The Compressiometer: Toward a New Skin Tensiometer for Research and Surgical Planning

Abstract

After surgery, around 35% of patients experience problems of excessive scarring, causing disfiguring and impaired function. An incision placed in the wrong direction causes unnecessary skin tension on the wound, resulting in increased collagen disposition and potentially hypertrophic scars. Currently, skin tension lines are used for incision planning. However, these lines are not universal and are a static representation of the skin tension that is in fact under influence of muscle action. By designing a new skin force measurement device the authors intend to make research on dynamic skin characteristics possible and to objectify incision planning and excision closure planning. The device applies a known compressive force to the skin in standardized directions and measures the displacement of the skin. This allows users to measure the skin reaction force in response to compression and to determine the optimal incision line or best wound closure direction. The device has an accuracy of 96% and a sensitivity of < 0.01 mm. It is compact, works non-invasively and standardizes measurement directions and is therefore an improvement over previously designed skin tensiometers.

Dynamic characteristics of skin reaction force in different body postures

“…The preferred direction changes in different body postures were not always consistent with current recommendations such as Langer's Lines. These results correspond with the data from a previous pilot study that also indicated a relationship between body posture and measured reaction force 12 . The prevention of pathological scar tissue formation after (skin) surgery remains challenging.…”

“…This study used a novel compressiometer (Fig. 1 ) recently developed and validated by the authors 12 . The device was used to determine the reaction force of the skin by determining the displacement of two fixed points on the skin under unidirectional loading.…”

Could Electromyographic and Pressure Related Signals Identify Differences in Abdominal Activity and Postural Control between Women with and without C-Section?

“…One of the most important causes of pathological healing, such as hypertrophic scars, is incorrect incision planning. An incision placed in the direction perpendicular to Langer’s lines causes unnecessary tension on the skin, pushing the wound edges apart [ 18 ], substantiating the last criterion mentioned. Only women who consented to be contacted were evaluated by resorting to other instruments, from which those who presented diastasis of the rectus abdominis greater than two fingers of the subject, types V and VI phototypes (Fitzpatrick Scale), obesity (Body Mass Index (BMI) greater than 29.99 kg/m 2 ), and were undergoing menopause, were excluded.…”

Quantification of skin wound tension using a newly designed wound tensiometer

“…Ziel (i) Report über die quantitative Messung der Wundspannung bei experimentellen Hautwunden unter Verwendung eines neu entwickelten Wundtensiometers und (ii) Entwicklung Introduction Halsted's 7 principles of surgery have been established for over 120 years [1], but objective data on wound tension are limited. Subjective assessment of wound tension by experienced surgeons remains the gold standard in small animal surgery, as there are no established methods for objective quantification or reference values for wound tension to guide the surgeon's decision whether to close the wound primarily without any tension-relieving procedures [2]. The detrimental impact of high wound tension on wound healing has led to the development of a variety of tension relieving techniques [3].…”