{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T22:36:18Z","timestamp":1776983778793,"version":"3.51.4"},"reference-count":39,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T00:00:00Z","timestamp":1743120000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"FCT","award":["UIDB\/50022\/2020"],"award-info":[{"award-number":["UIDB\/50022\/2020"]}]},{"name":"FCT","award":["UIDP\/50022\/2020"],"award-info":[{"award-number":["UIDP\/50022\/2020"]}]},{"name":"FCT","award":["LA\/P\/0079\/2020"],"award-info":[{"award-number":["LA\/P\/0079\/2020"]}]},{"name":"FCT","award":["2021.00077.CEECIND"],"award-info":[{"award-number":["2021.00077.CEECIND"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMMP"],"abstract":"<jats:p>Pelvic organ prolapse (POP) is a common condition among women, characterized by the descent of pelvic organs through the vaginal canal. Although traditional synthetic meshes are widely utilized, they are associated with complications such as erosion, infection, and tissue rejection. This study explores the design and fabrication of biodegradable auxetic implants using polycaprolactone and melt electrowriting technology, with the goal of developing implants that closely replicate the mechanical behavior of vaginal tissue while minimizing implant-related complications. Four distinct auxetic mesh geometries\u2014re-entrant Evans, Lozenge grid, square grid, and three-star honeycomb\u2014were fabricated with a 160 \u03bcm diameter and mechanically evaluated through uniaxial tensile testing. The results indicate that the square grid and three-star honeycomb geometries exhibit hyperelastic-like behavior, closely mimicking the stress\u2013strain response of vaginal tissue. The re-entrant Evans geometry has been observed to exhibit excessive stiffness for applications related to POP, primarily due to material overlap. This geometry demonstrates stiffness that is approximately five times greater than that of the square grid or the three-star honeycomb configurations, which contributes to an increase in local rigidity. The unique auxetic properties of these structures prevent the bundling effect observed in synthetic meshes, promoting improved load distribution and minimizing the risk of tissue compression. Additionally, increasing the extrusion diameter has been identified as a promising strategy for further refining the biomechanical properties of these meshes. These findings lay a solid foundation for the development of next-generation biodegradable implants.<\/jats:p>","DOI":"10.3390\/jmmp9040111","type":"journal-article","created":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T01:59:36Z","timestamp":1743386376000},"page":"111","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Melt Electrowritten Biodegradable Mesh Implants with Auxetic Designs for Pelvic Organ Prolapse Repair"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7783-1166","authenticated-orcid":false,"given":"Nuno Miguel","family":"Ferreira","sequence":"first","affiliation":[{"name":"Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal"},{"name":"LAETA, INEGI, 4200-465 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2608-9295","authenticated-orcid":false,"given":"Evangelia","family":"Antoniadi","sequence":"additional","affiliation":[{"name":"Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3566-5308","authenticated-orcid":false,"given":"Ana Telma","family":"Silva","sequence":"additional","affiliation":[{"name":"LAETA, INEGI, 4200-465 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4146-6224","authenticated-orcid":false,"given":"Ant\u00f3nio","family":"Silva","sequence":"additional","affiliation":[{"name":"Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal"},{"name":"LAETA, INEGI, 4200-465 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3326-6345","authenticated-orcid":false,"given":"Marco","family":"Parente","sequence":"additional","affiliation":[{"name":"Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal"},{"name":"LAETA, INEGI, 4200-465 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7146-9944","authenticated-orcid":false,"given":"Ant\u00f3nio","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal"},{"name":"LAETA, INEGI, 4200-465 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2889-4969","authenticated-orcid":false,"given":"Elisabete","family":"Silva","sequence":"additional","affiliation":[{"name":"LAETA, INEGI, 4200-465 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1007\/s00192-009-0976-9","article-title":"An International Urogynecological Association (IUGA)\/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction","volume":"21","author":"Haylen","year":"2010","journal-title":"Int. Urogynecol. J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1007\/s00192-020-04612-x","article-title":"Comparison of synthetic mesh erosion and chronic pain rates after surgery for pelvic organ prolapse and stress urinary incontinence: A systematic review","volume":"32","author":"MacCraith","year":"2021","journal-title":"Int. Urogynecol. J."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Guler, Z., and Roovers, J.P. (2022). Role of Fibroblasts and Myofibroblasts on the Pathogenesis and Treatment of Pelvic Organ Prolapse. Biomolecules, 12.","DOI":"10.3390\/biom12010094"},{"key":"ref_4","unstructured":"FDA (2019). FDA Takes Action to Protect Women\u2019s Health, Orders Manufacturers of Surgical Mesh Intended for Transvaginal Repair of Pelvic Organ Prolapse to Stop Selling All Devices, FDA."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41536-019-0076-5","article-title":"Synthetic scaffolds for musculoskeletal tissue engineering: Cellular responses to fiber parameters","volume":"4","author":"Jenkins","year":"2019","journal-title":"npj Regen. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e54687","DOI":"10.1002\/app.54687","article-title":"Development of new surgical mesh geometries with different mechanical properties using the design freedom of 3D printing","volume":"140","author":"Sterk","year":"2023","journal-title":"J. Appl. Polym. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e56408","DOI":"10.1002\/app.56408","article-title":"Optimizing melt electrowriting prototypes for printing non-medical and medical grade polycaprolactone meshes in prolapse repair","volume":"142","author":"Vaz","year":"2024","journal-title":"J. Appl. Polym. Sci."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1089\/3dp.2021.0010","article-title":"Melt Electrospinning Writing of Mesh Implants for Pelvic Organ Prolapse Repair","volume":"9","author":"Rynkevic","year":"2022","journal-title":"3D Print. Addit. Manuf."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"104101","DOI":"10.1016\/j.mtcomm.2022.104101","article-title":"Characterisation of polycaprolactone scaffolds made by melt electrospinning writing for pelvic organ prolapse correction - a pilot study","volume":"32","author":"Rynkevic","year":"2022","journal-title":"Mater. Today Commun."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1286","DOI":"10.1016\/j.promfg.2019.06.089","article-title":"An Overview on 3D Printing Technology: Technological, Materials, and Applications","volume":"35","author":"Shahrubudin","year":"2019","journal-title":"Procedia Manuf."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Liaw, C.Y., and Guvendiren, M. (2017). Current and emerging applications of 3D printing in medicine. Biofabrication, 9.","DOI":"10.1088\/1758-5090\/aa7279"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Baylon, K., Rodriguez-Camarillo, P., El\u00edas-Z\u00fa\u00f1iga, A., D\u00edaz-Elizondo, J.A., Gilkerson, R., and Lozano, K. (2017). Past, Present and Future of Surgical Meshes: A Review. Membranes, 7.","DOI":"10.3390\/membranes7030047"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Cho, Y.S., Gwak, S.J., and Cho, Y.S. (2021). Fabrication of polycaprolactone\/nano hydroxyapatite (Pcl\/nha) 3d scaffold with enhanced in vitro cell response via design for additive manufacturing (dfam). Polymers, 13.","DOI":"10.3390\/polym13091394"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Salimbeigi, G., Cahill, P.A., and McGuinness, G.B. (2022). Solvent system effects on the physical and mechanical properties of electrospun Poly(-caprolactone) scaffolds for in vitro lung models. J. Mech. Behav. Biomed. Mater., 136.","DOI":"10.1016\/j.jmbbm.2022.105493"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Kim, Y., Son, K.H., Lee, J.W., Kim, C., Son, Y., and Lee, K.H. (2021). Auxetic Structures for Tissue Engineering Scaffolds and Biomedical Devices. Materials, 14.","DOI":"10.3390\/ma14226821"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1097\/GRF.0b013e31804b184c","article-title":"Biologic grafts and synthetic meshes in pelvic reconstructive surgery","volume":"50","author":"Chen","year":"2007","journal-title":"Clin. Obstet. Gynecol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1002\/nau.23367","article-title":"Biomimetic implants for pelvic floor repair","volume":"37","author":"Vashaghian","year":"2018","journal-title":"Neurourol. Urodyn."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1847","DOI":"10.1002\/adem.201600053","article-title":"Three Decades of Auxetics Research - Materials with Negative Poisson\u2019s Ratio: A Review","volume":"18","author":"Saxena","year":"2016","journal-title":"Adv. Eng. Mater."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1007\/s40684-021-00332-9","article-title":"Development of Multi-layer Tubular Vascular Scaffold to Enhance Compliance by Exhibiting a Negative Poisson\u2019s Ratio","volume":"8","author":"Ahn","year":"2021","journal-title":"Int. J. Precis. Eng. Manuf. Green Technol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1800618","DOI":"10.1002\/adfm.201800618","article-title":"Auxetic Cardiac Patches with Tunable Mechanical and Conductive Properties toward Treating Myocardial Infarction","volume":"28","author":"Kapnisi","year":"2018","journal-title":"Adv. Funct. Mater."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2074","DOI":"10.1039\/C9BM01928F","article-title":"The use of auxetic materials in tissue engineering","volume":"8","author":"Mardling","year":"2020","journal-title":"Biomater. Sci."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Raggio, J.I.C., Arancibia, C.T., Mill\u00e1n, C., Ploeg, H.L., Aiyangar, A., and Vivanco, J.F. (2022). Height-to-Diameter Ratio and Porosity Strongly Influence Bulk Compressive Mechanical Properties of 3D-Printed Polymer Scaffolds. Polymers, 14.","DOI":"10.3390\/polym14225017"},{"key":"ref_23","unstructured":"3D4Makers. Facilan\u2122 PCL 100 Filament|3D Printing."},{"key":"ref_24","first-page":"102109","article-title":"FullControl GCode Designer: Open-source software for unconstrained design in additive manufacturing","volume":"46","author":"Gleadall","year":"2021","journal-title":"Addit. Manuf."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Vaz, M.F.R., Martins, J.A.P., Pinheiro, F., Ferreira, N.M., Brand\u00e3o, S., Alves, J.L., Fernandes, A.A., Parente, M.P.L., and Silva, M.E.T. (2024). Medical- and Non-Medical-Grade Polycaprolactone Mesh Printing for Prolapse Repair: Establishment of Melt Electrowriting Prototype Parameters. Appl. Sci., 14.","DOI":"10.3390\/app14219670"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Zhang, X., and Yang, D. (2016). Mechanical Properties of Auxetic Cellular Material Consisting of Re-Entrant Hexagonal Honeycombs. Materials, 9.","DOI":"10.3390\/ma9110900"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Mustahsan, F., Khan, S.Z., Zaidi, A.A., Alahmadi, Y.H., Mahmoud, E.R.I., Almohamadi, H., Zhang, J., Liu, L., Wang, Y., and Gao, X. (2022). Re-Entrant Honeycomb Auxetic Structure with Enhanced Directional Properties. Materials, 15.","DOI":"10.3390\/ma15228022"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/S0263-8223(96)00054-2","article-title":"Models for the elastic deformation of honeycombs","volume":"35","author":"Masters","year":"1996","journal-title":"Compos. Struct."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"4349","DOI":"10.1016\/S1359-6454(00)00269-X","article-title":"A novel mechanism for generating auxetic beha in reticulated foams: Missing rib foam model","volume":"48","author":"Smith","year":"2000","journal-title":"Acta Mater."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"5111","DOI":"10.1039\/C6RA27333E","article-title":"Auxetic mechanical metamaterials","volume":"7","author":"Kolken","year":"2017","journal-title":"RSC Adv."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1002\/jps.21077","article-title":"Porcine vagina Ex Vivo as a model for studying permeability and pathogenesis in mucosa","volume":"97","author":"Squier","year":"2008","journal-title":"J. Pharm. Sci."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1186\/s13567-015-0241-9","article-title":"A review of the human vs. porcine female genital tract and associated immune system in the perspective of using minipigs as a model of human genital Chlamydia infection","volume":"46","author":"Lorenzen","year":"2015","journal-title":"Vet. Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"101","DOI":"10.3390\/surgeries3020012","article-title":"Cog Threads for Transvaginal Prolapse Repair: Ex-Vivo Studies of a Novel Concept","volume":"3","author":"Soares","year":"2022","journal-title":"Surgeries"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1108\/EC-12-2023-0967","article-title":"3D printing and development of computational models of biodegradable meshes for pelvic organ prolapse","volume":"41","author":"Vaz","year":"2024","journal-title":"Eng. Comput."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Hedayati, R., Yousefi, A., Dezaki, M.L., and Bodaghi, M. (2023). Analytical relationships for 2D Re-entrant auxetic metamaterials: An application to 3D printing flexible implants. J. Mech. Behav. Biomed. Mater., 143.","DOI":"10.1016\/j.jmbbm.2023.105938"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"100546","DOI":"10.1016\/j.jcomc.2024.100546","article-title":"Experimental and numerical investigation of energy absorption in honeycomb structures based on lozenge grid unit cells under various loading angles","volume":"15","author":"Gharehbaghi","year":"2024","journal-title":"Compos. Part Open Access"},{"key":"ref_37","unstructured":"Pinheiro, D. (2022). Structure Design Optimisation Of Biodegradable Implants For Melt Electrowriting. [Master\u2019s Thesis, Faculty of Engineering of Porto]. Available online: https:\/\/repositorio-aberto.up.pt\/bitstream\/10216\/143649\/2\/575022.pdf."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Li, X., Li, Z., Guo, Z., Zhou, Y., Han, S., Mo, Z., and Li, J. (2024). A Parametric Study on Sandwich Structures with Star-Shaped Honeycomb Core Under Blast Loads, IOP Publishing.","DOI":"10.1088\/1742-6596\/2891\/4\/042016"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"102001","DOI":"10.1088\/2053-1591\/acfb60","article-title":"Enhancing Mechanical Properties of Cellular Core Sandwich Panels: A Review of Topological Parameters and Design Improvements","volume":"10","author":"Charkaoui","year":"2023","journal-title":"Mater. Res. Express"}],"container-title":["Journal of Manufacturing and Materials Processing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2504-4494\/9\/4\/111\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:04:45Z","timestamp":1760029485000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2504-4494\/9\/4\/111"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,28]]},"references-count":39,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,4]]}},"alternative-id":["jmmp9040111"],"URL":"https:\/\/doi.org\/10.3390\/jmmp9040111","relation":{},"ISSN":["2504-4494"],"issn-type":[{"value":"2504-4494","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,28]]}}}