The analysis of forces needed for the suturing of elliptical skin wounds

Abstract

There is a lack of information regarding the forces required for suturing human wounds. The knowledge of suturing forces serves as complementary information for setting up the limiting geometry when using tissue adhesives and it might also be used in robot-assisted surgery. The main purpose of this paper was to evaluate the forces required for suturing selected skin wounds. An elliptical wound was chosen for our study. In this study a numerical analysis and in vivo experiments were performed. Regarding the numerical models, the maximum forces occurred in the middle of the elliptical wound in all cases. In the case of highest pre-stress used in these analyses the maximal force varied from 0.5 N for the smallest wound (30 × 5 mm) to 1.5 N for the largest wound (30 × 15 mm). The maximum peak force for the wound with a size of 46 × 13 mm was 3.2 N. The minimum peak force for the wound with a size of 36 × 5 mm was 1.1 N.

Intra‐ and inter‐individual variability in the mechanical properties of the human skin from in vivo measurements on 20 volunteers

“…Numerical simulations of the wound closing efforts have been proposed but they are highly dependent on the mechanical skin behavior . The latter is known to depend on both individuals and body zones and no standardized data can be used satisfactorily.…”

Biofidelic soft composites–experimental and computational modeling

“…The wound was modeled as a symmetric diamond shape cavity with length 20 mm, width 2 mm at the top surface (or the top of epidermal layer) and at the bottom surface of length 10 mm, 1 mm width (at a 1.5 mm depth within the dermal layer), as shown in Figure 3. Compared to the dimension of the skin section considered in our work, the 20 mm X 2 mm wound size was considered reasonable (and was also based on literature [145,146]). It should be mentioned here that our current computational model is not restricted to any specific wound size, and any wound size could be modeled, based on which the estimated suture forces will differ accordingly.…”

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

“…However, in both these techniques, there has been a difficulty in the experimental method used being convenient and consistent. Previous authors have also commented on the lack of information about the forces needed to close a wound after excisional surgery [126] . The scalp is also unique because the presence of hair follicles and their relationship to skin lines.…”