Physical and biological characteristics of the main biomaterials used in pelvic surgery

Our study compared mechanical and biological properties of four materials classically used in surgery: polyethylene terephtalate (Mersilene), polypropylene (Marlex), polytetrafluoroethylene (Teflon) and expanded one (Gore-Tex) and polyaramide (Kevlar). No deterioration for polytetrafluoroethylene and polypropylene under irradiation was observed when materials were treated by physical means. Mechanical tests showed that all these materials could bear more than 50 N. Such a high tensile strength is never reached in visceral physiology. Results of graft elongation during tensile strength test shows two classes: a first one that includes high elongation grafts (Gore-Tex and Marlex) and a second one that includes low elongation grafts (Mersilene and Kevlar). As these materials have many potential uses in surgery, we have performed cytotoxicity tests. Material extracts were obtained under standardized conditions, and we have looked at a potentially toxic effect of substances eventually leached from the materials towards cells cultured in vitro. None of the material extracts listed above were cytotoxic except for untreated Kevlar. Toxicity disappeared when Kevlar was treated with methanol. As suspected, untreated Kevlar contains toxic additives introduced during the manufacture of this textile. Thus, in spite of good mechanical properties, Kevlar should not be used in pelvic surgery on account of its lower bicompatibility. These results shows that the choice of the grafts by surgeons must be relevant in a given application.