Abstract
After surgery, around 35% of patients experience problems of excessive scarring, causing disfiguring and impaired function. An incision placed in the wrong direction causes unnecessary skin tension on the wound, resulting in increased collagen disposition and potentially hypertrophic scars. Currently, skin tension lines are used for incision planning. However, these lines are not universal and are a static representation of the skin tension that is in fact under influence of muscle action. By designing a new skin force measurement device the authors intend to make research on dynamic skin characteristics possible and to objectify incision planning and excision closure planning. The device applies a known compressive force to the skin in standardized directions and measures the displacement of the skin. This allows users to measure the skin reaction force in response to compression and to determine the optimal incision line or best wound closure direction. The device has an accuracy of 96% and a sensitivity of < 0.01 mm. It is compact, works non-invasively and standardizes measurement directions and is therefore an improvement over previously designed skin tensiometers.
Highlights
Structured Abstract—After surgery, around 35% of patients experience problems of excessive scarring, causing disfiguring and impaired function
The formation of hypertrophic scars is mainly related to the tension on wound edges and surrounding skin [5], [6]
An incision placed in the wrong direction causes unnecessary skin tension, pulling the wound edges apart
Summary
Structured Abstract—After surgery, around 35% of patients experience problems of excessive scarring, causing disfiguring and impaired function. An incision placed in the wrong direction causes unnecessary skin tension on the wound, resulting in increased collagen disposition and potentially hypertrophic scars. The device applies a known compressive force to the skin in standardized directions and measures the displacement of the skin. Clinical and Translational Impact Statement— In this Early-Clinical Research, a Compressiometer device is presented which may help surgeons optimize surgical planning and possibly reduce patients’ burden of post-operative skin scarring. An incision placed in the wrong direction causes unnecessary skin tension, pulling the wound edges apart. In 1861, anatomy professor Langer punched circular holes in cadaveric skin at different locations and observed the change of shape of the holes Based on his observations, he drew a map of maximal skin tension lines [9], which are reprinted in Fig. 1 [10].
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More From: IEEE Journal of Translational Engineering in Health and Medicine
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