Larrabee W F
Laryngoscope. 1986 Apr;96(4):399-405.
Skin flap design has traditionally been based on geometric models which ignore the elastic properties of skin and its subcutaneous attachments. This study reviews the theoretical and experimental mechanics of skin and soft tissues (I) and proposes a mathematical model of skin deformation based on the finite element method (III). Finite element technique facilitates the modeling of complex structures by analyzing them as an aggregate of smaller elements. This paper gives the results of an animal model developed to study the deformation and mechanical properties of skin, including its viscoelastic properties (hysteresis, creep, and stress relaxation). A new skin extensometer, constructed with digital stepper motors and controlled with a microcomputer, is described to measure these properties for both skin and its subcutaneous attachments. Deformation grids quantitated from photographs with a digitalizing tablet are presented, and computer software is introduced to standardize and analyze them (II). The mathematical model is used to simulate wound closures such as the ellipse and rectangular advancement flap. In addition, a series of mathematical experiments performed to simulate deformation of a strip of skin are described; the relationships between the various elastic constants are investigated; and a comparison of these simulations with actual deformation is presented. Limitations of the model and areas for future investigation are discussed (III).
传统上,皮瓣设计基于几何模型,而这些模型忽略了皮肤及其皮下附着物的弹性特性。本研究回顾了皮肤和软组织的理论与实验力学(I),并提出了一种基于有限元方法的皮肤变形数学模型(III)。有限元技术通过将复杂结构分析为较小单元的集合来实现对其建模。本文给出了为研究皮肤变形及力学特性(包括其粘弹性特性,如滞后、蠕变和应力松弛)而建立的动物模型的结果。描述了一种用数字步进电机构建并由微型计算机控制的新型皮肤拉伸仪,用于测量皮肤及其皮下附着物的这些特性。给出了用数字化仪从照片中量化得到的变形网格,并介绍了用于标准化和分析这些网格的计算机软件(II)。该数学模型用于模拟伤口闭合,如椭圆形和矩形推进皮瓣。此外,还描述了为模拟一条皮肤条带的变形而进行的一系列数学实验;研究了各种弹性常数之间的关系;并给出了这些模拟结果与实际变形的比较。讨论了该模型的局限性以及未来研究的方向(III)。