Biomechanical modeling of novel high expansion auxetic skin grafts

Surgical Excision of Burn Wounds

Burn injuries affect patients of all ages, and timely surgical debridement and excision commence to protect dermal vascularity and integrity, improve healing, and minimize scarring. Several tools may be used for burn wound excision, which is performed either tangentially or down to muscular fascia. Once wounds are optimized from a tissue viability and healing standpoint, coverage may be obtained through grafts or secondary intention healing for more superficial injuries. A collaborative team of plastic and general surgeons, anesthesiologists, nutritionists, and therapists can provide improved patient care throughout the perioperative period, leading to improvements in overall patient morbidity and mortality.

A high-fidelity biomechanical modeling framework for injury prediction during frontal car crash

Injuries arising from car crashes are ubiquitous across the globe and account for over 1.3 million fatalities annually. 93% of mortalities are observed in middle- and low-income countries owing to the lack of infrastructure in the safety assessment of car designs. It is therefore imperative to predict the extent of injuries to the occupants during car crashes, which would lead to safer vehicle design. To date, conventional computational testing methods use Hybrid III dummies, which fail to reproduce fracture and tear injuries. In this work, a full-frontal collision of a vehicle against a rigid wall with a highly biofidelic human body model of an occupant was simulated for the first time to investigate fractures and tears using a novel fracture modeling technique. Fractures were observed in ribs (5-7), which occurred at stresses of 120 MPa at the left lateral vertebrosternal region. In the lower extremity, tears in the ligaments at 70.80 MPa, and fractures in the tibia and femur at 236 MPa were quantified. Stresses in the skull were limited to 11 MPa, indicating a possibility of concussion rather than fractures. The developed computational model would be indispensable for car manufacturers to test the crash impact on the human body at all possible accident scenarios accurately, which will help design better solutions for automotive injury mitigation.

Analysis of material parameter uncertainty propagation in preoperative flap suture simulation

Skin flap transplantation is the most commonly used method to repair tissue defect and cover the wound. In clinic, finite element method is often used to design the pre-operation scheme of flap suture. However, the material parameters of skin flap are uncertain due to experimental errors and differences in body parts. How to consider the influence of material parameter uncertainty on the mechanical response of flap suture in the finite element modeling is an urgent problem to be solved at present. Therefore, the influence of material parameter uncertainty propagation in skin flap suture simulation was studied, Firstly, the geometric model of clinical patient's hand wound was constructed by using reverse modeling technology, the patient's three-dimensional wound was unfolded into a flat surface by using curved surface expansion method, yielding a preliminary design contour for the patient's transplant flap. Based on the acquired patient wound geometry model, the finite element model of flap suture with different fiber orientations and different sizes was constructed in Abaqus, and the uncertainty propagation analysis method based on Monte Carlo simulation combined with surrogate model technology was further used to analyze the stress response of flap suture considering the uncertainty of material parameters. Results showed that the overall stress value was relatively lower when the average fiber orientation was 45°. which could be used as the optimal direction for the flap excision. when the preliminary design contour of the flap was scaled down within 90%, the stress value after flap suturing remained within a safe range.

Biomechanical modeling of footwear-fluid-floor interaction during slips

Slips and falls are among the major concerns for public safety. Slipping risks can be reduced by ensuring adequate traction at the shoe-floor interface. The outsole design of footwear is a critical factor to maintain sufficient shoe-floor traction in the presence of slippery contaminants such as water or oil. While the role of floorings and contaminants on footwear traction has been studied widely, limited works have investigated the role of footwear outsole geometry and tread patterns on shoe-floor traction. In this work, eight footwear outsole designs and their traction performance were tested on a common flooring with water contamination, through the development of a novel fluid-structure interaction based computational framework. Induced fluid pressure, mass flow rates, and contact areas were quantified across the outsole patterns, and their effect on footwear friction was investigated. The study results were validated using mechanical slip testing experiments. The results indicated that the outsoles which had horizontal treads or untreaded heel regions can lead to drastic reduction of footwear friction. Also, contact area alone was quantified to be a poor choice in estimating the traction performance of footwear on water contaminated floorings. Such novel study results have not been reported to date, and are anticipated to provide important guidelines to footwear manufacturers to evaluate and optimize footwear tread parameters which would help in reducing the risk of slips.

Development of an ultra-low-cost planar biaxial tester for soft tissue characterization

Nowadays, the research in the arena of biomedical engineering or specifically soft tissue characterization is rapidly increasing. Due to the complex properties of soft tissues such as, anisotropy and viscoelasticity, it is difficult to predict the deformation behaviour. Hence, soft tissue characterization is essential to analyze these metrics. Soft tissue characterization, specifically, can be done by implementing a planar biaxial tester. Currently, available biaxial testers are mostly developed with respect to other mechanical components such as metals, and not for the soft tissues. Also, these devices are very costly, which makes it difficult for the low and middle income countries to perform this characterization. To solve this problem, in this work, an extremely low-cost biaxial tester was designed and developed. The design of the biaxial tester was simple and modular to allow device modifications according to the applications. The device has a force capability of less than 0.4 kN and a variable speed of 18 mm min^-1to 300 mm min^-1. The biaxial tester was validated using a standard test material with mechanical testing machine and was further tested on several wound geometries including circular, square, diamond shaped, L-Plasty, and elliptical. The developed fully automated device exhibited high accuracy with real-time monitoring. Furthermore, test results on the wounds showed the device's capability to differentiate amongst the considered wound geometries. This device can be helpful to medical students and doctors in understanding the mechanical behaviour of soft tissues during injury induced damage, disease, wounds healing and also for plethora of applications such as expansion testing of skin grafts.

Therapeutic applications of electrospun nanofibers impregnated with various biological macromolecules for effective wound healing strategy - A review

A Non-healing infected wound is an ever-growing global epidemic, with increasing burden of mortality rates and management costs. The problems of chronic wound infections and their outcomes will continue as long as their underlying causes like diabetic wounds grow and spread. Commercial wound therapies employed have limited potential that inhibits pivotal functions and tissue re-epithelialization properties resulting in wound infections. Nanomaterial based drug delivery formulations involving biological macromolecules are developing areas of interest in wound healing applications which are utilized in the re-epithelialization of skin with cost-effective preparations. Research conducted on nanofibers has shown enhanced skin establishment with improved cell proliferation and growth and delivery of bioactive organic molecules at the wound site. However, drug targeted delivery with anti-scarring properties and tissue regeneration aspects have not been updated and discussed in the case of macromolecule impregnated nanofibrous mats. Hence, this review focuses on the brief concepts of wound healing and wound management, therapeutic commercialized wound dressings currently available in the field of wound care, effective electrospun nanofibers impregnated with different biological macromolecules and advancement of nanomaterials for tissue engineering have been discussed. These new findings will pave the way for producing anti-scarring high effective wound scaffolds for drug delivery.

The rise of mechanical metamaterials: Auxetic constructs for skin wound healing

Auxetic materials are known for their unique ability to expand/contract in multiple directions when stretched/compressed. In other words, they exhibit a negative Poisson's ratio, which is usually positive for most of materials. This behavior appears in some biological tissues such as human skin, where it promotes wound healing by providing an enhanced mechanical support and facilitating cell migration. Skin tissue engineering has been a growing research topic in recent years, largely thanks to the rapid development of 3D printing techniques and technologies. The combination of computational studies with rapid manufacturing and tailored designs presents a huge potential for the future of personalized medicine. Overall, this review article provides a comprehensive overview of the current state of research on auxetic constructs for skin healing applications, highlighting the potential of auxetics as a promising treatment option for skin wounds. The article also identifies gaps in the current knowledge and suggests areas for future research. In particular, we discuss the designs, materials, manufacturing techniques, and also the computational and experimental studies on this topic.