TY - JOUR
T1 - The Incompatibility of Living Systems
T2 - Characterizing Growth-Induced Incompatibilities in Expanded Skin
AU - Buganza Tepole, Adrian
AU - Gart, Michael
AU - Purnell, Chad A.
AU - Gosain, Arun K.
AU - Kuhl, Ellen
N1 - Funding Information:
This work was supported by the CONACyT Fellowship, the Stanford Graduate Fellowship, and the DARE Doctoral Fellowship to Adrian Buganza Tepole and by the National Science Foundation CAREER award CMMI 0952021, by the National Science Foundation INSPIRE Grant 1233054, and by the National Institutes of Health Grant U01 HL119578 to Ellen Kuhl.
Publisher Copyright:
© 2015, Biomedical Engineering Society.
PY - 2016/5/1
Y1 - 2016/5/1
N2 - Skin expansion is a common surgical technique to correct large cutaneous defects. Selecting a successful expansion protocol is solely based on the experience and personal preference of the operating surgeon. Skin expansion could be improved by predictive computational simulations. Towards this goal, we model skin expansion using the continuum framework of finite growth. This approach crucially relies on the concept of incompatible configurations. However, aside from the classical opening angle experiment, our current understanding of growth-induced incompatibilities remains rather vague. Here we visualize and characterize incompatibilities in living systems using skin expansion in a porcine model: We implanted and inflated two expanders, crescent, and spherical, and filled them to 225 cc throughout a period of 21 days. To quantify the residual strains developed during this period, we excised the expanded skin patches and subdivided them into smaller pieces. Skin growth averaged 1.17 times the original area for the spherical and 1.10 for the crescent expander, and displayed significant regional variations. When subdivided into smaller pieces, the grown skin patches retracted heterogeneously and confirmed the existence of incompatibilities. Understanding skin growth through mechanical stretch will allow surgeons to improve—and ultimately personalize—preoperative treatment planning in plastic and reconstructive surgery.
AB - Skin expansion is a common surgical technique to correct large cutaneous defects. Selecting a successful expansion protocol is solely based on the experience and personal preference of the operating surgeon. Skin expansion could be improved by predictive computational simulations. Towards this goal, we model skin expansion using the continuum framework of finite growth. This approach crucially relies on the concept of incompatible configurations. However, aside from the classical opening angle experiment, our current understanding of growth-induced incompatibilities remains rather vague. Here we visualize and characterize incompatibilities in living systems using skin expansion in a porcine model: We implanted and inflated two expanders, crescent, and spherical, and filled them to 225 cc throughout a period of 21 days. To quantify the residual strains developed during this period, we excised the expanded skin patches and subdivided them into smaller pieces. Skin growth averaged 1.17 times the original area for the spherical and 1.10 for the crescent expander, and displayed significant regional variations. When subdivided into smaller pieces, the grown skin patches retracted heterogeneously and confirmed the existence of incompatibilities. Understanding skin growth through mechanical stretch will allow surgeons to improve—and ultimately personalize—preoperative treatment planning in plastic and reconstructive surgery.
KW - Growth
KW - Incompatibility
KW - Isogeometric analysis
KW - Multi-view stereo
KW - Prestrain
KW - Skin
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U2 - 10.1007/s10439-015-1467-4
DO - 10.1007/s10439-015-1467-4
M3 - Article
C2 - 26416721
AN - SCOPUS:84944579817
SN - 0090-6964
VL - 44
SP - 1734
EP - 1752
JO - Annals of Biomedical Engineering
JF - Annals of Biomedical Engineering
IS - 5
ER -