Optimal patterns for suturing wounds

Document Type

Article

Publication Date

7-1-1998

Abstract

A mathematical model for computing stresses in sutured human skin wounds is presented. The model uses the incremental law of elasticity and elastic constants valid for in vitro orthotropic skin. The model is applied to compute the principal stress and displacements resulting from suturing small elliptical and circular wounds in a large flat sheet of skin, in order to determine the optimal suturing patterns. It is observed that the average stress index for a circular wound sutured toward the center is almost double that of a wound sutured transverse to the diameter. Thus, the latter type of suturing pattern is preferable. Similarly, suturing an elliptical wound transversely produces a lower average stress index than a circular wound of the same area. It is also found that the optimal ratio of semi-major to semi-minor axis of an elliptical wound is near 3 (for abdominal wounds), i.e., this ratio produces the most uniform stresses along the wound edges, where wound healing is slowest. Since high stresses have adverse effects on healing and blood flow, this work, depicting regions of high stresses, may be used along with other biological factors to help predict regions of slower healing in sutured wounds.

Identifier

0032122258 (Scopus)

Publication Title

Journal of Biomechanics

External Full Text Location

https://doi.org/10.1016/S0021-9290(98)00069-4

ISSN

00219290

PubMed ID

9796688

First Page

653

Last Page

662

Issue

7

Volume

31

Grant

DMS-9704746

Fund Ref

National Science Foundation

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