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Tuset L, López-Cano M, Fortuny G, López JM, Herrero J, Puigjaner D. A virtual simulation approach to assess the effect of trocar-site placement and scar characteristics on the abdominal wall biomechanics. Sci Rep 2024; 14:3583. [PMID: 38351278 PMCID: PMC10864383 DOI: 10.1038/s41598-024-54119-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 02/08/2024] [Indexed: 02/16/2024] Open
Abstract
Analyses of registries and medical imaging suggest that laparoscopic surgery may be penalized with a high incidence of trocar-site hernias (TSH). In addition to trocar diameter, the location of the surgical wound (SW) may affect TSH incidence. The intra-abdominal pressure (IAP) exerted on the abdominal wall (AW) might also influence the appearance of TSH. In the present study, we used finite element (FE) simulations to predict the influence of trocar location and SW characteristics (stiffness) on the mechanical behavior of the AW subject to an IAP. Two models of laparoscopy patterns on the AW, with trocars in the 5-12 mm range, were generated. FE simulations for IAP values within the 4 kPa-20 kPa range were carried out using the Code Aster open-source software. Different stiffness levels of the SW tissue were considered. We found that midline-located surgical wounds barely deformed, even though they moved outwards along with the regular LA tissue. Laterally located SWs hardly changed their location but they experienced significant variations in their volume and shape. The amount of deformation of lateral SWs was found to strongly depend on their stiffness. Trocar incisions placed in a LA with non-diastatic dimensions do not compromise its mechanical integrity. The more lateral the trocars are placed, the greater is their deformation, regardless of their size. Thus, to prevent TSH it might be advisable to close lateral trocars with a suture, or even use a prosthetic reinforcement depending on the patient's risk factors (e.g., obesity).
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Affiliation(s)
- Lluís Tuset
- Departament d'Enginyeria Informàtica i Matemàtiques, Universitat Rovira i Virgili, Av. Països Catalans 26, Tarragona, Catalunya, Spain
| | - Manuel López-Cano
- Abdominal Wall Surgery Unit, Department of General Surgery, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Gerard Fortuny
- Departament d'Enginyeria Informàtica i Matemàtiques, Universitat Rovira i Virgili, Av. Països Catalans 26, Tarragona, Catalunya, Spain
| | - Josep M López
- Departament d'Enginyeria Informàtica i Matemàtiques, Universitat Rovira i Virgili, Av. Països Catalans 26, Tarragona, Catalunya, Spain
| | - Joan Herrero
- Departament d'Enginyeria Química, Universitat Rovira i Virgili, Av. Països Catalans 26, Tarragona, Catalunya, Spain
| | - Dolors Puigjaner
- Departament d'Enginyeria Informàtica i Matemàtiques, Universitat Rovira i Virgili, Av. Països Catalans 26, Tarragona, Catalunya, Spain.
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Kriener K, Lala R, Homes RAP, Finley H, Sinclair K, Williams MK, Midwinter MJ. Mechanical Characterization of the Human Abdominal Wall Using Uniaxial Tensile Testing. Bioengineering (Basel) 2023; 10:1213. [PMID: 37892943 PMCID: PMC10604332 DOI: 10.3390/bioengineering10101213] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/14/2023] [Accepted: 10/15/2023] [Indexed: 10/29/2023] Open
Abstract
It is generally accepted that the human abdominal wall comprises skin, subcutaneous tissues, muscles and their aponeuroses, and the parietal peritoneum. Understanding these layers and their mechanical properties provides valuable information to those designing procedural skills trainers, supporting surgical procedures (hernia repair), and engineering-based work (in silico simulation). However, there is little literature available on the mechanical properties of the abdominal wall in layers or as a composite in the context of designing a procedural skills trainer. This work characterizes the tensile properties of the human abdominal wall by layer and as a partial composite. Tissues were collected from fresh-never-frozen and fresh-frozen cadavers and tested in uniaxial tension at a rate of 5 mm/min until failure. Stress-strain curves were created for each sample, and the values for elastic moduli, ultimate tensile strength, and strain at failure were obtained. The experimental outcomes from this study demonstrated variations in tensile properties within and between tissues. The data also suggest that the tensile properties of composite abdominal walls are not additive. Ultimately, this body of work contributes to a deeper comprehension of these mechanical properties and will serve to enhance patient care, refine surgical interventions, and assist with more sophisticated engineering solutions.
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Affiliation(s)
- Kyleigh Kriener
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane 4072, Australia; (R.L.); (R.A.P.H.); (M.J.M.)
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Whitehead-Clarke T, Brown C, Ail G, Mudera V, Smith C, Kureshi A. Characterisation of human posterior rectus sheath reveals mechanical and structural anisotropy. Clin Biomech (Bristol, Avon) 2023; 106:105989. [PMID: 37244136 DOI: 10.1016/j.clinbiomech.2023.105989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 05/01/2023] [Accepted: 05/10/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND Our work aims to investigate the mechanical properties of the human posterior rectus sheath in terms of its ultimate tensile stress, stiffness, thickness and anisotropy. It also aims to assess the collagen fibre organisation of the posterior rectus sheath using Second-Harmonic Generation microscopy. METHODS For mechanical analysis, twenty-five fresh-frozen samples of posterior rectus sheath were taken from six different cadaveric donors. They underwent uniaxial tensile stress testing until rupture either in the transverse (n = 15) or longitudinal (n = 10) plane. The thickness of each sample was also recorded using digital callipers. On a separate occasion, ten posterior rectus sheath samples and three anterior rectus sheath samples underwent microscopy and photography to assess collagen fibre organisation. FINDINGS samples had a mean ultimate tensile stress of 7.7 MPa (SD 4.9) in the transverse plane and 1.2 MPa (SD 0.8) in the longitudinal plane (P < 0.01). The same samples had a mean Youngs modulus of 11.1 MPa (SD 5.0) in the transverse plane and 1.7 MPa (SD 1.3) in the longitudinal plane (P < 0.01). The mean thickness of the posterior rectus sheath was 0.51 mm (SD 0.13). Transversely aligned collagen fibres could be identified within the posterior sheath tissue using Second-Harmonic Generation microscopy. INTERPRETATION The posterior rectus sheath displays mechanical and structural anisotropy with greater tensile stress and stiffness in the transverse plane compared to the longitudinal plane. The mean thickness of this layer is around 0.51 mm - consistent with other studies. The tissue is constructed of transversely aligned collagen fibres that are visible using Second-Harmonic Generation microscopy.
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Affiliation(s)
- Thomas Whitehead-Clarke
- Centre for 3D Models of Health and Disease, Division of Surgery and Interventional Science, University College London, UK.
| | | | - Geetika Ail
- Department of Anatomy, Brighton and Sussex Medical School, UK
| | - Vivek Mudera
- Division of Surgery and Interventional Science, University College London, UK
| | - Claire Smith
- Department of Anatomy, Brighton and Sussex Medical School, UK
| | - Alvena Kureshi
- Division of Surgery and Interventional Science, University College London, UK
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Aoun R, Charles I, DeRouen A, Takawira C, Lopez MJ. Shoe configuration effects on third phalanx and capsule motion of unaffected and laminitic equine hooves in-situ. PLoS One 2023; 18:e0285475. [PMID: 37155654 PMCID: PMC10166494 DOI: 10.1371/journal.pone.0285475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 04/23/2023] [Indexed: 05/10/2023] Open
Abstract
Equine shoes provide hoof protection and support weakened or damaged hoof tissues. Two hypotheses were tested in this study: 1) motion of the third phalanx (P3) and hoof wall deformation are greater in laminitic versus unaffected hooves regardless of shoe type; 2) P3 displacement and hoof wall deformation are greatest while unshod (US), less with open-heel (OH), then egg-bar (EB) shoes, and least with heart-bar (HB) shoes for both hoof conditions. Distal forelimbs (8/condition) were subjected to compressive forces (1.0x102-5.5x103 N) while a real-time motion detection system recorded markers on P3 and the hoof wall coronary band, vertical midpoint, and solar margin. Magnitude and direction of P3 displacement and changes in proximal and distal hemi-circumference, quarter and heel height and proximal and distal heel width were quantified. Hoof condition and shoe effects were assessed with 2-way ANOVA (p<0.05). P3 displacement was greater in laminitic hooves when US or with OH, and EB and HB reduced P3 displacement in laminitic hooves. P3 displacement was similar among shoes in unaffected hooves and greatest in laminitic hooves with OH, then US, EB and HB. EB and HB increased P3 displacement from the dorsal wall in unaffected hooves and decreased it in laminitic hooves. OH and EB increased P3 motion from the coronary band in laminitic hooves, and HB decreased P3 motion toward the solar margin in unaffected and laminitic hooves. In laminitic hooves, HB reduced distal hemi-circumference and quarter deformation and increased heel deformation and expansion. Proximal hemi-circumference constriction was inversely related to proximal heel expansion with and without shoes. Overall, shoe configuration alters hoof deformation distinctly between unaffected and laminitic hooves, and HB provided the greatest P3 stability in laminitic hooves. These unique results about P3 motion and hoof deformation in laminitic and unaffected hooves inform shoe selection and design.
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Affiliation(s)
- Rita Aoun
- Laboratory for Equine and Comparative Orthopedic Research, Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana, United States of America
| | - Iyana Charles
- Laboratory for Equine and Comparative Orthopedic Research, Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana, United States of America
| | - Abigail DeRouen
- Laboratory for Equine and Comparative Orthopedic Research, Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana, United States of America
| | - Catherine Takawira
- Laboratory for Equine and Comparative Orthopedic Research, Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana, United States of America
| | - Mandi J Lopez
- Laboratory for Equine and Comparative Orthopedic Research, Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana, United States of America
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Cardoso L, Khadka N, Dmochowski JP, Meneses E, Lee K, Kim S, Jin Y, Bikson M. Computational modeling of posteroanterior lumbar traction by an automated massage bed: predicting intervertebral disc stresses and deformation. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:931274. [PMID: 36189059 PMCID: PMC9397988 DOI: 10.3389/fresc.2022.931274] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 06/27/2022] [Indexed: 11/23/2022]
Abstract
Spinal traction is a physical intervention that provides constant or intermittent stretching axial force to the lumbar vertebrae to gradually distract spinal tissues into better alignment, reduce intervertebral disc (IVD) pressure, and manage lower back pain (LBP). However, such axial traction may change the normal lordotic curvature, and result in unwanted side effects and/or inefficient reduction of the IVD pressure. An alternative to axial traction has been recently tested, consisting of posteroanterior (PA) traction in supine posture, which was recently shown effective to increase the intervertebral space and lordotic angle using MRI. PA traction aims to maintain the lumbar lordosis curvature throughout the spinal traction therapy while reducing the intradiscal pressure. In this study, we developed finite element simulations of mechanical therapy produced by a commercial thermo-mechanical massage bed capable of spinal PA traction. The stress relief produced on the lumbar discs by the posteroanterior traction system was investigated on human subject models with different BMI (normal, overweight, moderate obese and extreme obese BMI cases). We predict typical traction levels lead to significant distraction stresses in the lumbar discs, thus producing a stress relief by reducing the compression stresses normally experienced by these tissues. Also, the stress relief experienced by the lumbar discs was effective in all BMI models, and it was found maximal in the normal BMI model. These results are consistent with prior observations of therapeutic benefits derived from spinal AP traction.
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Affiliation(s)
- Luis Cardoso
- Department of Biomedical Engineering, The City College of New York, New York, NY, United States
- *Correspondence: Luis Cardoso
| | - Niranjan Khadka
- Division of Neuropsychiatry and Neuromodulation, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Jacek P. Dmochowski
- Department of Biomedical Engineering, The City College of New York, New York, NY, United States
| | - Edson Meneses
- Department of Biomedical Engineering, The City College of New York, New York, NY, United States
| | - Kiwon Lee
- Clinical Research Institute, Ceragem Clinical Inc., Seoul, South Korea
| | - Sungjin Kim
- Clinical Research Institute, Ceragem Clinical Inc., Seoul, South Korea
| | - Youngsoo Jin
- Clinical Research Institute, Ceragem Clinical Inc., Seoul, South Korea
- Asan Medical Center, Seoul, South Korea
| | - Marom Bikson
- Department of Biomedical Engineering, The City College of New York, New York, NY, United States
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Fan Z, Guan W, Zhang T, Zhang D. A Modified Surgical Technique to Prevent Parastomal Hernia. Front Surg 2022; 9:907316. [PMID: 35836595 PMCID: PMC9273896 DOI: 10.3389/fsurg.2022.907316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/02/2022] [Indexed: 11/17/2022] Open
Abstract
An extraperitoneal colostomy is not sufficiently effective in preventing parastomal hernias. On the basis of anatomic structures and mechanical principles, we modified this surgical technique by preserving the integrity of the posterior rectus abdominis sheath to prevent parastomal hernia, and we applied it clinically.
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Jourdan A, Rapacchi S, Guye M, Bendahan D, Masson C, Bège T. Dynamic-MRI quantification of abdominal wall motion and deformation during breathing and muscular contraction. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 217:106667. [PMID: 35231757 DOI: 10.1016/j.cmpb.2022.106667] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 01/15/2022] [Accepted: 01/25/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND OBJECTIVE Biomechanical assessment of the abdominal wall represents a major prerequisite for a better understanding of physiological and pathological situations such as hernia, post-delivery recovery, muscle dystrophy or sarcopenia. Such an assessment is challenging and requires muscular deformations quantification which have been very scarcely reported in vivo. In the present study, we intended to characterize abdominal wall deformations in passive and active conditions using dynamic MRI combined to a semiautomatic segmentation procedure. METHODS Dynamic deformations resulting from three complementary exercises i.e. forced breathing, coughing and Valsalva maneuver were mapped in a transversal abdominal plane and so for twenty healthy volunteers. Real-time dynamic MRI series were acquired at a rate of 182 ms per image, then segmented semi-automatically to follow muscles deformation through each exercise. Circumferential and radial strains of each abdominal muscle were computed from the geometrical characteristics' quantification, namely the medial axis length and the thickness. Muscular radial displacement maps were computed using image registration. RESULTS Large variations in circumferential and radial strains were observed for the lateral muscles (LM) but remained low for the rectus abdominis muscles (RA). Contraction phases of each exercise led to LM muscle shortening down to -9.6 ± 5.9% during Valsalva maneuver with a 16.2 ± 9.6% thickness increase. Contraction also led to inward radial displacement of the LM up to 9.9 ± 4.1 mm during coughing. During maximal inhalation, a significant 10.0 ± 6.6% lengthening was quantified for LM while a significant thickness decrease was computed for the whole set of muscles (-14.7 ± 6.6% for LM and -7.3 ± 6.5% for RA). The largest displacement was observed for the medial part of RA (17.9 ± 8.0 mm) whereas the posterior part of LM underwent limited motion (2.8 ± 2.3 mm). Displacement rate and correlation between muscle thickness and medial axis length during each exercise provided insights regarding subject-specific muscle function. CONCLUSIONS Dynamic MRI is a promising tool for the assessment of the abdominal wall motion and deformations. The corresponding metrics which have been continuously recorded during the exercises provided global and regional quantitative information. These metrics offer perspectives for a genuine clinical evaluation tool dedicated to the assessment of abdominal muscles function in both healthy subjects and patients.
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Affiliation(s)
- Arthur Jourdan
- Aix-Marseille Univ, Univ Gustave Eiffel, IFSTTAR, LBA, F-13016 Marseille, France.
| | | | - Maxime Guye
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France; APHM, Hopital Universitaire Timone, CEMEREM, Marseille, France.
| | | | - Catherine Masson
- Aix-Marseille Univ, Univ Gustave Eiffel, IFSTTAR, LBA, F-13016 Marseille, France.
| | - Thierry Bège
- Aix-Marseille Univ, Univ Gustave Eiffel, IFSTTAR, LBA, F-13016 Marseille, France; Department of General Surgery, Aix Marseille Univ, North Hospital, APHM, Marseille, France.
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Kirilova-Doneva M, Pashkouleva D. The effects of age and sex on the elastic mechanical properties of human abdominal fascia. Clin Biomech (Bristol, Avon) 2022; 92:105591. [PMID: 35131681 DOI: 10.1016/j.clinbiomech.2022.105591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 12/19/2021] [Accepted: 01/28/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND The abdominal hernias become more prevalent with age, that can adversely affect life quality. The mechanical properties of abdominal wall layers are supposed to play a significant role in developing of an abdominal hernia.The objective of this study was to determine the mechanical properties of the human abdominal layer - fascia and the effects of age and sex on it for choosing the proper brand of hernia mesh. METHODS 78 samples harvested from 19 fresh cadavers were subjected to uniaxial tension tests and divided into four groups according to age. Group A corresponds to age up to 60 years, Group B to age 61-70 years, Group C to age 71-80 years and Group D to 81-90 years. Median stress-stretch ratio curves with respect to age, sex and direction of loading were obtained. Median values of the maximum tensile stress, stretch at maximum stress and elastic modulus calculated at 5% strain were determined. FINDINGS The abdominal fascia showed large variations between specimens depending on age and sex. The stiffness of the fascia increased with age. There is statistically significant differences between the median curves of male samples (P = 0.008) and female samples (P = 0.019) according to age in the L direction. Statistically significant differences between the values of maximum stress (P = 0.01) and elastic modulus (P = 0.003) from Group C in the L direction and maximum stress (P = 0.03) from Group D in the T direction was established. INTERPRETATION The female samples are stiffer than male samples especially after 80 years.
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Affiliation(s)
- Miglena Kirilova-Doneva
- Faculty of Pharmacy, Medical University-Sofia, Sofia, Bulgaria; Institute of Mechanics, Bulgarian Academy of Sciences, Sofia, Bulgaria.
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A Herniorrhaphy Lamination Technique for the Reconstruction of Midline Abdominal Wall Defects. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3558. [PMID: 33912375 PMCID: PMC8078233 DOI: 10.1097/gox.0000000000003558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 03/02/2021] [Indexed: 12/04/2022]
Abstract
The primary goal of abdominal wall reconstruction is to prevent hernia recurrence through robust and durable repair. Synthetic mesh utilization can provide sound strength but is susceptible to extrusion, infection, and intestinal fistulization. The use of autologous fasciae latae to reinforce the primary fascial reapproximation has mostly been abandoned, presumably because synthetic patches are readily available. There is a specific demand for a sustainable, less-invasive, and ready-to-use repair method without mesh. The authors devised a herniorrhaphy lamination technique using local musculofascial flaps inspired by composite laminates. In this procedure, the primary fascial reapproximation is reinforced with 3 additional laminated musculofascial layers: (1) turnover hinge flaps of the anterior sheath of the rectus abdominis, (2) bilateral rectus abdominis, and (3) advancement flaps of newly generated edges of the fascia of the rectus sheath. Our technique’s stability is essentially due to the mechanical superiority of the centralized pipe-like structure of musculofascia. Between February 2009 and November 2019, we used the lamination technique to repair midline incisional hernias in 10 patients. The operative procedure was successful in all patients, and there has been no evidence of recurrence. The follow-up period ranged from 12 to 69 months, with a mean follow-up of 35 months. The herniorrhaphy lamination technique to reinforce the primary repair can help prevent hernia recurrence. Although our technique is suitable for a small-sized defect, it is less invasive, and can be readily applied. Because it does not include any mesh, it is suitable for the contaminated abdominal wall reconstruction.
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Morch A, Astruc L, Mayeur O, Witz JF, Lecomte-Grosbras P, Brieu M. Is there any objective and independent characterization and modeling of soft biological tissues? J Mech Behav Biomed Mater 2020; 110:103915. [PMID: 32771881 DOI: 10.1016/j.jmbbm.2020.103915] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/28/2020] [Accepted: 06/04/2020] [Indexed: 10/23/2022]
Abstract
The characterization of soft tissue raises several difficulties. Indeed, soft biological tissues usually shrink when dissected from their in vivo location. This shrinkage is characteristic of the release of residual stresses, since soft tissues are indeed often pre-stressed in their physiological configuration. During experimental loading, large extension at very low level of force are expected and assumed to be related to the progressive recruitment and stretching of fibers. However, the first phase of the mechanical test is also aiming at recovering the pre-stressed in vivo behavior. As a consequence, the initial phase, corresponding to the recovering of prestress and/or recruitment of fiberes, is questionable and frequently removed. One of the preferred methods to erase it consists in applying a preforce or prestress to the sample: this allows to easily get rid of the sample retensioning range. However this operation can impact the interpretation of the identified mechanical parameters. This study presents an evaluation of the impact of the data processing on the mechanical properties of a numerically defined material. For this purpose, a finite element simulation was performed to replicate a uniaxial tensile test on a biological soft tissue sample. The influence of different pre-stretches on the mechanical parameters of a second order Yeoh model was investigated. The Yeoh mechanical parameters, or any other strain energy density, depend strongly on any pre- and post-processing choices: they adapt to compensate the error made when choosing an arbitrary level of prestretch or prestress. This observation spreads to any modeling approach used in soft tissues. Mechanical parameters are indeed naturally bound to the choice of the pre-stretch (or pre-stress) through the elongation and the constitutive law. Regardless of the model, it would therefore be pointless to compare mechanical parameters if the conditions for the processing of experimental raw data are not fully documented.
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Affiliation(s)
- A Morch
- Univ. Lille, CNRS, Centrale Lille, UMR 9013 LaMcube Laboratoire de mécanique multiphysique et multiéchelle, F-59000, Lille, France
| | - L Astruc
- Univ. Lille, CNRS, Centrale Lille, UMR 9013 LaMcube Laboratoire de mécanique multiphysique et multiéchelle, F-59000, Lille, France
| | - O Mayeur
- Univ. Lille, CNRS, Centrale Lille, UMR 9013 LaMcube Laboratoire de mécanique multiphysique et multiéchelle, F-59000, Lille, France
| | - J-F Witz
- Univ. Lille, CNRS, Centrale Lille, UMR 9013 LaMcube Laboratoire de mécanique multiphysique et multiéchelle, F-59000, Lille, France
| | - P Lecomte-Grosbras
- Univ. Lille, CNRS, Centrale Lille, UMR 9013 LaMcube Laboratoire de mécanique multiphysique et multiéchelle, F-59000, Lille, France.
| | - M Brieu
- Univ. Lille, CNRS, Centrale Lille, UMR 9013 LaMcube Laboratoire de mécanique multiphysique et multiéchelle, F-59000, Lille, France; California State University, Los Angeles College Engineering, Computer Science and Technology, Dept. Mechanical Engineering, USA
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Kirilova-Doneva M, Pashkouleva D, Stoytchev S. Age-related changes in mechanical properties of human abdominal fascia. Med Biol Eng Comput 2020; 58:1565-1573. [PMID: 32415553 DOI: 10.1007/s11517-020-02172-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 03/26/2020] [Indexed: 11/29/2022]
Abstract
The purpose of this study is to assess and model age-related changes in the mechanical properties of human fascia. The samples were divided into three age groups: group A-up to 60 years (mean age 52.5 ± 6 years), group B-61-80 years (mean age 70.4 ± 5.2 years), and group C-81-90 years (mean age 83.2 ± 2 years). A uniaxial tensile test was applied to fascia specimens cut perpendicular and parallel to fibers. The secant modulus at 5% strain, the maximum stress, and the stretch at maximum stress were calculated from the stress-stretch ratio curves. The results indicated an increase in the secant modulus with the increased age. The trend is clearer in the longitudinal direction. Considering the strain energy function which accounts the isotropic and non-isotropic response of the fascia where isotropic and anisotropic parts are split, we evaluated which material model is the most suitable to present isotropic mechanical behavior of the tissue. The experimental stress-stretch ratio curves were approximated using Mooney-Rivlin, Yeoh, and neo-Hookean strain energy functions and a good match between theoretical and experimental results was obtained. On the basis of objective function values and normalized mean square root error, we recommend using the Yeoh model to describe the isotropic mechanical behavior of human abdominal fascia. Graphical abstract .
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Affiliation(s)
- Miglena Kirilova-Doneva
- Faculty of Pharmacy, Medical University of Sofia, 2 Dunav Str., 1000, Sofia, Bulgaria. .,Institute of Mechanics, Bulgarian Academy of Sciences, Acad. G. Bonchev Str., Bl. 4, Sofia, Bulgaria.
| | - Dessislava Pashkouleva
- Institute of Mechanics, Bulgarian Academy of Sciences, Acad. G. Bonchev Str., Bl. 4, Sofia, Bulgaria
| | - Stoyan Stoytchev
- Institute of Mechanics, Bulgarian Academy of Sciences, Acad. G. Bonchev Str., Bl. 4, Sofia, Bulgaria
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Todros S, de Cesare N, Pianigiani S, Concheri G, Savio G, Natali AN, Pavan PG. 3D surface imaging of abdominal wall muscular contraction. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2019; 175:103-109. [PMID: 31104699 DOI: 10.1016/j.cmpb.2019.04.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 04/10/2019] [Accepted: 04/11/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND AND OBJECTIVE The biomechanical analysis of the abdominal wall should take into account muscle activation and related phenomena, such as intra-abdominal pressure variation and abdomen surface deformation. The geometry of abdominal surface and its deformation during contraction have not been extensively characterized, while represent a key issue to be investigated. METHODS In this work, the antero-lateral abdominal wall surface of ten healthy volunteers in supine position is acquired via laser scanning in relaxed conditions and during abdominal muscles contraction, repeating each acquisition six times. The average relaxed and contracted abdominal surfaces are compared for each subject and displacements measured. RESULTS Muscular activation induces raising in the region adjacent to linea alba along the posterior-anterior direction and a simultaneous lowering along lateral-medial direction of the abdominal wall sides. Displacements reach a maximum value of 12.5 mm for the involved subjects. The coefficient of variation associated to the abdomen surface measurements in the same configuration (relaxed or contracted) is below 0.75%. Non-parametric Mann-Whitney U test highlights that the differences between relaxed and contracted abdominal wall surfaces are significant (p < 0.01). CONCLUSIONS Laser scanning is an accurate and reliable method to evaluate surface changes on the abdominal wall during muscular contraction. The results of this experimental activity can be useful to validate numerical models aimed at describing abdominal wall biomechanics.
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Affiliation(s)
- Silvia Todros
- Department of Industrial Engineering, Centre for Mechanics of Biological Materials, University of Padova, Padova, Italy
| | - Niccolò de Cesare
- Department of Industrial Engineering, Centre for Mechanics of Biological Materials, University of Padova, Padova, Italy.
| | - Silvia Pianigiani
- Department of Industrial Engineering, Centre for Mechanics of Biological Materials, University of Padova, Padova, Italy
| | - Gianmaria Concheri
- Department of Civil, Environmental and Architectural Engineering, Laboratory of Design Tools and Methods in Industrial Engineering, University of Padova, Padova, Italy
| | - Gianpaolo Savio
- Department of Civil, Environmental and Architectural Engineering, Laboratory of Design Tools and Methods in Industrial Engineering, University of Padova, Padova, Italy
| | - Arturo N Natali
- Department of Industrial Engineering, Centre for Mechanics of Biological Materials, University of Padova, Padova, Italy
| | - Piero G Pavan
- Department of Industrial Engineering, Centre for Mechanics of Biological Materials, University of Padova, Padova, Italy
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Decellularisation affects the strain rate dependent and dynamic mechanical properties of a xenogeneic tendon intended for anterior cruciate ligament replacement. J Mech Behav Biomed Mater 2019; 91:18-23. [DOI: 10.1016/j.jmbbm.2018.11.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 11/02/2018] [Accepted: 11/23/2018] [Indexed: 01/20/2023]
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14
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Astruc L, De Meulaere M, Witz JF, Nováček V, Turquier F, Hoc T, Brieu M. Characterization of the anisotropic mechanical behavior of human abdominal wall connective tissues. J Mech Behav Biomed Mater 2018; 82:45-50. [PMID: 29567529 DOI: 10.1016/j.jmbbm.2018.03.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 03/05/2018] [Accepted: 03/09/2018] [Indexed: 11/30/2022]
Abstract
Abdominal wall sheathing tissues are commonly involved in hernia formation. However, there is very limited work studying mechanics of all tissues from the same donor which prevents a complete understanding of the abdominal wall behavior and the differences in these tissues. The aim of this study was to investigate the differences between the mechanical properties of the linea alba and the anterior and posterior rectus sheaths from a macroscopic point of view. Eight full-thickness human anterior abdominal walls of both genders were collected and longitudinal and transverse samples were harvested from the three sheathing connective tissues. The total of 398 uniaxial tensile tests was conducted and the mechanical characteristics of the behavior (tangent rigidities for small and large deformations) were determined. Statistical comparisons highlighted heterogeneity and non-linearity in behavior of the three tissues under both small and large deformations. High anisotropy was observed under small and large deformations with higher stress in the transverse direction. Variabilities in the mechanical properties of the linea alba according to the gender and location were also identified. Finally, data dispersion correlated with microstructure revealed that macroscopic characterization is not sufficient to fully describe behavior. Microstructure consideration is needed. These results provide a better understanding of the mechanical behavior of the abdominal wall sheathing tissues as well as the directions for microstructure-based constitutive model.
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Affiliation(s)
- Laure Astruc
- Univ. Lille, CNRS, Centrale Lille, FRE 2016 - LaMcube - Laboratoire de mécanique multiphysique multiéchelle, F-59000 Lille, France.
| | - Maurice De Meulaere
- Laboratoire d'Anatomie, CHRU de Lille, 1 Place de Verdun, 59045 Lille, France
| | - Jean-François Witz
- Univ. Lille, CNRS, Centrale Lille, FRE 2016 - LaMcube - Laboratoire de mécanique multiphysique multiéchelle, F-59000 Lille, France
| | - Vit Nováček
- Medtronic, Sofradim Production, 116 avenue du Formans, 01600 Trévoux, France
| | - Frédéric Turquier
- Medtronic, Sofradim Production, 116 avenue du Formans, 01600 Trévoux, France
| | - Thierry Hoc
- LTDS, UMR CNRS 5513, Université de Lyon, École Centrale de Lyon, 36 av Guy de Collongue, 69134 Écully Cedex, France
| | - Mathias Brieu
- Univ. Lille, CNRS, Centrale Lille, FRE 2016 - LaMcube - Laboratoire de mécanique multiphysique multiéchelle, F-59000 Lille, France
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15
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Computational modeling of abdominal hernia laparoscopic repair with a surgical mesh. Int J Comput Assist Radiol Surg 2017; 13:73-81. [DOI: 10.1007/s11548-017-1681-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 10/20/2017] [Indexed: 11/25/2022]
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16
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Deeken CR, Lake SP. Mechanical properties of the abdominal wall and biomaterials utilized for hernia repair. J Mech Behav Biomed Mater 2017; 74:411-427. [DOI: 10.1016/j.jmbbm.2017.05.008] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 04/26/2017] [Accepted: 05/04/2017] [Indexed: 12/29/2022]
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17
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Todros S, Pachera P, Pavan PG, Natali AN. Investigation of the Mechanical Behavior of Polyester Meshes for Abdominal Surgery: A Preliminary Study. J Med Biol Eng 2017. [DOI: 10.1007/s40846-017-0337-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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18
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Kahan LG, Lake SP, McAllister JM, Tan WH, Yu J, Thompson D, Brunt LM, Blatnik JA. Combined in vivo and ex vivo analysis of mesh mechanics in a porcine hernia model. Surg Endosc 2017; 32:820-830. [DOI: 10.1007/s00464-017-5749-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 07/14/2017] [Indexed: 12/29/2022]
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19
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Towards the mechanical characterization of abdominal wall by inverse analysis. J Mech Behav Biomed Mater 2017; 66:127-137. [DOI: 10.1016/j.jmbbm.2016.11.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 10/24/2016] [Accepted: 11/01/2016] [Indexed: 12/31/2022]
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20
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Tran D, Podwojewski F, Beillas P, Ottenio M, Voirin D, Turquier F, Mitton D. Abdominal wall muscle elasticity and abdomen local stiffness on healthy volunteers during various physiological activities. J Mech Behav Biomed Mater 2016; 60:451-459. [DOI: 10.1016/j.jmbbm.2016.03.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 02/19/2016] [Accepted: 03/03/2016] [Indexed: 10/22/2022]
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21
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PAVAN PIEROGIOVANNI, PACHERA PAOLA, TODROS SILVIA, TIENGO CESARE, NATALI ARTURONICOLA. MECHANICAL CHARACTERIZATION OF ANIMAL DERIVED GRAFTS FOR SURGICAL IMPLANTATION. J MECH MED BIOL 2016. [DOI: 10.1142/s0219519416500238] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Bioprostheses obtained from animal models are often adopted in abdominal surgery for repair and reconstruction. The functionality of these prosthetic implants is related also to their mechanical characteristics that are analyzed here. This work illustrates a constitutive model to describe the short-term mechanical response of Permacol[Formula: see text] bioprostheses. Experimental tests were developed on tissue samples to highlight mechanical non-linear characteristics and viscoelastic phenomena. Uni-axial tensile tests were developed to evaluate the strength and strain stiffening. Incremental uni-axial stress relaxation tests were carried out at nominal strain ranging from 10% to 20% and to monitor the stress relaxation process up to 400[Formula: see text]s. The constitutive model effectively describes the mechanical behavior found in experimental testing. The mechanical response appears to be independent on the loading direction, showing that the tissue can be considered as isotropic. The viscoelastic response of the tissue shows a strong decay of the stress in the first seconds of the relaxation process. The investigation performed is aimed at a general characterization of the biomechanical response and addresses the development of numerical models to evaluate the biomechanical performance of the graft with surrounding host tissues.
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Affiliation(s)
- PIERO GIOVANNI PAVAN
- Department of Industrial Engineering, Centre of Mechanics of Biological Materials, University of Padova, Via G. Colombo 3, Padova I-35131, Italy
| | - PAOLA PACHERA
- Department of Industrial Engineering, Centre of Mechanics of Biological Materials, University of Padova, Via G. Colombo 3, Padova I-35131, Italy
| | - SILVIA TODROS
- Department of Industrial Engineering, Centre of Mechanics of Biological Materials, University of Padova, Via G. Colombo 3, Padova I-35131, Italy
| | - CESARE TIENGO
- Department of Molecular Medicine, University of Padova, Via A. Gabelli 63, Padova I-35131, Italy
| | - ARTURO NICOLA NATALI
- Department of Industrial Engineering, Centre of Mechanics of Biological Materials, University of Padova, Via G. Colombo 3, Padova I-35131, Italy
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22
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A numerical investigation of the healthy abdominal wall structures. J Biomech 2016; 49:1818-1823. [PMID: 27133659 DOI: 10.1016/j.jbiomech.2016.04.019] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 04/15/2016] [Accepted: 04/18/2016] [Indexed: 10/21/2022]
Abstract
The present work aims to assess, via numerical modeling, the global passive mechanical behavior of the healthy abdominal wall under the action of pressures that characterize different daily tasks and physiological functions. The evaluation of a normal range of intra-abdominal pressure (IAP) during activities of daily living is fundamental because pressure alterations can cause several adverse effects. At this purpose, a finite element model is developed from literature histomorphometric data and from diagnostic images of Computed Tomography (CT), detailing the different anatomical regions. Numerical simulations cover an IAP up to the physiological limit of 171 (0.0223MPa) mmHg reached while jumping. Numerical results are in agreement with evidences on physiological abdomens when evaluating the local deformations along the craniocaudal direction, the transversal load forces in different regions and the increase of the abdominal area at a IAP of 12mmHg. The developed model can be upgraded for the investigation of the abdominal hernia repair and the assessment of prostheses mechanical compatibility, correlating stiffness and tensile strength of the abdominal tissues with those of surgical meshes.
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23
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Simón-Allué R, Montiel J, Bellón J, Calvo B. Developing a new methodology to characterize in vivo the passive mechanical behavior of abdominal wall on an animal model. J Mech Behav Biomed Mater 2015. [DOI: 10.1016/j.jmbbm.2015.06.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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24
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Acosta Santamaría V, Siret O, Badel P, Guerin G, Novacek V, Turquier F, Avril S. Material model calibration from planar tension tests on porcine linea alba. J Mech Behav Biomed Mater 2015; 43:26-34. [DOI: 10.1016/j.jmbbm.2014.12.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 11/30/2014] [Accepted: 12/04/2014] [Indexed: 11/24/2022]
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25
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Uniaxial and biaxial mechanical properties of porcine linea alba. J Mech Behav Biomed Mater 2015; 41:68-82. [DOI: 10.1016/j.jmbbm.2014.09.026] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 09/23/2014] [Accepted: 09/26/2014] [Indexed: 11/18/2022]
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26
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Podwojewski F, Otténio M, Beillas P, Guérin G, Turquier F, Mitton D. Mechanical response of human abdominal walls ex vivo: Effect of an incisional hernia and a mesh repair. J Mech Behav Biomed Mater 2014; 38:126-33. [DOI: 10.1016/j.jmbbm.2014.07.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Revised: 06/26/2014] [Accepted: 07/01/2014] [Indexed: 11/15/2022]
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27
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Contribution of the skin, rectus abdominis and their sheaths to the structural response of the abdominal wall ex vivo. J Biomech 2014; 47:3056-63. [DOI: 10.1016/j.jbiomech.2014.06.031] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Revised: 06/12/2014] [Accepted: 06/27/2014] [Indexed: 11/17/2022]
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28
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Lyons M, Winter DC, Simms CK. Mechanical characterisation of porcine rectus sheath under uniaxial and biaxial tension. J Biomech 2014; 47:1876-84. [DOI: 10.1016/j.jbiomech.2014.03.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 02/12/2014] [Accepted: 03/01/2014] [Indexed: 12/11/2022]
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