Purpose

Proper understanding of skin biomechanics, viscoelasticity and investigation of skin tension vectors is necessary to find optimal incision lines. Great tension across a healing wound after any surgical procedure might lead to forming hypertrophic scars. The aim of the study was to investigate tension lines in volar forearm skin in young males and females, in order to ensure best incision line.

Methods

Five biomechanical and viscoelastic parameters were measured using a hand-held myotonometer: Oscillation Frequency [Hz], Dynamic Stiffness [N/m], Logarithmic Decrement of tissue's natural oscillation, Mechanical Stress Relaxation Time [ms], and Creep. Measurements were taken in four different directions; Along Forearm, Across Forearm, Along Langer's Line and Across Langer's Line.

Results

Significant main effects for direction were found for Oscillation Frequency (p < 0.001, η² = 0.371) [Hz], Dynamic Stiffness (p < 0.001, η² = 0.522) [N/m], Logarithmic Decrement (p < 0.001, η² = 0.083), Mechanical Stress Relaxation Time (p < 0.001, η² = 0.494) [ms] and Creep (p < 0.001, η² = 0.480). For each parameter except for logarithmic decrement results obtained Along Langers Line and Across Forearm were significantly different to Across Langers Line and Along Forearm (p < 0.001, d = −2.76 – 2.66). Significant main effects for sex were found for logarithmic decrement Along Forearm (p < 0.001, d = 1.698) and Across Langer's Line (p = 0.021, d = 1.697).

Conclusions

Our results suggested that optimal incision line for this age group in males and females could potentially be performed diagonally i.e. Across Langer's Line or parallel i.e. Along Forearm to forearm axis. These directions would provide the lowest tension across a healing wound and possibly minimalize the risk of hypertrophic scarring post incision.

中文翻译：

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皮肤各向异性：寻找男性和女性掌侧前臂的最佳切口线

目的

正确理解皮肤生物力学、粘弹性和皮肤张力矢量的研究对于找到最佳切口线是必要的。任何外科手术后愈合伤口上的巨大张力都可能导致形成肥厚性疤痕。该研究的目的是调查年轻男性和女性前臂掌侧皮肤的张力线，以确保最佳的切口线。

方法

使用手持肌张力计测量了五个生物力学和粘弹性参数：振荡频率 [Hz]、动态刚度 [N/m]、组织自然振荡的对数衰减、机械应力松弛时间 [ms] 和蠕变。在四个不同的方向进行测量；沿着前臂、穿过前臂、沿着兰格线和穿过兰格线。

结果

发现对振荡频率 (p < 0.001, η ²  = 0.371) [Hz]、动态刚度 (p < 0.001, η ²  = 0.522) [N/m]、对数减量 (p < 0.001, η ²  = 0.083)、机械应力松弛时间 (p < 0.001, η ²  = 0.494) [ms] 和蠕变 (p < 0.001, η ² = 0.480）。对于每个参数，除了沿兰杰斯线和沿前臂获得的对数递减结果与沿兰杰斯线和沿前臂获得的结果显着不同（p < 0.001，d = -2.76 – 2.66）。沿着前臂 (p < 0.001, d = 1.698) 和跨兰格线 (p = 0.021, d = 1.697) 的对数递减对性别有显着的主要影响。

结论

我们的结果表明，该年龄组男性和女性的最佳切口线可能是对角线进行的，即跨兰格线或平行，即沿前臂到前臂轴。这些方向将在愈合伤口上提供最低的张力，并可能最大限度地降低切口后增生性瘢痕形成的风险。