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research-article

Preventing Mesh Pore Collapse by Designing Mesh Pores with Auxetic Geometries: A Comprehensive Evaluation via Computational Modeling

[+] Author and Article Information
Katrina Knight

Musculoskeletal Research Center, Department of Bioengineering, University of Pittsburgh, 405 Center for Bioengineering, 300 Technology Drive, Pittsburgh, PA 15219, USA
kmk144@pitt.edu

Pamela Moalli

Magee-Womens Research Institute, Department of Obstetrics and Gynecology and Reproductive Sciences at Magee Womens Hospital, University of Pittsburgh, Pittsburgh, PA, 204 Craft Avenue, Pittsburgh, PA 15213, USA
moalpa@mail.magee.edu

Steven D. Abramowitch

Musculoskeletal Research Center, Department of Bioengineering, University of Pittsburgh, Magee-Womens Research Institute, Magee-Womens Hospital, University of Pittsburgh, 309 Center for Bioengineering, 300 Technology Drive, Pittsburgh, PA 15219, USA
sdast9@pitt.edu

1Corresponding author.

ASME doi:10.1115/1.4039058 History: Received August 22, 2017; Revised January 08, 2018

Abstract

Pelvic organ prolapse meshes are exposed to predominately tensile loading conditions in vivo that can lead to pore collapse by 70-90%, decreasing overall porosity, and providing a plausible mechanism for the contraction/shrinkage of mesh observed following implantation. To prevent pore collapse, we proposed to design synthetic meshes with a macrostructure that results in auxetic behavior, the pores expand laterally, instead of contracting when loaded. Such behavior can be achieved with a range of auxetic structures/geometries. This study utilized finite element analysis to assess the behavior of mesh models with 8 auxetic pore geometries subjected to uniaxial loading to evaluate their potential to allow for pore expansion while simultaneously providing resistance to tensile loading. Overall, substituting auxetic geometries for standard pore geometries yielded more pore expansion, but often at the expense of increased model elongation, with 2 of the 8 auxetics not able to maintain pore expansion at higher levels of tension. Meshes with stable pore geometries that remain open with loading will afford the ingrowth of host tissue into the pores and improved integration of the mesh. Given the demonstrated ability of auxetic geometries to allow for pore size maintenance (and pore expansion), auxetically designed meshes have the potential to significantly impact surgical outcomes and decrease the likelihood of major mesh related complications.

Copyright (c) 2018 by ASME
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