The assessment of natural human skin tension orientation and its variation according to age for two body areas: Forearm and thigh

Ayadh, Meriem; Guillermin, Amaury; Abellan, Marie-Angèle; Bigouret, Armelle; Zahouani, H.

doi:10.1016/j.jmbbm.2023.105798

Cited by 9 publications

(5 citation statements)

References 34 publications

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“…19 Other possible reasons include differences in body contour and distribution of subcutaneous fat, 20 as well as connective tissue properties including the proportion of elastin. 21 Being well-educated and young was also associated with higher costs at both the individual, healthcare system and societal level. Most younger people are part of the workforce and often carry out physically demanding activities necessitating more frequent changes of stoma disposables and, in some cases, requiring more expensive products.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Costs Related to Diverting Ileostomy After Rectal Cancer Surgery: A Population-Based Healthcare Cost Analysis Based on Nationwide Registers

Dahlstrand,

Gustafsson,

Näsvall

et al. 2023

INQUIRY

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Low anterior resection for rectal cancer often includes a diverting loop-ileostomy to avoid the severe consequences of anastomotic leakage. Reversal of the stoma is often delayed, which can incur health-care costs on different levels. The aim is to, on population basis, determine stoma-related costs, and to investigate habitual and socioeconomic factors associated to the level of cost. Multi-register design with data from the Swedish Rectal Cancer Registry, the National Prescribed Drug Register, Statistics Sweden and cost-administrative data from the National Board of Health and Welfare. Data was gathered for 3564 patients with rectal cancer surgery 2007 to 2013, for 3 years following the surgery. Factors influencing the cost of inpatient care and stoma-related consumables were assessed with linear regression analyses. All monthly costs were higher for females (consumables P < .001 and in-patient care P = .031). Post-secondary education ( P = .003) and younger age ( P = .020) was associated with a higher cost for consumables while suffering a surgical complication was associated with increased cost for inpatient care ( P < .001). Patients who had their stoma longer had lower monthly costs (consumables P < .001 and in-patient care P < .001). Female gender, longer duration of stoma, young age, and higher education are associated with higher costs for the care of a diverting stoma after rectal cancer surgery. This study does not allow for analyses of causality but the results together with deepened analyses of underlying reasons form a proper basis for decisions in health care planning and allocation of resources. These findings may have implications on the debate of equal care for all.

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Section: Discussionmentioning

confidence: 99%

“… 19 Other possible reasons include differences in body contour and distribution of subcutaneous fat, 20 as well as connective tissue properties including the proportion of elastin. 21 …”

Section: Discussionmentioning

confidence: 99%

Costs Related to Diverting Ileostomy After Rectal Cancer Surgery: A Population-Based Healthcare Cost Analysis Based on Nationwide Registers

Dahlstrand,

Gustafsson,

Näsvall

et al. 2023

INQUIRY

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“…Inclusion criteria were a lesion whose major diameter was equal to or smaller than 4 cm; the orientation of the major axis was angulated between 45 and 60 degrees compared to the local relaxed skin tension lines (RSTL); and patient's age was between 40 and 80. These age limits were chosen in order to limit the variability of skin elasticity based on the patient's age, which is a scientifically proven factor determining variations in cutaneous elasticity and tension, as described by Ayadh et al [9]. It was also considered that the age window defined has the highest incidence of skin tumors.…”

Section: Methodsmentioning

confidence: 99%

“…The term used to describe this feature of the human cutaneous map is anisotropy, which refers to the variability of skin tension according to the various body sites. The reason behind this is a biological and biomechanical feature, and is related to the amount, the quality and the direction of collagen and elastin fibers in each body area, with variations depending on gender and age [8,9].…”

Section: Introductionmentioning

confidence: 99%

Parallelogram Excision: An Algorithmic Approach for Excision Designs in High-Tension Skin Areas

Costa,

Boriani,

Ali Shah

et al. 2023

Healthcare

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Introduction: The excision of lesions that are not oriented along the skin tension lines may cause the surgeon to design extremely broad elliptical preoperative markings, with the intent to follow the tension lines as recommended for the best postoperative course and the best quality scars. The aim of this study is to describe and clinically apply a new surgical technique called the parallelogram excision technique, in which the traditional ellipse with a major axis parallel to the tension lines is converted into a parallelogram whose lesser sides are coincident with the local skin tension lines. This technique was specifically conceived for lesions whose major axis is non-coincident with skin tension lines, and the primary advantage is that it reduces the amount of healthy tissue excised. Methods: Preliminarily to this clinical study, a comparative geometrical analysis was conducted between various excision shapes and angles using Geometry Pad version 2.7.10 (Bytes Arithmetic LLC) and verifying the data obtained through AutoCAD 2D 2016 (Autodesk, San Rafael, CA, USA), with the purpose of optimizing the technique from a geometrical point of view. A comparison was performed between the theoretical traditional elliptical excision and the hypothetical parallelogram excision. A pilot proof of concept clinical study was performed to verify the validity of the excisional design proposed. The patients considered for parallelogram excision suffered from skin lesions with a diameter no greater than 4 cm and oriented 45° to 60° with respect to tension lines. In order to limit variability, patients’ ages were between 40 and 80, and the selected areas were limbs, sternum and dorsum. Scar quality was assessed with the validated POSAS method at 6 months post-operation. Results: The geometrical analysis of the parallelogram’s design showed that it allows a diminution of the excised healthy skin compared to the traditional ellipse. The clinical series included 16 patients, with a mean age of 63.5. Of these, nine patients were men and seven were women. Diagnoses included basal cell carcinoma in seven cases, dysplastic naevus in five patients, Bowen’s disease in three individuals, and one case where a wider excision of a malignant melanoma was performed. Six-month follow up results showed: (1) an uneventful postoperative course; (2) good scar healing with an observer’s POSAS median score of 16 and a patient’s POSAS median score of 19; and (3) complete excision of lesions. Conclusions: When indicated, the parallelogram excision technique appears to be a good option for the excision and primary closure of skin lesions that are not parallel to skin tension lines, since it allows a reproducible and surgeon-friendly method of preoperative marking and implies a favorable use of the local tension, which determines good quality scars. The amount of healthy tissue removed is smaller compared to traditional elliptic excisions.

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“…This capability provides non-invasive "virtual biopsies" with an isotropic spatial resolution of approximatively 1.3 µm. 15,16 Through integration with artificial intelligence (AI)-based segmentation algorithms, LC-OCT has been employed to quantify superficial dermis thickness, 22,23 epidermal thickness and dermal-epidermal junction (DEJ) undulation in healthy skin, 18,24 as well as in pathological conditions such as inflammatory diseases. 25 Additionally, it has enabled to identify clear biomarkers of facial skin ageing.…”

Section: Introductionmentioning

confidence: 99%

Skin dark spot mapping and evaluation of brightening product efficacy using Line‐field Confocal Optical Coherence Tomography (LC‐OCT)

Jdid,

Pedrazzani,

Lejeune

et al. 2024

Skin Research and Technology

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BackgroundFacial dark spots remain a significant challenge for the cosmetic industry, in terms of providing effective treatment. Using Line‐field Confocal Optical Coherence Tomography (LC‐OCT), we investigated the internal structural features of photo‐aging spot areas and evaluated the efficacy of a skin‐brightening cosmetic product.Materials and MethodsTwenty‐six Asian female volunteers, aged between 29 and 65 years, applied a cosmetic product on their entire face twice a day for 2 months. LC‐OCT was used to evaluate the dermal‐epidermal junction (DEJ) undulation and the volume density of melanin in the epidermis at D0 and D56. Skin brightening and redness were also assessed by photography (SkinCam).ResultsUsing LC‐OCT technology, various microscopic dark spot morphologies, spanning from minimally deformed DEJ to complex DEJ patterns, were identified. Dark spots characterized by slight deformities in the DEJ were predominantly observed in the youngest age group, while older volunteers displayed a wavier pattern. Furthermore, a total of 44 spots were monitored to evaluate the brightening product efficacy. A statistically significant reduction in melanin volumetric density of 7.3% in the spots and 12.3% in their surrounding area was observed after 56 days of product application. In line with these results, an analysis of color parameters using SkinCam reveals a significant increase in brightening and decrease in redness in both pigmented spots and the surrounding skin following application.ConclusionsLC‐OCT proves to be a valuable tool for in‐depth dark spots characterization and assessment of skin brightening products, enabling various applications in the field of dermatological sciences.

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The assessment of natural human skin tension orientation and its variation according to age for two body areas: Forearm and thigh

Cited by 9 publications

References 34 publications

Costs Related to Diverting Ileostomy After Rectal Cancer Surgery: A Population-Based Healthcare Cost Analysis Based on Nationwide Registers

Costs Related to Diverting Ileostomy After Rectal Cancer Surgery: A Population-Based Healthcare Cost Analysis Based on Nationwide Registers

Parallelogram Excision: An Algorithmic Approach for Excision Designs in High-Tension Skin Areas

Skin dark spot mapping and evaluation of brightening product efficacy using Line‐field Confocal Optical Coherence Tomography (LC‐OCT)

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