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

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

One of the problems in planning cutaneous surgery is that human skin is anisotropic, or directionally dependent. Indeed, skin tension varies between individuals and at different body sites. Many a surgeon has tried to design different devices to measure skin tension to help plan excisional surgery, or to understand wound healing. However, many of the devices have been beset with problems due to...

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

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 ...

Biomechanics of the rhombic transposition flap.

OBJECTIVE To develop a computational model of cutaneous wound closures comparing variations of the rhombic transposition flap. STUDY DESIGN A nonlinear hyperelastic finite element model of human skin was developed and used to assess flap biomechanics in simulated rhombic flap wound closures as flap geometric parameters were varied. SETTING In silico. METHODS The simulation incorporated va...

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...