In:
Plastic & Reconstructive Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 146, No. 4 ( 2020-10), p. 792-798
Abstract:
Tissue expansion relies on the ability of skin to grow in response to sustained mechanical strain. This study focuses on correlation of cellular and histologic changes with skin growth and deformation during tissue expansion. Methods: Tissue expanders were placed underneath the skin of five Yucatan minipigs and inflated with one fill of 60 cc of saline 1 hour, 24 hours, 3 days, and 7 days before the animals were killed, or two fills of either 30 cc or 60 cc at 10 and 3 days or 14 and 7 days before the animals were killed. Skin biopsy specimens and three-dimensional photographs were used to calculate skin growth and stretch according to the authors’ novel finite element analysis model. Results: The mitotic index of keratinocytes in the basal layer increased 1 hour after stimulus was applied (4 percent) ( p = 0.022), peaked at approximately day 3 (26 percent) ( p 〈 0.0001), and tapered by day 7 (12.5 percent) ( p = 0.012) after tissue expansion. The authors demonstrated that it is the volume per fill rather than the total volume in the expander that scales the magnitude of response. Lastly, the authors demonstrated that the ratio of deformation attributable to growth versus stretch (F growth /F stretch ) after 60 cc of tissue expansion fill was 1.03 at 1 hour, 0.82 at 1 day, 0.85 at day 3, and 0.95 at 7 days. Conclusions: Peak cell proliferation occurred 3 days after tissue expansion fill and is scaled in response to stimulus magnitude. The growth component of deformation equilibrates to the stretch component at day 7, as cell proliferation has started to translate to skin growth.
Type of Medium:
Online Resource
ISSN:
0032-1052
DOI:
10.1097/PRS.0000000000007153
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2020
detail.hit.zdb_id:
2037030-1
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