Mersilene tape is a flat, braided polyester (polyethylene terephthalate) strip manufactured by Ethicon, used across a surprisingly wide range of surgical specialties. It is non-absorbable, meaning the body does not break it down over time, and its woven structure gives it a broader surface area than round sutures. Surgeons reach for it when they need a strong, permanent material that distributes force across tissue rather than cutting through it like a thin thread would. From preventing premature birth to stabilizing separated shoulder joints to lifting drooping eyelids, Mersilene tape shows up in operating rooms that have almost nothing else in common.
What Mersilene Tape Actually Is
Mersilene tape is made of polyester fibers braided into a flat ribbon, typically 5 mm wide. That flat profile is the key design feature. A round suture concentrates its load on a narrow line of tissue contact, which can cause the suture to cut through soft tissue under tension. A flat tape spreads the same load over a wider area, reducing the chance of tissue damage at the anchor points. Polyester itself is chemically stable in the body and does not degrade, so the tape provides permanent mechanical support for as long as it remains in place.
The braided, multifilament construction gives the tape a slightly textured surface and creates microscopic spaces within the weave. This matters for how tissue grows into and around the tape, a topic that turns out to be both an advantage and a potential source of complications depending on where the tape is implanted.
Mechanical Behavior Compared to Other Suture Materials
Mersilene tape is strong, but it stretches more than some alternatives. In biomechanical testing comparing it with Ethibond suture and stainless steel wire for tension-band fixation, one loop of Mersilene and two loops of Ethibond carried similar peak loads before failure, while stainless steel wire was significantly stronger and stiffer. The standout difference was elongation: Mersilene tape stretched significantly more before failing than any of the other materials or knot configurations tested.1PubMed. Comparison of the mechanical properties of different tension band materials and suture techniques
A separate study looking at suture loops for ACL reconstruction found a similar pattern. Mersilene loops held an ultimate load of about 437 N (roughly 98 pounds of force), compared to about 338 N for Ethibond and 474 N for Polylene. But under a moderate tension load, Mersilene again elongated more than the other two materials.2PubMed. Structural properties of sutures used in anchoring multistranded hamstrings in anterior cruciate ligament reconstruction: a biomechanical study
That extra stretch is not necessarily a flaw. In applications where some give is desirable, like cerclage around a cervix that will expand gradually during pregnancy, a degree of elongation can be an asset. In applications demanding rigid fixation, like fracture repair, it is a drawback. Choosing the right material depends on whether you want the implant to behave more like a cable or more like a belt.
Cervical Cerclage and Preventing Preterm Birth
The most widely discussed use of Mersilene tape is in cervical cerclage, a procedure where a stitch or band is placed around the cervix to keep it closed during pregnancy when it would otherwise open too early. This is typically performed in women with cervical insufficiency, a condition where the cervix shortens and dilates prematurely, leading to second-trimester pregnancy loss or very early preterm birth.
The tape can be placed either vaginally (the most common route) or abdominally. In the vaginal approach, surgeons thread it around the cervix and tie it snugly. In the abdominal approach, the tape is placed higher, at the level of the internal os, often through laparoscopy. The abdominal route avoids placing foreign material in the vagina, which reduces the risk of ascending infection from the lower genital tract and allows the tape to stay in place between pregnancies, though it requires cesarean delivery.
A systematic review and meta-analysis comparing Mersilene tape to conventional thinner sutures (like Prolene or Ethibond) in transvaginal cerclage found no overall difference in preterm birth before 37 weeks. But the breakdown by gestational age was interesting: women who received Mersilene tape had a higher rate of delivery between 34 and 37 weeks, yet a lower rate of very early preterm birth before 34 weeks.3PubMed Central. Mersilene tape versus conventional sutures in transvaginal cervical cerclage: a systematic review and meta-analysis Rates of serious complications like infection of the fetal membranes, NICU admission, and neonatal death were not significantly different between the two groups.
A separate study examining suture thickness specifically found that thick suture (which includes Mersilene tape) was associated with longer pregnancy duration in women whose cerclage was placed because of ultrasound findings or a physical exam showing cervical dilation, though not in women whose cerclage was placed purely based on obstetric history. Thick suture was also linked to lower odds of very early preterm birth, membrane infection, and NICU admission compared to thin suture.4PubMed Central. Suture thickness and transvaginal cervical cerclage outcomes
The practical takeaway for patients is that Mersilene tape performs at least as well as thinner sutures for cerclage overall, and it may offer an edge in the highest-risk scenarios where the cervix is already shortening or dilating. The choice often comes down to surgeon preference and the specific clinical situation.
Laparoscopic Cerclage Left in Place Between Pregnancies
One of the more distinctive features of abdominal cerclage with Mersilene tape is the option to leave the tape permanently in place. A woman who has had a successful laparoscopic cerclage can become pregnant again without needing a second procedure. In one retrospective series of 98 patients who underwent pre-conceptional laparoscopic cerclage, 95 had live births, with a mean neonatal weight of about 3,310 grams (roughly 7.3 pounds). Nearly all delivered by cesarean section, which is expected because the tape cannot be easily removed vaginally at delivery.5PubMed Central. A simplified pre-conceptional laparoscopic cervical cerclage for cervical insufficiency: a retrospective study from a single center
This approach is typically reserved for women who have had a failed vaginal cerclage or whose cervix is too short or scarred to accept a vaginal stitch. It is a more involved procedure upfront but eliminates the need for repeat cerclage placement each pregnancy, which is a meaningful quality-of-life benefit for someone facing serial high-risk pregnancies.
Shoulder and Joint Stabilization
Outside obstetrics, Mersilene tape sees heavy use in orthopedic surgery, particularly for acromioclavicular (AC) joint dislocations. These injuries, common in contact sports and falls, separate the collarbone from the shoulder blade. Surgeons reconstruct the torn ligaments using various fixation methods, and Mersilene tape is one option for recreating the coracoclavicular ligament that holds the joint together.
A retrospective comparison of Mersilene tape fixation versus hook plate fixation for severe AC dislocations found that both methods provided temporary stabilization and yielded comparable clinical outcomes. The hook plate maintained radiographic alignment slightly better, but the Mersilene tape fixation had the advantage of not requiring a second surgery for implant removal, since the tape is left in place permanently.6PubMed Central. Single coracoclavicular suture fixation with Mersilene tape versus hook plate in the treatment of acute type V acromioclavicular dislocation: a retrospective analysis
Some surgeons augment the tape with additional Ethibond sutures to reconstruct both the coracoclavicular and acromioclavicular ligaments simultaneously, aiming for stability in multiple planes of motion.7Orthopaedic Journal of Madhya Pradesh Chapter. Surgical Management of Acromioclavicular Joint Injuries by Ligament Reconstruction Using Mersilene Tape and Ethibond The flat tape handles the heavy-duty vertical stabilization, while the thinner suture addresses the more subtle front-to-back motion.
Pelvic Floor Repair
Mersilene tape has also been used in pelvic organ prolapse repair, where the goal is to lift and support a uterus or vaginal vault that has descended from its normal position. In sacrohysteropexy, a procedure that suspends the uterus from the sacrum (the bone at the base of the spine), one randomized trial compared Mersilene tape directly against polypropylene mesh and found that the tape was a safe alternative with comparable effectiveness and fewer complications. The tape required a smaller area of dissection for sacral fixation, reducing the risk of injury during the procedure.8Actas Urológicas Españolas (English Edition). Abdominal Sacrohysteropexy using Proline mesh versus Mersilene tape in apical prolapse: A randomized clinical trial
This is worth noting because the broader mesh debate in pelvic surgery has been contentious. Large sheets of synthetic mesh for pelvic floor repair have drawn scrutiny due to erosion and pain complications, leading to regulatory restrictions in several countries. Mersilene tape, as a narrow strip rather than a broad sheet, presents a different risk profile. It contacts less tissue, requires less dissection, and is easier to anchor. That said, it is not immune to the complications that affect all synthetic implants in this region.
Eyelid Surgery for Ptosis
In a completely different anatomical neighborhood, Mersilene mesh (a wider version of the same polyester material, cut into a strip for sling use) serves as a frontalis sling to correct severe drooping of the upper eyelid. This procedure is used when the levator muscle that normally lifts the eyelid is too weak to function, a condition that can be congenital or acquired. The mesh is threaded from the eyelid up to the frontalis muscle of the forehead, so the patient lifts the lid by raising their brow.
A study of children and adults who underwent this procedure reported good long-term functional results in about three-quarters of cases, though up to 20% of patients experienced early soft-tissue complications like swelling or granuloma formation near the mesh.9PubMed Central. Functional results and complications of Mersilene mesh use for frontalis suspension ptosis surgery A modified version of the technique that simultaneously creates a natural-looking eyelid crease reported symmetrical lid contour in all cases after about 10 months of follow-up, with significantly improved eyelid opening.10PubMed Central. Modified frontalis sling procedure with lid crease formation
The appeal of polyester for this application is that it integrates with surrounding tissue and stays in place long-term without the need for replacement. Autologous materials (harvested from the patient’s own body, like fascia lata from the thigh) are the other main option, but they require a second surgical site and donor-site discomfort. For children especially, avoiding that additional procedure is a real advantage.
How Tissue Responds to the Tape
The body does not simply ignore a piece of polyester threaded through it. A chronic inflammatory reaction occurs around any implanted synthetic material, and the character of that reaction varies depending on the material’s chemistry and architecture. In hernia mesh studies comparing several materials, polyester meshes triggered a moderate chronic inflammatory response, with about 8% of surrounding tissue volume occupied by inflammatory cells. That was lower than standard polypropylene (about 32%) but higher than expanded PTFE (about 12%). The amount of new connective tissue that formed correlated significantly with the degree of inflammation. Even after years, macrophages remained present at the interface between tissue and the polyester material in about 45% of examined areas.11PubMed. Foreign body reaction to meshes used for the repair of abdominal wall hernias
In urinary incontinence procedures, Mersilene slings triggered a more pronounced foreign body reaction in the tissue around the urethra compared to Prolene (monofilament polypropylene), with a significant increase in collagen breakdown and remodeling. Prolene caused minimal inflammatory response, while Mersilene provoked an obvious one.12PubMed. Influence of different sling materials on connective tissue metabolism in stress urinary incontinent women
Interestingly, this inflammatory and collagen-generating behavior can be turned into a feature. Animal research has shown that an implanted Mersilene tape can act as a template, provoking a controlled linear deposition of collagen along its length. When the tape was later removed, the collagen structure remained, essentially forming a neo-ligament. The procedure deliberately harnesses what is normally considered a negative aspect of wound healing: foreign body reaction, bacterial colonization, and ongoing tissue breakdown and regeneration.13Acta Obstetricia et Gynecologica Scandinavica. The Autogenic Ligament Procedure: A Technique for Planned Formation of an Artificial Neo-Ligament This is still largely experimental, but it illustrates how the same biological response can be either a complication or a therapeutic tool depending on context.
The Erosion and Infection Problem
The most significant complication associated with Mersilene tape is erosion, where the material gradually works its way through tissue and becomes exposed on a mucosal surface. This is mostly documented in pelvic surgery, where the tape sits near the vaginal wall or urethra.
The explanation involves the tape’s braided microstructure. Mersilene’s weave creates pores that are smaller than a typical macrophage (the immune cell responsible for clearing foreign material and bacteria) but larger than most bacteria. This creates a situation where bacteria can colonize the interstices of the tape in spaces the immune system cannot effectively reach. The bacterial colonization promotes a chronic low-grade infection that weakens the surrounding tissue and drives the erosion process.14PubMed Central. Postoperative erosions of the Mersilene® suburethral sling mesh for antiincontinence surgery
This is not unique to Mersilene. Any woven, multifilament synthetic material with microporous architecture shares this vulnerability. Monofilament materials like polypropylene, which have a smooth surface and no interstices for bacteria to hide in, generally have lower erosion rates in pelvic applications. The trade-off is that monofilament materials do not integrate with tissue as readily and may feel stiffer in the body.
For surgeons, the erosion risk is a factor in material selection for any procedure where the tape will lie adjacent to a thin mucosal surface. In locations with thicker tissue coverage, like the shoulder or around the cervix in abdominal cerclage, erosion is much less of a concern.
When Surgeons Choose Mersilene Tape Over Alternatives
The decision to use Mersilene tape rather than a different material comes down to a few practical considerations that vary by procedure. Its flat profile makes it a better choice than round sutures when load distribution matters, such as in cerclage or ligament reconstruction, because it is less likely to cut through soft tissue under sustained tension. Its permanent nature is an advantage over absorbable sutures in situations requiring long-term mechanical support, since absorbable materials lose strength over weeks to months as the body breaks them down.
Compared to stainless steel wire, which is stronger and stiffer, Mersilene tape is easier to handle, easier to tie, and does not require wire-cutting instruments for removal. Compared to monofilament sutures like Prolene, the tape integrates more with surrounding tissue, which can provide better anchorage over time, though at the cost of a stronger inflammatory response and a higher erosion risk in thin-tissue environments.
Cost is another factor. Mersilene tape is substantially cheaper than some newer synthetic ligament devices and high-tech suture anchors. For a technique like AC joint reconstruction, where outcomes with the tape are comparable to more expensive hardware, the economic argument can be compelling, especially in healthcare systems with tight budgets.
Imaging and Follow-Up Considerations
Mersilene tape is not radiopaque, meaning it does not show up clearly on standard X-rays. This is relevant for surgeons monitoring the position of a cerclage or joint reconstruction over time. Ultrasound can sometimes identify the tape, and MRI can visualize it in many contexts, but the material itself does not have the bright signal that metal implants produce on plain films. Patients who have Mersilene tape in place and undergo imaging for unrelated reasons should be aware that the tape is there, since it can occasionally cause confusion on scans if the radiologist is not informed.
For abdominal cerclage patients who keep the tape between pregnancies, this also means that routine imaging to confirm the tape’s position typically involves ultrasound or MRI rather than X-ray. The tape’s position at the level of the internal cervical os can be confirmed on transvaginal ultrasound, which is already a standard tool in high-risk pregnancy monitoring.
Polyester’s Long Game in the Body
One underappreciated aspect of any permanent implant is what happens over decades. Mersilene tape does not dissolve, but polyester is not perfectly inert either. Over very long time frames, hydrolysis (the slow chemical breakdown by water) can degrade polyester fibers, though this process takes many years and the clinical significance in most applications is unclear. Patients who receive a cerclage tape at age 30 and keep it for life will have that material in their body for potentially 50 or more years, a duration that exceeds the follow-up of most surgical studies.
The chronic foreign body reaction described in hernia mesh studies, with macrophages still present at the material interface years after implantation, suggests that the body never fully stops responding to the implant. Whether this ongoing low-level inflammation has any meaningful long-term consequences in the context of a narrow tape, as opposed to a large mesh sheet, is not well studied. For most patients, the benefit of the tape in its original surgical role far outweighs the theoretical concerns about decades-long tissue interaction, but it is a gap in the evidence worth acknowledging.