Contribution of human skin topography to the characterization of dynamic skin tension during senescence: morpho-mechanical approach

Zahouani, H.; Djaghloul, M.; Vargiolu, R.; Mezghani, S.; Mansori, Mohammed

doi:10.1088/1742-6596/483/1/012012

Cited by 23 publications

(46 citation statements)

References 13 publications

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“…Analysis of skin tension lines of Caucasian women aged between 20 and 80 years, shows a decrease of the density of lines of depth < 60 microns and an augmentation of deep lines beyond 60 μm --the former is due to elastin and the latter are what we note as cleavage or tension lines [109] . One of the main reasons why incisional and excisional lines must be considered differently is because of the properties of skin extension under load -to begin with there is a rapid increase in length for very small increments of force; towards the end, relatively small extensions result from relatively large increases in force [110] .…”

Section: Relaxed Skin Tension Lines (Rstl)mentioning

confidence: 55%

“…One way to consider skin is to consider it as a 3-D network of lines, with multidirectional tensions of elastic fibres and the collagen beams --and this has in some ways contributed to the confusion between tension lines, wrinkle lines and cleavage lines [101] . As discussed earlier, skin resistance to traction predominates in the Langer's lines direction and varies with body site.…”

Section: Relaxed Skin Tension Lines (Rstl)mentioning

confidence: 99%

“…As discussed earlier, skin resistance to traction predominates in the Langer's lines direction and varies with body site. In many situations, the skin tension is greater in the direction of Langer's lines [101] , and their dynamic nature may accentuate their unsuitability as excisional lines. However, in some situations like the lower limb, the situation is different when compared to facial skin -on the lower limbs Langer's lines are aligned along elastin fibres --in a study 76% were in the direction of Langer lines, and 5.1% perpendicular [101] .…”

Section: Relaxed Skin Tension Lines (Rstl)mentioning

confidence: 99%

See 2 more Smart Citations

Biodynamic Excisional Skin Tension (BEST) Lines: Revisiting Langer’s Lines, Skin Biomechanics, Current Concepts in Cutaneous Surgery, and the (lack of) Science behind Skin Lines used for Surgical Excisions

Paul¹

2017

Journal of Dermatological Research

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Section: Relaxed Skin Tension Lines (Rstl)mentioning

confidence: 55%

Section: Relaxed Skin Tension Lines (Rstl)mentioning

confidence: 99%

Section: Relaxed Skin Tension Lines (Rstl)mentioning

confidence: 99%

See 1 more Smart Citation

Biodynamic Excisional Skin Tension (BEST) Lines: Revisiting Langer’s Lines, Skin Biomechanics, Current Concepts in Cutaneous Surgery, and the (lack of) Science behind Skin Lines used for Surgical Excisions

Paul¹

2017

Journal of Dermatological Research

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“…Moreover, they measured that young people buffer strain between these groups of lines during arm extension, while elderly tend to have one orientation which rotates. The lines in one orientation relate to Langer's line have depth greater than 60 μm and increase in intensity with age . The lines in the second orientation relate to the tension effect of elastic fibres network, are sallower and fade with age …”

Section: Introductionmentioning

confidence: 96%

Micro‐relief analysis with skin capacitive imaging

Bontozoglou

Zhang

Xiao

2018

Skin Research and Technology

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Background In this study, the performance of capacitive imagining in skin micro‐relief analysis was investigated. This measurement principle has been used for skin hydration measurements over the last decade and it is commercially available by various manufacturers. Strengthening its potential for new applications could offer an affordable and portable multi‐purpose device for in vivo skin research. Previous studies in the literature have used a wide range of optical devices to determine how the skin surface topographic features are affected by chronological age, environmental influences and living habits. Material and methods A capacitive system was used in order to capture hydration images from the middle volar forearm of twelve volunteers. The visual output of the system was studied and image processing algorithms were adapted to automatically extract skin micro‐relief features. The change in the skin network of lines during arm extension, the lines’ anisotropy index and the number of closed polygons per skin surface area were plotted against the subjects’ chronological age. The results were compared with optical measurements from the literature to validate our algorithms and evaluate the capacitive imaging in skin micro‐relief analysis. Results The change in the intensity of primary and secondary lines during arm extension and the number of closed polygons per surface area were in agreement with the literature. The anisotropy index output gave inconclusive results. Conclusions The experimental results show that the capacitive systems could only extract two‐dimensional skin topographic features.

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“…(4,5) It has already been suggested by others that in the trunk and limbs, Langer's lines predominantly align with elastin fibers. (6) After Langer marked out cleavage lines by using a round-tipped cutting instrument and noting the direction the clefts elongated, Kocher, in 1892, suggested that these lines be used for surgical procedures. (7) It has been noted in recent times that incisions placed at right angles to the direction of skin cleavage lines had a higher risk of hematoma and tension, and thereby a higher risk of hypertrophic scarring.…”

Section: Introductionmentioning

confidence: 99%

Are Incisional and Excisional Skin Tension Lines Biomechanically Different? Understanding the Interplay between Elastin and Collagen during Surgical Procedures

Paul¹

2017

IJBM

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Background: Since Langer's first foray into studying cutaneous lines, although people have studied skin lines across the body, there has not been a study that elucidates changes to skin structure of elastin and collagen at different load levels. This study set out to look at whether incisional lines and excisional lines have different biodynamics and have to be considered differently.Materials and Methods: For this study, we used a two-photon microscopic camera using optimal wavelengths to detect collagen and elastin. Measurements were taken in 5 patients at the center of the excisional wound (high-load) and at the ends of the wound (tapered end of the ellipse) where effectively the wound is an incisional wound.Results: Wounds were observed after they were surgically closed. When incisional wounds were observed, where there was minimal tension (<1.5N force) we found that, in each case, elastin stretched and collagen buckled, revealing mostly elastin. Where larger defects were created after excisions (as in the figure where a skin cancer had been removed, where forces to close wounds were typically greater than 2N), we noted that the image revealed mostly collagen, suggesting that the reverse had occurred (i.e. collagen stretched and elastin buckled). Conclusion:This difference between tension loads on skin and the interplay between collagen and elastin has never before been elucidated for incisional and excisional wounds, and in the author's view has great research interest for a cutaneous surgeon seeking to identify the best skin lines to utilize to minimize scarring.

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Contribution of human skin topography to the characterization of dynamic skin tension during senescence: morpho-mechanical approach

Cited by 23 publications

References 13 publications

Biodynamic Excisional Skin Tension (BEST) Lines: Revisiting Langer’s Lines, Skin Biomechanics, Current Concepts in Cutaneous Surgery, and the (lack of) Science behind Skin Lines used for Surgical Excisions

Biodynamic Excisional Skin Tension (BEST) Lines: Revisiting Langer’s Lines, Skin Biomechanics, Current Concepts in Cutaneous Surgery, and the (lack of) Science behind Skin Lines used for Surgical Excisions

Micro‐relief analysis with skin capacitive imaging

Are Incisional and Excisional Skin Tension Lines Biomechanically Different? Understanding the Interplay between Elastin and Collagen during Surgical Procedures

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