Computational modeling of skin: Using stress profiles as predictor for tissue necrosis in reconstructive surgery
Identifieur interne : 001793 ( Pmc/Curation ); précédent : 001792; suivant : 001794Computational modeling of skin: Using stress profiles as predictor for tissue necrosis in reconstructive surgery
Auteurs : Adrián Buganza Tepole [États-Unis] ; Arun K. Gosain [États-Unis] ; Ellen Kuhl [États-Unis]Source :
- Computers & structures [ 0045-7949 ] ; 2014.
Abstract
Local skin flaps have revolutionized reconstructive surgery. Mechanical loading is critical for flap survival: Excessive tissue tension reduces blood supply and induces tissue necrosis. However, skin flaps have never been analyzed mechanically. Here we explore the stress profiles of two common flap designs, direct advancement flaps and double back-cut flaps. Our simulations predict a direct correlation between regions of maximum stress and tissue necrosis. This suggests that elevated stress could serve as predictor for flap failure. Our model is a promising step towards computer-guided reconstructive surgery with the goal to minimize stress, accelerate healing, minimize scarring, and optimize tissue use.
Url:
DOI: 10.1016/j.compstruc.2014.07.004
PubMed: 25225454
PubMed Central: 4162094
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<author><name sortKey="Gosain, Arun K" sort="Gosain, Arun K" uniqKey="Gosain A" first="Arun K." last="Gosain">Arun K. Gosain</name>
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<front><div type="abstract" xml:lang="en"><p id="P1">Local skin flaps have revolutionized reconstructive surgery. Mechanical loading is critical for flap survival: Excessive tissue tension reduces blood supply and induces tissue necrosis. However, skin flaps have never been analyzed mechanically. Here we explore the stress profiles of two common flap designs, direct advancement flaps and double back-cut flaps. Our simulations predict a direct correlation between regions of maximum stress and tissue necrosis. This suggests that elevated stress could serve as predictor for flap failure. Our model is a promising step towards computer-guided reconstructive surgery with the goal to minimize stress, accelerate healing, minimize scarring, and optimize tissue use.</p>
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<front><journal-meta><journal-id journal-id-type="nlm-journal-id">101314430</journal-id>
<journal-id journal-id-type="pubmed-jr-id">33812</journal-id>
<journal-id journal-id-type="nlm-ta">Comput Struct</journal-id>
<journal-id journal-id-type="iso-abbrev">Comput Struct</journal-id>
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<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
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<title-group><article-title>Computational modeling of skin: Using stress profiles as predictor for tissue necrosis in reconstructive surgery</article-title>
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<contrib-group><contrib contrib-type="author"><name><surname>Tepole</surname>
<given-names>Adrián Buganza</given-names>
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<contrib contrib-type="author"><name><surname>Kuhl</surname>
<given-names>Ellen</given-names>
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<xref ref-type="aff" rid="A3">c</xref>
<xref rid="FN1" ref-type="author-notes">*</xref>
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<aff id="A1"><label>a</label>
Department of Mechanical Engineering, Stanford University, Stanford, CA 94305, USA</aff>
<aff id="A2"><label>b</label>
Division of Pediatric Plastic Surgery, Lurie Children's Hospital of Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA</aff>
<aff id="A3"><label>c</label>
Departments of Mechanical Engineering, Bioengineering, and Cardiothoracic Surgery, Stanford University, Stanford, CA 94305, USA</aff>
<author-notes><corresp id="FN1"><label>*</label>
Corresponding author. Tel.: +1 650 450 0855; fax: +1 650 725 1587. <email>ekuhl@stanford.edu</email>
(E. Kuhl). URL: <ext-link ext-link-type="uri" xlink:href="http:/biomechanics.stanford.edu">http://biomechanics.stanford.edu</ext-link>
(E. Kuhl)</corresp>
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<pub-date pub-type="nihms-submitted"><day>1</day>
<month>8</month>
<year>2014</year>
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<pub-date pub-type="ppub"><day>1</day>
<month>9</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>01</day>
<month>9</month>
<year>2015</year>
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<volume>143</volume>
<fpage>32</fpage>
<lpage>39</lpage>
<pmc-comment>elocation-id from pubmed: 10.1016/j.compstruc.2014.07.004</pmc-comment>
<permissions><copyright-statement>© 2014 Elsevier Ltd. All rights reserved.</copyright-statement>
<copyright-year>2014</copyright-year>
</permissions>
<abstract><p id="P1">Local skin flaps have revolutionized reconstructive surgery. Mechanical loading is critical for flap survival: Excessive tissue tension reduces blood supply and induces tissue necrosis. However, skin flaps have never been analyzed mechanically. Here we explore the stress profiles of two common flap designs, direct advancement flaps and double back-cut flaps. Our simulations predict a direct correlation between regions of maximum stress and tissue necrosis. This suggests that elevated stress could serve as predictor for flap failure. Our model is a promising step towards computer-guided reconstructive surgery with the goal to minimize stress, accelerate healing, minimize scarring, and optimize tissue use.</p>
</abstract>
<kwd-group><kwd>Finite element analysis</kwd>
<kwd>Membranes</kwd>
<kwd>Transverse isotropy</kwd>
<kwd>Skin</kwd>
<kwd>Tissue expansion</kwd>
<kwd>Reconstructive surgery</kwd>
</kwd-group>
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