A New Skin Tensiometer Device: Computational Analyses To Understand Biodynamic Excisional Skin Tension Lines

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

Surgical literature is inundated with references to Langer’s Lines, Cleavage Lines, Wrinkle Lines and Skin Tension Lines. The author undertakes a detailed literature review to understand the “state-ofthe art” regarding skin lines in cutaneous surgery and puts forward a hypothesis that incisional and excisional lines are different. While the lines mentioned above are fine for making incisions, w...

The Golden Spiral Flap: A New Flap Design that Allows for Closure of Larger Wounds under Reduced Tension – How Studying Nature’s Own Design Led to the Development of a New Surgical Technique

This paper details the study of biodynamic excisional skin tension lines on the scalp and the development of a new flap technique for closure of scalp wounds. Recently, a study by this author, on pigskin, replicated whorls by placing tissue under rapid stretch using saline tissue expanders, by recreating rapid dermo-epidermal shear of skin - thereby concluding that the golden spiral pattern is ...

Biodynamic Excisional Skin Tension Lines for Excisional Surgery of the Lower Limb and the Technique of Using Parallel Relaxing Incisions to Further Reduce Wound Tension

Reducing Wound Tension with Undermining or Imbrication—Do They Work?

BACKGROUND For the noncolonized wound, achieving tension-free, primary wound closure is ideal. Some surgeons advocate imbrication of deeper tissues rather than undermining, posing that imbrication preserves more dermal perfusion while still reducing tension at the wound edge. We sought to determine which technique most reliably reduced wound tension while preserving dermal wound perfusion. ME...

Evaluation of the difference in surgical margin values in excisional skin lesions during surgery and after formalin fixation

Background: Surgical margin determination in malignant lesions is essential and has a direct impact on the choice of postoperative treatments and patient follow-up. Therefore, the processes affecting this variable are worth exploring. This study aimed to evaluate the difference in surgical margin values in excisional skin samples during surgery and after formalin fixation. Methods: A cross-sec...