Modeling Tissue Expansion with Isogeometric Analysis: Skin Growth and Tissue Level Changes in the Porcine Model

Lindsay E. Janes, Joanna K. Ledwon, Elbert E. Vaca, Sergey Y. Turin, Taeksang Lee, Adrian B. Tepole, Hanah Bae, Arun K. Gosain*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Background: Tissue expansion relies on the ability of skin to grow in response to sustained mechanical strain. This study focuses on correlation of cellular and histologic changes with skin growth and deformation during tissue expansion. Methods: Tissue expanders were placed underneath the skin of five Yucatan minipigs and inflated with one fill of 60 cc of saline 1 hour, 24 hours, 3 days, and 7 days before the animals were killed, or two fills of either 30 cc or 60 cc at 10 and 3 days or 14 and 7 days before the animals were killed. Skin biopsy specimens and three-dimensional photographs were used to calculate skin growth and stretch according to the authors' novel finite element analysis model. Results: The mitotic index of keratinocytes in the basal layer increased 1 hour after stimulus was applied (4 percent) (p = 0.022), peaked at approximately day 3 (26 percent) (p < 0.0001), and tapered by day 7 (12.5 percent) (p = 0.012) after tissue expansion. The authors demonstrated that it is the volume per fill rather than the total volume in the expander that scales the magnitude of response. Lastly, the authors demonstrated that the ratio of deformation attributable to growth versus stretch (Fgrowth/Fstretch) after 60 cc of tissue expansion fill was 1.03 at 1 hour, 0.82 at 1 day, 0.85 at day 3, and 0.95 at 7 days. Conclusions: Peak cell proliferation occurred 3 days after tissue expansion fill and is scaled in response to stimulus magnitude. The growth component of deformation equilibrates to the stretch component at day 7, as cell proliferation has started to translate to skin growth.

Original languageEnglish (US)
Pages (from-to)792-798
Number of pages7
JournalPlastic and reconstructive surgery
Volume146
Issue number4
DOIs
StatePublished - Oct 1 2020

Funding

This work was funded by grants from the National Institute of Biomedical Imaging and Bioengineering (NIH 1R21EB021590-01A1) to Arun K. Gosain (principal investigator), and from the National Institute of Biomedical Imaging and Bioengineering (NIH 1R01AR074525-01A1) to Adrian B. Tepole (principal investigator) and Arun K. Gosain (co-investigator). The authors wish to thank Hanah Bae, B.S., for help in processing tissue specimens. Histology services were provided by the Northwestern University Mouse Histology and Phenotyping Laboratory, which is supported by National Cancer Institute grant P30-CA060553 awarded to the Robert H. Lurie Comprehensive Cancer Center.

ASJC Scopus subject areas

  • Surgery

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