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Improving tissue expansion protocols through computational modeling.

Taeksang Lee1, Elbert E Vaca2, Joanna K Ledwon2

  • 1School of Mechanical Engineering, Purdue University, West Lafayette, IN 47907, USA.

Journal of the Mechanical Behavior of Biomedical Materials
|April 9, 2018
PubMed
Summary
This summary is machine-generated.

Tissue expansion protocols impact skin growth. Larger inflation volumes and longer durations (14 days) promote more significant skin growth compared to smaller volumes or shorter periods, suggesting stretch alone isn't the sole driver.

Keywords:
GrowthIsogeometric analysisRemodelingSkinTissue expansion

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Area of Science:

  • Biomedical Engineering
  • Reconstructive Surgery
  • Tissue Engineering

Background:

  • Tissue expansion is crucial for reconstructive surgery, yet lacks quantitative understanding of skin growth mechanisms.
  • Current expansion protocols are often arbitrary, relying on surgeon experience rather than predictive models.
  • Controversies exist regarding optimal inflation volumes and expansion rates.

Purpose of the Study:

  • To quantitatively analyze the effects of varying inflation volumes and durations on tissue expansion-induced skin growth.
  • To investigate the relationship between local stretch and skin growth patterns.
  • To inform the development of more predictable and effective tissue expansion protocols.

Main Methods:

  • Utilized a porcine model to test four distinct tissue expansion protocols.
  • Employed a combination of 3D photography, isogeometric kinematics, and finite growth theory for quantitative analysis.
  • Systematically varied inflation volumes (30ml vs. 60ml) and protocol durations (10 days vs. 14 days).

Main Results:

  • All protocols achieved similar peak stretches, but growth patterns differed significantly.
  • Smaller inflation volumes (30ml) did not induce notable expander-driven growth.
  • Larger volumes (60ml) triggered skin adaptation, with greater growth at higher stretch regions and more growth in the 14-day protocol.
  • Expander-induced growth is influenced by factors beyond local stretch alone.

Conclusions:

  • Expander-induced skin growth is not solely dependent on local stretch; other factors play a role.
  • Larger inflation volumes and longer expansion durations (e.g., 14 days) are more effective in promoting significant skin growth.
  • Clinical practice should consider longer expansion protocols to achieve sufficient skin for large defect reconstruction.