The Effect of Cyclic Loading on the Mechanical Performance of Surgical Mesh

Polymeric meshes in the form of knitted nets are commonly used in the surgical repair of pelvic organ prolapses. Although a number of these prosthetic meshes are commercially available, there is little published data on their mechanical performance, in particular on the change in stiffness under the repeated loading experienced in vivo. In this in vitro study, cyclic tensile loading was applied to rectangular strips of four different commercially available meshes. The applied force and resultant displacement was monitored throughout the tests in order to evaluate the change in stiffness. In addition, each mesh was randomly marked using indelible ink in order to permit the use of three-dimensional digital image correlation to evaluate local displacements during the tests. However, the scale and form of the deformation experienced by some of the meshes made correlation difficult so that confirmation of the values of stiffness were only obtained for two meshes. The results demonstrate that all the meshes experience an increase in stiffness during cyclic loading, that in most cases cyclic creep occurs and in some cases large-scale, irreversible reorganisation of the mesh structure occurs after as few as 200 cycles at loads of the order of 10N