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The work presented in this report provides scientific support to building renovation policies in the EU by promoting a holistic point of view on the topic. Integrated renovation can be seen as a nexus between European policies on disaster resilience, energy efficiency and circularity in the building sector. An overview of policy measures for the seismic and energy upgrading of buildings across EU Member States identified only a few available measures for combined upgrading. Regulatory framework, financial instruments and digital tools similar to those for energy renovation, together with awareness and training may promote integrated renovation. A framework for regional prioritisation of building renovation was put forward, considering seismic risk, energy efficiency, and socioeconomic vulnerability independently and in an integrated way. Results indicate that prioritisation of building renovation is a multidimensional problem. Depending on priorities, different integrated indicators should be used to inform policies and accomplish the highest relative or most spread impact across different sectors. The framework was further extended to assess the impact of renovation scenarios across the EU with a focus on priority regions. Integrated renovation can provide a risk-proofed, sustainable, and inclusive built environment, presenting an economic benefit in the order of magnitude of the highest benefit among the separate interventions. Furthermore, it presents the unique capability of reducing fatalities and energy consumption at the same time and, depending on the scenario, to a greater extent.
Purpose
In vivo, a loss of mesh porosity triggers scar tissue formation and restricts functionality. The purpose of this study was to evaluate the properties and configuration changes as mesh deformation and mesh shrinkage of a soft mesh implant compared with a conventional stiff mesh implant in vitro and in a porcine model.
Material and Methods
Tensile tests and digital image correlation were used to determine the textile porosity for both mesh types in vitro. A group of three pigs each were treated with magnetic resonance imaging (MRI) visible conventional stiff polyvinylidene fluoride meshes (PVDF) or with soft thermoplastic polyurethane meshes (TPU) (FEG Textiltechnik mbH, Aachen, Germany), respectively. MRI was performed with a pneumoperitoneum at a pressure of 0 and 15 mmHg, which resulted in bulging of the abdomen. The mesh-induced signal voids were semiautomatically segmented and the mesh areas were determined. With the deformations assessed in both mesh types at both pressure conditions, the porosity change of the meshes after 8 weeks of ingrowth was calculated as an indicator of preserved elastic properties. The explanted specimens were examined histologically for the maturity of the scar (collagen I/III ratio).
Results
In TPU, the in vitro porosity increased constantly, in PVDF, a loss of porosity was observed under mild stresses. In vivo, the mean mesh areas of TPU were 206.8 cm2 (± 5.7 cm2) at 0 mmHg pneumoperitoneum and 274.6 cm2 (± 5.2 cm2) at 15 mmHg; for PVDF the mean areas were 205.5 cm2 (± 8.8 cm2) and 221.5 cm2 (± 11.8 cm2), respectively. The pneumoperitoneum-induced pressure increase resulted in a calculated porosity increase of 8.4% for TPU and of 1.2% for PVDF. The mean collagen I/III ratio was 8.7 (± 0.5) for TPU and 4.7 (± 0.7) for PVDF.
Conclusion
The elastic properties of TPU mesh implants result in improved tissue integration compared to conventional PVDF meshes, and they adapt more efficiently to the abdominal wall. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 827–833, 2018.