Division of Plastic Surgery, University of California San Diego, San Diego, California.
Department of Orthopedic Surgery, Military Central Hospital Koblenz, Koblenz, Germany.
J Bone Joint Surg Am. 2019 Mar 6;101(5):392-399. doi: 10.2106/JBJS.18.00331.
Patients, particularly those who are young, often develop noticeable orthopaedic scars. In order to achieve minimal scarring, surgeons should attempt to place incisions in skinfolds or skin creases.
Optimal incision lines can be determined from the direction of stretch marks (striae distensae), which develop perpendicular to lines of tension or main folding lines. A composite diagram of photographs of 213 individuals with striae distensae was created and compared with 276 images of incisions and scars derived from the Internet.
Classically described Langer cleavage lines often run counter to real tension lines and poorly predict the optimal direction for skin incisions.
Whenever possible, main folding lines should be utilized as a guide in planning surgical incisions for young patients as well as for correction of problem scars.
患者，尤其是年轻人，往往会留下明显的整形外科疤痕。为了实现最小化的疤痕，外科医生应该尝试在皮肤褶皱或皮肤折痕处进行切口。
可以根据膨胀纹（伸展纹）的方向确定最佳切口线，这些纹线与张力线或主要折叠线垂直。创建了一张包含 213 名有伸展纹的个体照片的组合图，并与从互联网上获得的 276 张切口和疤痕图像进行了比较。
经典描述的朗格分裂线常常与实际的张力线相反，并且不能很好地预测皮肤切口的最佳方向。
只要有可能，主要折叠线就应该被用作年轻患者手术切口规划以及问题疤痕矫正的指导。
