Background Difference in scar formation at different sites, in different directions at the same site, but with changes in the elasticity of skin with age, sex, and race or in some pathological conditions, is well known to clinicians. The inappropriate collagen syntheses and delayed or lack of epithelialization are known to induce scar formation with negligible elasticity at the site of damage. Changes in the elasticity of scars may be due to an unequal distribution of dermal collagen (C) and elastic (E) fibers. Materials and Methods Spearman correlation coefficients (r) of collagen and elastic fibers in horizontal (H) and in vertical (V) directions (variables CV, CH, EV, and EH) were measured from the respective quantitative fraction data in 320 skin samples from 32 human cadavers collected at five selected sites over extremities. Results Spearman's correlation analysis revealed the statistically significant (p < 0.01) strong positive correlation between CH and CV in all the areas, that is, shoulder joint area (r = 0.66), wrist (r = 0.75), forearm (r = 0.75), and thigh (r = 0.80), except at the ankle (r = 0.26, p = 0.14) region. Similarly, positive correlation between EH and EV has been observed at the forearm (r = 0.65, moderate) and thigh (r = 0.42, low) regions. However, a significant moderate negative correlation was observed between CV and EV at the forearm (r = −0.51) and between CH and EH at the thigh region (r = −0.65). Conclusion Significant differences of correlations of collagen and elastic fibers in different directions from different areas of extremities were noted. This may be one of the possible anatomical reasons of scar behavior in different areas and different directions of the same area.
Background. Unequal distribution of dermal collagen and elastic fibers in different orientations of skin is reported to be one of the multifocal causes of scar related complications. Present study is to understand the correlation pattern between collagen in horizontal (CH) and in vertical (CV) directions as well as that of elastic in horizontal (EH) and vertical (EV) directions. Materials and Method. A total of 320 skin samples were collected in two orientations from suprascapular, anterior chest, lateral chest, anterior abdominal wall, and inguinal regions of 32 human cadavers. Spearman correlation coefficient (r) was calculated between the variables (CH, CV, EH, and EV). Results. Significant positive correlation between CH and CV, and between EH and EV observed in all 5 areas tested. A negative correlation between CV and EV at suprascapular, lateral chest, and inguinal regions and negative correlation between CH and EH at anterior chest and anterior abdominal wall have been identified. Conclusion. Knowledge of asymmetric content of dermal collagen and elastic fibers together with the varied strength and degree of association in the given area provides guidelines to the dermatologists and aesthetic surgeons in placing elective incisions in the direction maximally utilizing the anatomical facts for aesthetically pleasing result.
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