Wick effect Wick effect: A comparative study of its potential for development using polypropylene and titanium mesh implant models
Ivanov O.A., Bezhenar V.F., Palastin P.M.
Background. Implant-associated infections are primarily driven by bacterial biofilm formation. While the physicochemical properties of the material surface are recognized as key factors in adhesion, the role of implant macromorphology, particularly its wicking effect that facilitates microbial spread, remains understudied. A comparative analysis of Staphylococcus aureus adhesion, a primary pathogen in such infections, on widely used polypropylene and titanium meshes in surgery is of significant interest for assessing long-term risks.
Objective. To conduct a comparative analysis of Staphylococcus aureus adhesion on titanium and polypropylene implants, focusing on the distribution pattern of microorganisms and assessing the potential biofilm formation risk associated with the wicking properties of the materials.
Materials and methods. This in vitro study used commercial mesh implants: polypropylene (Gynemesh PS, Johnson & Johnson, USA) and titanium (Titanium Silk, Elastic Titanium Implants LLC, Russia). Samples were incubated overnight with S. aureus VT209 at 37°C for 24 h. The number of adherent bacteria was quantitatively assessed using a culture-based method with colony-forming unit (CFU) counting. Scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS) were used to analyze the bacterial distribution and surface characteristics.
Results. The quantitative adhesion levels of S. aureus to titanium (Me=4.30×10² CFU [4.25×10²; 4.40×10²]) and polypropylene (Me=4.45×10² CFU [4.40×10²; 4.50×10²]) implants were comparable (p>0.05). However, a fundamental difference in the distribution patterns was observed. On titanium implants, adhesion was strictly localized to the edge areas with increased roughness and micro-defects, as confirmed by SEM and EDS. In contrast, the polypropylene implants showed a uniform distribution of bacteria over the entire surface, indicating the pronounced wicking properties of the material that facilitate passive spread and colonization of the entire available area.
Conclusion. Despite similar adhesion levels, the identified differences in microbial distribution indicate a higher potential risk of forming extensive biofilms that are difficult to eradicate with antibiotics and the immune system when using polypropylene implants owing to their pronounced wicking effect. Conversely, the localized nature of adhesion on titanium potentially simplifies the identification and surgical debridement of the infection focus. These findings challenge the safety of polypropylene from a long-term infectious risk perspective and highlight the critical need to develop implants with suppressed wicking properties or apply antimicrobial coatings over their entire surface.
Authors' contributions. Ivanov O.A. – conception and design of the study, data collection and analysis, drafting of the manuscript; Bezhenar V.F. –approval of the final version to be submitted; Palastin P.M. – data collection and analysis, editing of the manuscript.
Conflicts of interest. The authors have no conflicts of interest to declare.
Funding. There was no funding for this study.
Ethical Approval. Ethical approval was not required because the study involved only standard bacterial reference strains and non‑biological materials and did not include human or animal subjects.
Generative Artificial Intelligence. No artificial intelligence tools were used in the preparation of this manuscript.
Patient Consent for Publication. All patients provided informed consent for the publication of their data.
Authors' Data Sharing Statement. The data supporting the findings of this study are available upon request from the corresponding author after approval from the principal investigator.
For citation: Ivanov O.A., Bezhenar V.F., Palastin P.M. Wick effect: A comparative study of
its potential for development using polypropylene and titanium mesh implant models.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (6): 135-143 (in Russian)
https://dx.doi.org/10.18565/aig.2025.336
Keywords
mesh implant
polypropylene
titanium
adhesion
Staphylococcus aureus
wicking effect
biofilm formation
References
- Беженарь В.Ф., Богатырева Е.В., Цыпурдеева А.А., Цуладзе Л.К., Русина Е.И., Гусева Е.С. Новые возможности хирургической коррекции тазового пролапса с использованием синтетических имплантов: пути профилактики послеоперационных осложнений. Акушерство, гинекология и репродукция. 2012; 6(2): 6-13. [Bezhenar V.F., Bogatyreva E.V., Tsypurdeeva A.A., Tsuladze L.K., Rusina E.I., Guseva E.S. New possibilities for surgical correction of pelvic prolapse using synthetic implants: ways to prevent postoperative complications. Obstetrics, Gynecology and Reproduction. 2012; 6(2): 6-13 (in Russian)].
- Попов А.А., Бабаева С.А., Федоров А.А., Тюрина С.С., Идашкин А.Д., Клюшников И.Д., Ефремова Е.С. Изучение клинической эффективности и безопасности методов хирургической коррекции апикального пролапса гениталий. Российский вестник акушера-гинеколога. 2023; 23(4): 58‑64. https://dx.doi.org/10.17116/rosakush20232304158 [Popov A.A., Babaeva S.A., Fedorov A.A., Tyurina S.S., Idashkin A.D., Klyushnikov I.D., Efremova E.S. Study of the clinical efficacy and safety of surgical methods for correction of apical genital prolapse. Russian Bulletin of Obstetrician-Gynecologist. 2023; 23(4): 58-64 (in Russian). https://dx.doi.org/10.17116/rosakush20232304158].
- Беженарь В.Ф., Паластин П.М., Толибова Г.Х. Эрозии влагалища в отдаленные сроки после постановки синтетических имплантатов при гинекологических операциях. РМЖ. Медицинское обозрение. 2018; 10: 17-21. [Bezhenar V.F., Palastin P.M., Tolibova G.Kh. Vaginal erosion at a long time after synthetic implants insertion during gynecological surgery. RMJ. Medical Review. 2018; 10: 17-21 (in Russian)].
- Seifalian A, Basma Z, Digesu A, Khullar V. Polypropylene pelvic mesh: what went wrong and what will be of the future? Biomedicines. 2023; 11(3): 741. https://dx.doi.org/10.3390/biomedicines11030741
- da Silveira S.D.R.B., Auge A.P., Jarmy-Dibella Z.I., Margarido P.F., Carramao S., Alves Rodrigues C. et al. A multicenter, randomized trial comparing pelvic organ prolapse surgical treatment with native tissue and synthetic mesh: a 5-year follow-up study. Neurourol. Urodyn, 2020; 39(3): 1002-11. https://dx.doi.org/10.1002/nau.24323
- Chapple C.R., Cruz F., Deffieux X., Milani A.L., Arlandis S., Artibani W. et al. Consensus statement of the european urology association and the European urogynaecological association on the use of implanted materials for treating pelvic organ prolapse and stress urinary incontinence. Eur. Urol. 2017; 72(3): 424-31. https://dx.doi.org/10.1016/j.eururo.2017.03.048
- Галлямов Э.А., Бусырев Ю.Б., Гвоздев А.А., Шалыгин А.Б., Федоров А.В. Эндоскопическое стентирование как метод выбора в лечении послеоперационной стриктуры гепатикоеюноанастомоза. Эндоскопическая хирургия. 2023; 29(6): 18-24. https://dx.doi.org/10.17116/endoskopi20231218 [Gallyamov E.A., Busyrev Yu.B., Gvozdev A.A., Shalygin A.B., Fedorov A.V. Endoscopic stenting as a method of choice in the treatment of postoperative stricture of hepaticojejunal anastomosis. Endoscopic Surgery. 2023; 29(6): 18-24 (in Russian). https://dx.doi.org/10.17116/endoskopi20231218].
- Sharma D., Misba L., Khan A.U. Antibiotics versus biofilm: an emerging battleground in microbial communities. Antimicrob. Resist. Infect. Control. 2019; 8: 76. https://dx.doi.org/10.1186/s13756-019-0533-3
- Борисова М.И., Лазакович Д.Н., Сидорова Н.А., Савушкин А.И. Биопленкообразующая активность и феномен персистенции микроорганизмов. Journal of Biomedical Technologies. 2015; 2: 28-35. https://dx.doi.org/10.15393/j6.art.2015.3382 [Borisova M.I., Lazakovich D.N., Sidorova N.A., Savushkin A.I. Biofilm-forming activity and the phenomenon of microbial persistence. Journal of Biomedical Technologies. 2015; 2: 28-35 (in Russian). https://dx.doi.org/10.15393/j6.art.2015.3382].
- Wassmann T., Kreis S., Behr M., Buergers R. The influence of surface texture and wettability on initial bacterial adhesion on titanium and zirconium oxide dental implants. Int. J. Implant. Dent. 2017; 3(1): 32. https://dx.doi.org/10.1186/s40729-017-0093-3
- Гветадзе Р.Ш., Дмитриева Н.А., Воронин А.Н. Особенности адгезии микроорганизмов к стоматологическим материалам, используемым для формирования контура десны при протезировании с опорой на дентальные имплантаты. Стоматология. 2019; 98(5): 118-23. https://dx.doi.org/10.17116/stomat201998051118 [Gvetadze R.Sh., Dmitrieva N.A., Voronin A.N. Adhesion of microorganisms to various dental materials used to form a gum contour in implant-retained restorations. Stomatology. 2019; 98(5): 118-23 (in Russian). https://dx.doi.org/10.17116/stomat201998051118].
- Камоева С.В., Маковская Д.С., Доброхотова Ю.Э. Хирургическая коррекция пролапса тазовых органов у женщин с использованием сетчатых эндопротезов на основе титанового «шелка»: результаты 5-летнего наблюдения. РМЖ. Мать и дитя. 2024; 7(3): 227-235. https://dx.doi.org/10.32364/2618-8430-2024-7-3-6 [Kamoeva S.V., Makovskaya D.S., Dobrokhotova Yu.E. Surgical management of female pelvic organ prolapse using titanium "silk" mesh replacement: 5-year results. Russian Journal of Woman and Child Health. 2024; 7(3): 227-35 (in Russian). https://dx.doi.org/10.32364/2618-8430-2024-7-3-6].
- Heinonen P., Ala-Nissilä S., Aaltonen R., Kiilholma P. Trocar-guided polypropylene mesh for pelvic organ prolapse surgery-perioperative morbidity and short-term outcome of the first 100 patients. Gynecol. Surg. 2011; 8: 165-70. https://dx.doi.org/10.1007/s10397-010-0628-6
- Villegas M., Bayat F., Kramer T., Schwarz E., Wilson D., Hosseinidoust Z. et al. Emerging strategies to prevent bacterial infections on titanium-based implants. Small. 2024; 20(46): e2404351. https://dx.doi.org/10.1002/smll.202404351
- Zacher A.T., Schwarz F., Dailey S.K., Rupp M., Alt V., Schmitz P. et al. Biofilm formation of Staphylococcus aureus on various implants used for surgical treatment of destructive spondylodiscitis. Sci. Rep. 2024; 14: 19364. https://dx.doi.org/10.1038/s41598-024-70244-6
- Паластин П.М., Беженарь В.Ф., Петров А.В. Реакция местного иммунитета на введение полипропиленового синтетического имплантата (экспериментальное исследование). Российский вестник акушера-гинеколога. 2019; 19(2): 45-9. https://dx.doi.org/10.17116/rosakush20191902147 [Palastin P.M., Bezhenar V.F., Petrov A.V. The reaction of local immunity to the introduction of a polypropylene synthetic implant (an experimental study). Russian Bulletin of Obstetrician-Gynecologist. 2019; 19(2): 45-9 (in Russian). https://dx.doi.org/10.17116/rosakush20191902147].
- Sanchez C.J., Mende K., Beckius M.L., Akers K.S., Romano D.R., Wenke J.C. et al. Biofilm formation by clinical isolates and the implications in chronic infections. BMC Infect. Dis. 2013; 13: 47. https://dx.doi.org/10.1186/1471-2334-13-47
- Swalsky A., Noumbissi S.S., Wiedemann T.G. The systemic and local interactions related to titanium implant corrosion and hypersensitivity reactions: a narrative review of the literature. Int. J. Implant. Dent. 2024; 10: 58. https://dx.doi.org/10.1186/s40729-024-00578-3
- Rezaei N.M., Hasegawa M., Ishijima M., Nakhaei K., Okubo T., Taniyama T. et al. Biological and osseointegration capabilities of hierarchically (meso-/micro-/nano-scale) roughened zirconia. Int. J. Nanomedicine. 2018; 8(13): 3381-95. https://dx.doi.org/10.2147/IJN.S159955
- Valente F., Scarano A., Murmura G., Varvara G., Sinjari B., Mandelli F. et al. Collagen fibres orientation in the bone matrix around dental implants: does the implant’s thread design play a role? Int. J. Mol. Sci. 2021; 22(15): 7860. https://dx.doi.org/10.3390/ijms22157860
- Черкасов М.Ф., Черкасов Д.М., Меликова С.Г., Старцев Ю.М., Галашокян К.М., Ендоренко К.В. Стратегия сохранения сетчатых имплантатов при инфицированных послеоперационных ранах передней брюшной стенки. Хирургия. Журнал им. Н.И. Пирогова. 2022; 11: 49-54. https://dx.doi.org/10.17116/hirurgia202211149 [Cherkasov M.F., Cherkasov D.M., Melikova S.G., Startsev Yu.M., Galashokyan K.M., Endorenko K.V. Strategy for maintaining mesh implants in infected postoperative wounds of anterior abdominal wall. Pirogov Russian Journal of Surgery. 2022; (11): 49-54 (in Russian). https://dx.doi.org/10.17116/hirurgia202211149].
- Артюшков Е.Л., Лызиков А.А., Каплан М.Л., Дорошко Е.Ю., Осипов Б.Б. Бактериальная биопленка как фактор риска инфекционных осложнений при применении полипропиленовых эндопротезов в хирургии грыж передней брюшной стенки. Проблемы здоровья и экологии. 2025; 22(1): 15-22. https://dx.doi.org/10.51523/2708-6011.2025-22-1-02 [Artyushkov E.L., Lyzikov А.A., Kaplan M.L., Doroshko Y.Y., Osipov B.B. Bacterial biofilm as a risk factor for infectious complications in the use of polypropylene endoprostheses in surgery of anterior wall hernias. Health and Ecology Issues. (in Russian). https://dx.doi.org/10.51523/2708-6011.2025-22-1-02].
Received 19.11.2025
Accepted 08.06.2026
About the Authors
Oleg A. Ivanov, PhD Student, Department of Obstetrics, Gynecology and Neonatology, Senior Laboratory Assistant, Department of Obstetrics, Gynecology and Neonatology, Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia, 197022, Russia, St. Petersburg, Leo Tolstoy str., 6-8, ivanoffmd@gmail.com, eLibrary SPIN: 8620-9749, https://orcid.org/0000-0002-6596-4105Vitaly F. Bezhenar, Dr. Med. Sci., Professor, Head of the Departments of Obstetrics, Gynecology and Neonatology/Reproductology, Head of the Clinic of Obstetrics and Gynecology, Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia, 197022, Russia, St. Petersburg, Leo Tolstoy str., 6-8; Main Supernumerary Specialist Obstetrician-Gynecologist of the Health Committee of St. Petersburg, eLibrary SPIN: 8626-7555, https://orcid.org/0000-0002-7807-4929
Peter M. Palastin, PhD, Associate Professor at the Department of Obstetrics, Gynecology and Neonatology, Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia, 197022, Russia, St. Petersburg, Leo Tolstoy str., 6-8, eLibrary SPIN: 8008-8723, https://orcid.org/0000-0003-3502-2499
Similar Articles
