Nonlinear finite element simulations of injuries with free boundaries: Application to surgical wounds

Valero, Clara; Javierre, E.; García-Aznar, J.M.; Gómez‐Benito, María José

doi:10.1002/cnm.2621

Cited by 15 publications

(10 citation statements)

References 36 publications

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“…Similar to Olsen et al ( 1995 ), we assume that the rate of cell differentiation is dependent on the concentration of the signaling molecule with no cell differentiation taking place in the absence of this signaling molecule. Like others such as Javierre et al ( 2009 ), Murphy et al ( 2012 ), and Valero et al ( 2014a ; b ), we are aware of the fact that this cell differentiation can only take place under conditions of sufficient mechanical stiffness. It seems like a good idea then to incorporate this phenomenon also into the model.…”

Section: Discussionsupporting

confidence: 53%

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A mathematical model for the simulation of the contraction of burns

et al. 2016

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A continuum hypothesis-based model is developed for the simulation of the contraction of burns in order to gain new insights into which elements of the healing response might have a substantial influence on this process. Tissue is modeled as a neo-Hookean solid. Furthermore, (myo)fibroblasts, collagen molecules, and a generic signaling molecule are selected as model components. An overview of the custom-made numerical algorithm is presented. Subsequently, good agreement is demonstrated with respect to variability in the evolution of the surface area of burns over time between the outcomes of computer simulations and measurements obtained in an experimental study. In the model this variability is caused by varying the values for some of its parameters simultaneously. A factorial design combined with a regression analysis are used to quantify the individual contributions of these parameter value variations to the dispersion in the surface area of healing burns. The analysis shows that almost all variability in the surface area can be explained by variability in the value for the myofibroblast apoptosis rate and, to a lesser extent, the value for the collagen molecule secretion rate. This suggests that most of the variability in the evolution of the surface area of burns over time in the experimental study might be attributed to variability in these two rates. Finally, a probabilistic analysis is used in order to investigate in more detail the effect of variability in the values for the two rates on the healing process. Results of this analysis are presented and discussed.

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Section: Discussionsupporting

confidence: 53%

“…2002; Valero et al. 2014a, b; Vermolen and Javierre 2012). However, skin tissues are actually nonlinear, anisotropic, viscoelastic, and inhomogeneous materials (Fung 1993).…”

Section: Discussionmentioning

confidence: 99%

A mathematical model for the simulation of the contraction of burns

et al. 2016

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“…2002; Valero et al. 2014a, b; Vermolen and Javierre 2012). More recently, continuum models have appeared where the dermis is modeled as a hyperelastic solid (Koppenol et al.…”

Section: Discussionmentioning

confidence: 99%

Biomedical implications from a morphoelastic continuum model for the simulation of contracture formation in skin grafts that cover excised burns

Koppenol

Vermolen

2017

Biomech Model Mechanobiol

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A continuum hypothesis-based model is developed for the simulation of the (long term) contraction of skin grafts that cover excised burns in order to obtain suggestions regarding the ideal length of splinting therapy and when to start with this therapy such that the therapy is effective optimally. Tissue is modeled as an isotropic, heterogeneous, morphoelastic solid. With respect to the constituents of the tissue, we selected the following constituents as primary model components: fibroblasts, myofibroblasts, collagen molecules, and a generic signaling molecule. Good agreement is demonstrated with respect to the evolution over time of the surface area of unmeshed skin grafts that cover excised burns between outcomes of computer simulations obtained in this study and scar assessment data gathered previously in a clinical study. Based on the simulation results, we suggest that the optimal point in time to start with splinting therapy is directly after placement of the skin graft on its recipient bed. Furthermore, we suggest that it is desirable to continue with splinting therapy until the concentration of the signaling molecules in the grafted area has become negligible such that the formation of contractures can be prevented. We conclude this study with a presentation of some alternative ideas on how to diminish the degree of contracture formation that are not based on a mechanical intervention, and a discussion about how the presented model can be adjusted.

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“…Moreover, these models added the mechanical properties of the skin in order to evaluate the ECM displacement that the skin suffers during wound healing. Most wound healing models that include mechanics are focused on the contraction stage during wound healing [25,42,44,57,[60][61][62][63][64][65] and one of their main objectives is to quantify the size reduction that the wound suffers during healing. Nevertheless, other models pay attention to other phenomena that occurs during wound healing such as angiogenesis [12,13,24,33,35,45,46,49,59,63,64].…”

Section: Computational Models Of Wound Healingmentioning

confidence: 99%

Computational Modelling of Wound Healing Insights to Develop New Treatments

Gómez‐Benito

Valero

García-Aznar

et al. 2019

New Developments in Tissue Engineering and Regeneration

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About 1% of the population will suffer a severe wound during their life. Thus, it is really important to develop new techniques in order to properly treat these injuries due to the high socioeconomically impact they suppose. Skin substitutes and pressure based therapies are currently the most promising techniques to heal these injuries. Nevertheless, we are still far from finding a definitive skin substitute for the treatment of all chronic wounds. As a first step in developing new tissue engineering tools and treatment techniques for wound healing, in silico models could help in understanding the mechanisms and factors implicated in wound healing. Here, we review mathematical models of wound healing. These models include different tissue and cell types involved in healing, as well as biochemical and mechanical factors which determine this process. Special attention is paid to the contraction mechanism of cells as an answer to the tissue mechanical state. Other cell processes such as differentiation and proliferation are also included in the models together with extracellular matrix production. The results obtained show the dependency of the success of wound healing on tissue composition and the importance of the different biomechanical and biochemical factors. This could help to individuate the adequate concentration of growth factors to accelerate healing and also the best mechanical properties of the new skin substitute depending on the wound location in the body and

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Nonlinear finite element simulations of injuries with free boundaries: Application to surgical wounds

Cited by 15 publications

References 36 publications

A mathematical model for the simulation of the contraction of burns

A mathematical model for the simulation of the contraction of burns

Biomedical implications from a morphoelastic continuum model for the simulation of contracture formation in skin grafts that cover excised burns

Computational Modelling of Wound Healing Insights to Develop New Treatments

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