4.6 Article

Simulation and optimization of reconstructive surgery procedures on human skin

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ELSEVIER
DOI: 10.1016/j.jmbbm.2022.105215

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Hyperelastic membrane; Reconstructive surgery; Skin mechanics; Z-plasty; Rhombic flap transposition

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The complex procedures involved in reconstructive surgery of human skin to minimize post-operative scarring are modeled using an automated computational tool. A finite strain no-compression membrane model is presented to account for the tendency to develop wrinkling regions in the skin. The transposition of skin flaps during surgery is described using a general mapping technique. The study focuses on Z-plasty and rhombic flap transpositions and discusses optimal deformation parameters related to stress/strain localization, displacement discontinuities, and wrinkling.
The complex procedures involved in the reconstructive surgery of human skin to minimize post-operative scarring are here modeled by means of an automated computational tool. A finite strain no-compression membrane model accounting for the tendency to develop wrinkling regions in the skin is presented. The constitutive behavior of the material is then described by a suitable hyperelastic incompressible potential. Transpositions of skin flaps during surgery procedures are here computationally described by a general mapping technique of the internal boundary corresponding to surgery cut. The archetypal reconstructive surgery of a Z-plasty, where a rotational transposition of the resulting triangular flaps is involved, is considered in details, along with multiple Z-plasty and rhombic flap transposition. The results are discussed in terms of optimal deformation parameters, related to stress/strain localization, displacement discontinuities and wrinkling.

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