes were selected. Longitudinal and transverse axes were defined for each mesh, and samples were cut in each axis orientation. Samples underwent uniaxial tensile testing, from which the elastic modulus (E) in each axis was determined. The degree of anisotropy (λ) was calculated as a logarithmic expression of the ratio between the elastic modulus in each axis. Results: Five of six meshes displayed significant anisotropic behavior. Ultrapro™ and Infinit exhibited approximately 12- and 20-fold differences between perpendicular axes, respectively. Trelex®, ProLite™, and Parietex™ were 2.3-2.4 times. Dualmesh® was the least anisotropic mesh, without marked difference between the axes. Conclusion: Anisotropy of synthetic meshes has been underappreciated. In this study, we found striking differences between elastic properties of perpendicular axes for most commonly used synthetic meshes. Indiscriminate orientation of anisotropic mesh may adversely affect hernia repairs. Proper labeling of all implants by manufacturers should be mandatory. Understanding the specific anisotropic behavior of synthetic meshes should allow surgeons to employ rational implant orientation to maximize outcomes of hernia repair.

KW - Anisotropy

KW - Biomechanical test

KW - Hernia

KW - Mesh

KW - Synthetic

UR - http://www.scopus.com/inward/record.url?scp=79951725306&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79951725306&partnerID=8YFLogxK

U2 - 10.1007/s10029-010-0731-7

DO - 10.1007/s10029-010-0731-7

M3 - Article

VL - 15

SP - 47

EP - 52

JO - Hernia : the journal of hernias and abdominal wall surgery

JF - Hernia : the journal of hernias and abdominal wall surgery

SN - 1265-4906

IS - 1

ER -