Mechanical biocompatibility of prosthetic meshes: a comprehensive protocol for mechanical characterization

This study is aimed at a comprehensive and extensive characterization of the mechanical biocompatibility of mesh prostheses. A robust and simple experimental protocol and a set of parameters is proposed, addressing stiffness under uniaxial and biaxial loading conditions, anisotropy, influence of prior deformation history, local mismatch of deformation mechanisms, and changes in mechanical properties when embedded in a homogeneous matrix. These parameters can form the basis for comparison of different mesh types and for evaluation of their mechanical biocompatibility. Measurements were performed on nine mesh types used for hernia and/or pelvic repair, including heavier as well as lighter implants and covering a wide range of mechanical responses. A total of 93 experiments were performed and all parameters are represented for each mesh in a single diagram to facilitate the quantitative assessment of implant characteristics and their comparison. The mechanics of implants is a critical factor determining clinical performance which should be accounted for in mesh selection and for development of future implants.