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

نویسندگان

  • Daniël C. Koppenol
  • Fred J. Vermolen
چکیده

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.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Evaluation and comparison of composite and split-thickness skin grafts using cutometer mpa 580.

BACKGROUND In our preliminary experiments we found that composite skin grafts consisting of allogeneic acellular dermis and thin epidermal autologous grafts applied to the excised burn wound in one stage led to better results in terms of viscoelastic properties than autologous split-thickness skin grafts. PATIENTS AND METHODS In ten burn patients we applied composite skin grafts consisting of...

متن کامل

Does Orientation of Full-Thickness Groin Grafts Affect Hyperpigmentation in Burn Contracture and Syndactyly Hands?

BACKGROUND Some grafts harvested from the groin area do not become hyperpigmented and in an individual with multiple pieces of grafts, the hyperpigmentation of the pieces may vary. This study evaluates the orientation of the inset of groin grafts according to their donor sites (superior-inferior) and its role in graft hyperpigmentation. METHODS Patients with hand burn contracture or syndacty...

متن کامل

A Continuum Model For Stone-wales Defected Carbon Nanotubes

In this paper, a continuum model is proposed so that a Stone-Wales (SW) defected carbon nanotube (CNT) is replaced by an initial circumferential crack in a continuum cylindrical shell. For this purpose, the critical energy release rate and then the fracture toughness of a defected CNT are calculated using the results of an existing atomistic-based continuum finite element simulation. Finally, t...

متن کامل

Effect of Pullback Speed and the Distance between the Skin and Vein on the Performance of Endovenous Laser Treatment by Numerical Simulation

Introduction: Endovenous laser treatment (ELT) is a new treatment method for the reflux of the great saphenous vein. A successful ELT is dependent on the selection of optimum parameters required to achieve optimal vein damage while avoiding side effects including skin burns. The mathematical modeling of ELT can be used to understand the process of ELT. This study was conducted to examine the ef...

متن کامل

Treatment modalities in severe mento-sternal synechia.

OBJECTIVE Scar contracture of the neck after a burn-injury can cause both functional and aesthetic problems, and still presents a challenge for plastic surgeons. The anatomic area and adjacent structures such as the lower lip, trachea and neuro-vascular structures which are affected by the scar make treatment diffucult. Scarring and contracture of the neck region may severely limit function, ca...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:

دوره 16  شماره 

صفحات  -

تاریخ انتشار 2017