Wolffʼs Law in Relation to the Healing Skin Wound

Forrester, James C.; Zederfeldt, B; Hayes, T.; Hunt, Thomas K.

doi:10.1097/00005373-197009000-00008

Cited by 44 publications

(10 citation statements)

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“…As examples, collagen fibers align along the direction of applied tension in healing skin wounds but orient randomly in the absence of applied tension,[22, 23] and hindlimb unloading and joint immobilization affect the organization of collagen fibers in healing ligaments. [24–26] Accordingly, many recognized features of fibroblast biology could govern the alignment of collagen fibers in healing myocardial infarcts.…”

Section: Discussionmentioning

confidence: 99%

Regional mechanics determine collagen fiber structure in healing myocardial infarcts

Fomovsky

Rouillard

Holmes

2012

Journal of Molecular and Cellular Cardiology

107

139

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Following myocardial infarction, the mechanical properties of the healing infarct are an important determinant of heart function and the risk of progression to heart failure. In particular, mechanical anisotropy (having different mechanical properties in different directions) in the healing infarct can preserve pump function of the heart. Based on reports of different collagen structures and mechanical properties in various animal models, we hypothesized that differences in infarct size, shape, and/or location produce different patterns of mechanical stretch that guide evolving collagen fiber structure. We tested the effects of infarct shape and location using a combined experimental and computational approach. We studied mechanics and collagen fiber structure in cryoinfarcts in 53 Sprague-Dawley rats and found that regardless of shape or orientation, cryoinfarcts near the equator of the left ventricle stretched primarily in the circumferential direction and developed circumferentially aligned collagen, while infarcts at the apex stretched similarly in the circumferential and longitudinal direction and developed randomly oriented collagen. In a computational model of infarct healing, an effect of mechanical stretch on fibroblast and collagen alignment was required to reproduce the experimental results. We conclude that mechanical environment determines collagen fiber structure in healing myocardial infarcts. Our results suggest that emerging post-infarction therapies that alter regional mechanics will also alter infarct collagen structure, offering both potential risks and novel therapeutic opportunities.

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Section: Discussionmentioning

confidence: 99%

Regional mechanics determine collagen fiber structure in healing myocardial infarcts

Fomovsky

Rouillard

Holmes

2012

Journal of Molecular and Cellular Cardiology

107

139

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“…Since the original results of Levenson et al, numerous investigations using animal models support the conclusion that 1 week postoperatively, there is a rapid gain in tensile strength lasting approximately 6 weeks. 15–25 To demonstrate this, we developed a curve reflecting the findings of individual studies (Fig. 3A) and one with averaged data (Fig.…”

Section: Tensile Strengthmentioning

confidence: 99%

The Role of Wound Healing and Its Everyday Application in Plastic Surgery

Ireton

Unger

Rohrich

2013

Plastic and Reconstructive Surgery Global Open

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Background:After surgery it is often recommended that patients should refrain from strenuous physical activity for 4–6 weeks. This recommendation is based on the time course of wound healing. Here, we present an overview of incisional wound healing with a focus on 2 principles that guide our postoperative recommendations: the gain of tensile strength of a wound over time and the effect of mechanical stress on wound healing.Methods:A systematic search of the English literature was conducted using OVID, Cochrane databases, and PubMed. Inclusion criteria consisted of articles discussing the dynamics of incisional wound healing, and exclusion criteria consisted of articles discussing nonincisional wounds.Results:Experiments as early as 1929 laid the groundwork for our postoperative activity recommendations. Research using animal models has shown that the gain in tensile strength of a surgical wound is sigmoidal in trajectory, reaching maximal strength approximately 6 weeks postoperatively. Although human and clinical data are limited, the principles gained from laboratory investigation have provided important insights into the relationship among mechanical stress, collagen dynamics, and the time course of wound healing.Conclusion:Our postoperative activity recommendations are based on a series of animal studies. Clinical research supporting these recommendations is minimal, with the most relevant clinical data stemming from early motion protocols in the orthopedic literature. We must seek to establish clinical data to support our postoperative activity recommendations so that we can maximize the physiologic relationships between wound healing and mechanical stress.

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“…Scanning electron microscopic studies of healing skin wounds (11,12,36) and healing ligaments (26), as well as gross anatomic observations, have shown a gradual alteration in fibre anatomy with time. For the medial collateral ligament in the rabbit model, the results of a study in our laboratory (16) suggest that collagen organization is a key factor in determining the difference between the normal and healing behaviour of this ligament and the strengthening of the scar tissue itself.…”

Section: Crosslinks In L I G a M E N T H E A L I N G I 6mentioning

confidence: 99%

Rabbit medial collateral ligament scar weakness is associated with decreased collagen pyridinoline crosslink density

Frank

McDonald

Wilson

et al. 1995

Journal Orthopaedic Research

119

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This study was carried out to quantify the potential associations between material strength and both collagen concentration and pyridinoline collagen crosslink density in the healing medial collateral ligament of the rabbit and to compare these parameters with those of normal ligaments. The right hindlimbs of 24 skeletally mature (12-month-old) New Zealand White rabbits were subjected to a standardized 4 mm midsubstance "gap" injury to the medial collateral ligament. The animals were killed in groups of six at postoperative intervals of 3, 6, 14, or 40 weeks, and the femur-medial collateral ligament-tibia complexes were mechanically tested in tension to failure. Subsequent to mechanical testing, the failure sites of the ligaments were assessed for concentrations of hydroxyproline and hydroxylysyl pyridinoline. Nine additional rabbits served as age-matched normal controls. In healing ligaments, normal collagen concentrations were reached in less than 14 weeks, but the hydroxylysyl pyridinoline crosslink densities remained low and were only 45% of the control values after 40 weeks of healing. Similarly, mechanical values remained much less than the controls. Linear regression analysis of data on scar tissue alone showed a moderately strong positive correlation between hydroxyproline concentration and material strength (r2 = 0.51, p = 0.0001) but no correlation between crosslink density and strength of scar tissue. A similar pattern of correlation was obtained between the elastic modulus of the scar tissue and the biochemical variables, but the r2 values were lower.(ABSTRACT TRUNCATED AT 250 WORDS)

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Wolffʼs Law in Relation to the Healing Skin Wound

Cited by 44 publications

References 0 publications

Regional mechanics determine collagen fiber structure in healing myocardial infarcts

Regional mechanics determine collagen fiber structure in healing myocardial infarcts

The Role of Wound Healing and Its Everyday Application in Plastic Surgery

Rabbit medial collateral ligament scar weakness is associated with decreased collagen pyridinoline crosslink density

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