Civilini Vittoria, Aldieri Alessandra, Giacalone Vincenzo, Audenino Alberto L, Terzini Mara
Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy.
PolitoBIOMed Lab, Politecnico di Torino, Turin, Italy.
Int J Numer Method Biomed Eng. 2025 Sep;41(9):e70092. doi: 10.1002/cnm.70092.
The impact of morphological and mechanical parameters of surgical meshes on the healing processes and patient comfort after abdominal repair surgery is widely accepted. However, how the structure of the knitted pattern of synthetic meshes affects the mechanical behavior remains primarily theoretical. The objective of this study was therefore to assess the correlation between these key factors, identifying the most crucial morphological parameters able to support the design of new meshes. In this perspective, morphological parameters related to pore size, shape, and orientation were computed based on high-resolution images using the poreScanner app and the Matlab Image Processing toolbox. Additional parameters such as weight and thickness were measured through high-precision instruments. Concurrently, 12 mechanical parameters were assessed by executing a comprehensive testing protocol. Multivariate regression models were implemented, each using one to five morphological parameters as independent variables and one of the 12 mechanical parameters as dependent variables. A leave-one-out (LOO) validation algorithm was then employed to estimate the models' performance, robustness, and accuracy for potential future predictions. Regression models showed high coefficients of determination (R ≥ 0.8), except for uniaxial strains (0.59 < R < 0.71). The LOO validation reveals good predictive capabilities (R > 0.65) for 5 out of 12 mechanical parameters, whereas moderate predictive capabilities (R > 0.55) for one model. Promising results demonstrate a quantifiable relationship between pore characteristics and mechanical behavior. Thanks to further validation using different meshes, the models could be beneficial for all stakeholders involved in this field, from patients to manufacturers.
外科补片的形态学和力学参数对腹部修复手术后愈合过程及患者舒适度的影响已得到广泛认可。然而，合成补片针织图案的结构如何影响力学行为，目前主要仍停留在理论层面。因此，本研究的目的是评估这些关键因素之间的相关性，确定能够支持新型补片设计的最关键形态学参数。从这个角度来看，基于高分辨率图像，使用poreScanner应用程序和Matlab图像处理工具箱计算了与孔径、形状和方向相关的形态学参数。通过高精度仪器测量了重量和厚度等其他参数。同时，通过执行全面的测试方案评估了12个力学参数。实施了多变量回归模型，每个模型使用一到五个形态学参数作为自变量，12个力学参数中的一个作为因变量。然后采用留一法（LOO）验证算法来估计模型在未来潜在预测中的性能、稳健性和准确性。回归模型显示出较高的决定系数（R≥0.8），单轴应变除外（0.59＜R＜0.71）。留一法验证显示，12个力学参数中有5个具有良好的预测能力（R＞0.65），而有一个模型具有中等预测能力（R＞0.55）。有前景的结果表明孔隙特征与力学行为之间存在可量化的关系。通过使用不同补片进行进一步验证，这些模型可能会使该领域的所有利益相关者受益，从患者到制造商。
