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Frontin JB, Anthony BW. Quantifying Dermatology: Method and Device for User-Independent Ultrasound Measurement of Skin Thickness. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2019; 2019:5743-5748. [PMID: 31947157 DOI: 10.1109/embc.2019.8857813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A device and technique to acquire and construct 3D ultrasound volumes of the skin of the hand and arm were developed. The Repeated Skin Thickness Measurement (RSTM) Device moves a high frequency ultrasound probe linearly in 3 axes in a water tank and images a submerged arm. These images are combined into an ultrasound volume, the skin layer segmented, and the thickness extracted. One particular application is measuring progression of scleroderma, a skin thickening disease. The current ultrasound-based scleroderma diagnostic processes assess skin thickness based on a single ultrasound image taken by a clinician holding the ultrasound probe, resulting in low measurement repeatability. The imagery that results from the instrumentation and analysis presented here can be used to create quantitative maps of skin thickness, to monitor the progression of skin-thickening diseases, and to observe the structures of tendons, ligaments, and the other soft tissue of the hand.
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Sano M, Hirakawa S, Yamanaka Y, Naruse E, Inuzuka K, Saito T, Katahashi K, Yata T, Kayama T, Tsuyuki H, Yamamoto N, Takeuchi H, Unno N. Development of a Noninvasive Skin Evaluation Method for Lower Limb Lymphedema. Lymphat Res Biol 2019; 18:7-15. [PMID: 31211932 DOI: 10.1089/lrb.2018.0089] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background: The skin's condition is altered in lymphedema patients, and evaluating this change is important. Some noninvasive methods for evaluating skin condition have been reported, especially in upper limb lymphedema. However, evaluating the skin in lower limb lymphedema remains challenging and is often limited to palpation. We aimed to develop a noninvasive skin evaluation method for lower limb lymphedema patients. Methods and Results: Twenty-five lower limb lymphedema patients were included. Skin induration and elasticity were measured using Indentometer® IDM 400 and Cutometer® MPA580. The relationship between the properties of skin from the healthy forearm and thigh, those of the affected thigh, and age was analyzed. Predicted skin induration age (IA) and elasticity age (EA) were calculated from the forearm, whereas actual values were calculated from the thigh, and the differences (ΔIA and ΔEA) were assessed. Patients were classified according to the International Society of Lymphology clinical staging system, and the differences in ΔIA and ΔEA were analyzed among the three groups (healthy, stage I/IIa, and stage IIb/III). Skin biopsy was performed in five unilateral lower limb lymphedema patients, and the dermal elastic fiber area was determined using microscopy with Elastica van Gieson staining. ΔEA significantly increased with disease progression, but ΔIA did not change significantly. Microscopy revealed elastic fiber filamentous changes, with decreased elastic fiber areas in lymphedema-affected skin. Conclusion: To our knowledge, this is the first report to evaluate lower limb skin elasticity in lymphedema quantitatively and noninvasively. ΔEA is useful for evaluating skin condition progression in lymphedema patients.
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Affiliation(s)
- Masaki Sano
- Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.,Department of Vascular Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Satoshi Hirakawa
- Institute for NanoSuit Research, Preeminent Medical Photonics Education & Research Center, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yuta Yamanaka
- Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.,Department of Vascular Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.,Department of Vascular Surgery, Hamamatsu Medical Center, Hamamatsu, Japan
| | - Ena Naruse
- Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Kazunori Inuzuka
- Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.,Department of Vascular Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Takaaki Saito
- Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.,Department of Vascular Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Kazuto Katahashi
- Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.,Department of Vascular Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Tatsuro Yata
- Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.,Department of Vascular Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Takafumi Kayama
- Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.,Department of Vascular Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hajime Tsuyuki
- Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.,Department of Vascular Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Naoto Yamamoto
- Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.,Department of Vascular Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.,Department of Vascular Surgery, Hamamatsu Medical Center, Hamamatsu, Japan
| | - Hiroya Takeuchi
- Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Naoki Unno
- Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.,Department of Vascular Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.,Department of Vascular Surgery, Hamamatsu Medical Center, Hamamatsu, Japan
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3
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Blaise S, Roustit M, Cracowski JL. Skin biomechanical properties in patients with systemic sclerosis: what parameter should be used? J Eur Acad Dermatol Venereol 2017; 32:e173-e175. [PMID: 29114989 DOI: 10.1111/jdv.14679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- S Blaise
- Department of Vascular Medicine, Grenoble Alpes University Hospital, Grenoble, France.,HP2 laboratory, University Grenoble Alpes, Grenoble, France
| | - M Roustit
- HP2 laboratory, University Grenoble Alpes, Grenoble, France.,INSERM CIC1406, Grenoble, France
| | - J L Cracowski
- HP2 laboratory, University Grenoble Alpes, Grenoble, France.,INSERM CIC1406, Grenoble, France
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Kumar R, Griffin M, Adigbli G, Kalavrezos N, Butler PEM. Lipotransfer for radiation-induced skin fibrosis. Br J Surg 2016; 103:950-61. [PMID: 27169866 DOI: 10.1002/bjs.10180] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 12/21/2015] [Accepted: 03/02/2016] [Indexed: 01/04/2023]
Abstract
BACKGROUND Radiation-induced fibrosis (RIF) is a late complication of radiotherapy that results in progressive functional and cosmetic impairment. Autologous fat has emerged as an option for soft tissue reconstruction. There are also sporadic reports suggesting regression of fibrosis following regional lipotransfer. This systematic review aimed to identify cellular mechanisms driving RIF, and the potential role of lipotransfer in attenuating these processes. METHODS PubMed, OVID and Google Scholar databases were searched to identify all original articles regarding lipotransfer for RIF. All articles describing irradiated fibroblast or myofibroblast behaviour were included. Data elucidating the mechanisms of RIF, role of lipotransfer in RIF and methods to quantify fibrosis were extracted. RESULTS Ninety-eight studies met the inclusion criteria. A single, definitive model of RIF is yet to be established, but four cellular mechanisms were identified through in vitro studies. Twenty-one studies identified connective tissue growth factor and transforming growth factor β1 cytokines as drivers of fibrotic cascades. Hypoxia was demonstrated to propagate fibrogenesis in three studies. Oxidative stress from the release of reactive oxygen species and free radicals was also linked to RIF in 11 studies. Purified autologous fat grafts contain cellular and non-cellular properties that potentially interact with these processes. Six methods for quantifying fibrotic changes were evaluated including durometry, ultrasound shear wave elastography, thermography, dark field imaging, and laser Doppler and laser speckle flowmetry. CONCLUSION Understanding how lipotransfer causes regression of RIF remains unclear; there are a number of new hypotheses for future research.
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Affiliation(s)
- R Kumar
- Division of Surgery and Interventional Science, Royal Free Campus, London, UK.,Charles Wolfson Centre for Reconstructive Surgery, Royal Free Hospital, London, UK
| | - M Griffin
- Division of Surgery and Interventional Science, Royal Free Campus, London, UK.,Department of Plastic and Reconstructive Surgery, Royal Free Hospital, London, UK.,Charles Wolfson Centre for Reconstructive Surgery, Royal Free Hospital, London, UK
| | - G Adigbli
- Division of Surgery and Interventional Science, Royal Free Campus, London, UK.,Charles Wolfson Centre for Reconstructive Surgery, Royal Free Hospital, London, UK
| | - N Kalavrezos
- Head and Neck Unit, Macmillan Cancer Centre, University College London Hospital, London, UK.,Charles Wolfson Centre for Reconstructive Surgery, Royal Free Hospital, London, UK
| | - P E M Butler
- Division of Surgery and Interventional Science, Royal Free Campus, London, UK.,Head and Neck Unit, Macmillan Cancer Centre, University College London Hospital, London, UK.,Department of Plastic and Reconstructive Surgery, Royal Free Hospital, London, UK.,Charles Wolfson Centre for Reconstructive Surgery, Royal Free Hospital, London, UK
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5
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Han F, Zhu C, Guo Q, Yang H, Li B. Cellular modulation by the elasticity of biomaterials. J Mater Chem B 2016; 4:9-26. [DOI: 10.1039/c5tb02077h] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The elasticity of the extracellular matrix has been increasingly recognized as a dominating factor of cell fate and activities. This review provides an overview of the general principles and recent advances in the field of matrix elasticity-dependent regulation of a variety of cellular activities and functions, the underlying biomechanical and molecular mechanisms, as well as the pathophysiological implications.
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Affiliation(s)
- Fengxuan Han
- Department of Orthopaedics
- The First Affiliated Hospital
- Orthopaedic Institute
- Soochow University
- Suzhou
| | - Caihong Zhu
- Department of Orthopaedics
- The First Affiliated Hospital
- Orthopaedic Institute
- Soochow University
- Suzhou
| | - Qianping Guo
- Department of Orthopaedics
- The First Affiliated Hospital
- Orthopaedic Institute
- Soochow University
- Suzhou
| | - Huilin Yang
- Department of Orthopaedics
- The First Affiliated Hospital
- Orthopaedic Institute
- Soochow University
- Suzhou
| | - Bin Li
- Department of Orthopaedics
- The First Affiliated Hospital
- Orthopaedic Institute
- Soochow University
- Suzhou
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Weickenmeier J, Jabareen M, Mazza E. Suction based mechanical characterization of superficial facial soft tissues. J Biomech 2015; 48:4279-86. [PMID: 26584965 DOI: 10.1016/j.jbiomech.2015.10.039] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 10/15/2015] [Accepted: 10/25/2015] [Indexed: 10/22/2022]
Abstract
The present study is aimed at a combined experimental and numerical investigation of the mechanical response of superficial facial tissues. Suction based experiments provide the location, time, and history dependent behavior of skin and SMAS (superficial musculoaponeurotic system) by means of Cutometer and Aspiration measurements. The suction method is particularly suitable for in vivo, multi-axial testing of soft biological tissue including a high repeatability in subsequent tests. The campaign comprises three measurement sites in the face, i.e. jaw, parotid, and forehead, using two different loading profiles (instantaneous loading and a linearly increasing and decreasing loading curve), multiple loading magnitudes, and cyclic loading cases to quantify history dependent behavior. In an inverse finite element analysis based on anatomically detailed models an optimized set of material parameters for the implementation of an elastic-viscoplastic material model was determined, yielding an initial shear modulus of 2.32kPa for skin and 0.05kPa for SMAS, respectively. Apex displacements at maximum instantaneous and linear loading showed significant location specificity with variations of up to 18% with respect to the facial average response while observing variations in repeated measurements in the same location of less than 12%. In summary, the proposed parameter sets for skin and SMAS are shown to provide remarkable agreement between the experimentally observed and numerically predicted tissue response under all loading conditions considered in the present study, including cyclic tests.
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Affiliation(s)
- J Weickenmeier
- Department of Mechanical and Process Engineering, ETH Zurich, Zurich, Switzerland; Department of Mechanical Engineering, Stanford University, Stanford, USA
| | - M Jabareen
- Faculty of Civil and Environmental Engineering, Technion - Israel Institute of Technology, Haifa, Israel.
| | - E Mazza
- Department of Mechanical and Process Engineering, ETH Zurich, Zurich, Switzerland; Swiss Federal Laboratories for Materials Science and Technology, EMPA Duebendorf, Duebendorf, Switzerland
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Weickenmeier J, Jabareen M. Elastic-viscoplastic modeling of soft biological tissues using a mixed finite element formulation based on the relative deformation gradient. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2014; 30:1238-62. [PMID: 24817477 DOI: 10.1002/cnm.2654] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 04/27/2014] [Accepted: 05/04/2014] [Indexed: 05/17/2023]
Abstract
The characteristic highly nonlinear, time-dependent, and often inelastic material response of soft biological tissues can be expressed in a set of elastic-viscoplastic constitutive equations. The specific elastic-viscoplastic model for soft tissues proposed by Rubin and Bodner (2002) is generalized with respect to the constitutive equations for the scalar quantity of the rate of inelasticity and the hardening parameter in order to represent a general framework for elastic-viscoplastic models. A strongly objective integration scheme and a new mixed finite element formulation were developed based on the introduction of the relative deformation gradient-the deformation mapping between the last converged and current configurations. The numerical implementation of both the generalized framework and the specific Rubin and Bodner model is presented. As an example of a challenging application of the new model equations, the mechanical response of facial skin tissue is characterized through an experimental campaign based on the suction method. The measurement data are used for the identification of a suitable set of model parameters that well represents the experimentally observed tissue behavior. Two different measurement protocols were defined to address specific tissue properties with respect to the instantaneous tissue response, inelasticity, and tissue recovery.
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Affiliation(s)
- J Weickenmeier
- Department of Mechanical and Process Engineering, ETH Zurich, Zurich, Switzerland
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Piérard GE, Hermanns-Lê T, Gaspard U, Piérard-Franchimont C. Asymmetric facial skin viscoelasticity during climacteric aging. Clin Cosmet Investig Dermatol 2014; 7:111-8. [PMID: 24748810 PMCID: PMC3990288 DOI: 10.2147/ccid.s60313] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background Climacteric skin aging affects certain biophysical characteristics of facial skin. The purpose of the present study was to assess the symmetric involvement of the cheeks in this stage of the aging process. Methods Skin viscoelasticity was compared on both cheeks in premenopausal and post-menopausal women with indoor occupational activities somewhat limiting the influence of chronic sun exposure. Eighty-four healthy women comprising 36 premenopausal women and 48 early post-menopausal women off hormone replacement therapy were enrolled in two groups. The tensile characteristics of both cheeks were tested and compared in each group. A computerized suction device equipped with a 2 mm diameter hollow probe was used to derive viscoelasticity parameters during a five-cycle procedure of 2 seconds each. Skin unfolding, intrinsic distensibility, biological elasticity, and creep extension were measured. Results Both biological elasticity and creep extension were asymmetric on the cheeks of the post-menopausal women. In contrast, these differences were more discrete in the premenopausal women. Conclusion Facial skin viscoelasticity appeared to be asymmetric following menopause. The possibility of asymmetry should be taken into account in future studies of the effects of hormone replacement therapy and any antiaging procedure on the face in menopausal women.
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Affiliation(s)
- Gérald E Piérard
- Laboratory of Skin Bioengineering and Imaging, Department of Clinical Sciences, University of Liège, Belgium
| | - Trinh Hermanns-Lê
- Laboratory of Skin Bioengineering and Imaging, Department of Clinical Sciences, University of Liège, Belgium
| | - Ulysse Gaspard
- Department of Gynecology and Obstetrics, University Hospital of Liège, Liège, Belgium
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9
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Piérard GE, Paquet P, Piérard-Franchimont C. Skin viscoelasticity in incipient gravitational syndrome. J Cosmet Dermatol 2014; 13:52-5. [DOI: 10.1111/jocd.12077] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2013] [Indexed: 12/01/2022]
Affiliation(s)
- Gérald E Piérard
- Laboratory of Skin Bioengineering and Imaging; Department of Clinical Sciences; University of Liège; Liège Belgium
- Department of Dermatology; University Hospital; Besançon France
| | - Philippe Paquet
- Laboratory of Skin Bioengineering and Imaging; Department of Clinical Sciences; University of Liège; Liège Belgium
| | - Claudine Piérard-Franchimont
- Laboratory of Skin Bioengineering and Imaging; Department of Clinical Sciences; University of Liège; Liège Belgium
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10
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Piérard GE, Hermanns-Lê T, Paquet P, Piérard-Franchimont C. Skin viscoelasticity during hormone replacement therapy for climacteric ageing. Int J Cosmet Sci 2013; 36:88-92. [DOI: 10.1111/ics.12100] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 10/16/2013] [Indexed: 01/10/2023]
Affiliation(s)
- G. E. Piérard
- Laboratory of Skin Bioengineering and Imaging (LABIC); Department of Clinical Sciences, B23; University of Liège; B-4000 Liège Belgium
| | - T. Hermanns-Lê
- Laboratory of Skin Bioengineering and Imaging (LABIC); Department of Clinical Sciences, B23; University of Liège; B-4000 Liège Belgium
| | - P. Paquet
- Laboratory of Skin Bioengineering and Imaging (LABIC); Department of Clinical Sciences, B23; University of Liège; B-4000 Liège Belgium
| | - C. Piérard-Franchimont
- Laboratory of Skin Bioengineering and Imaging (LABIC); Department of Clinical Sciences, B23; University of Liège; B-4000 Liège Belgium
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In vivo evaluation of the skin tensile strength by the suction method: pilot study coping with hysteresis and creep extension. ISRN DERMATOLOGY 2013; 2013:841217. [PMID: 23986871 PMCID: PMC3748421 DOI: 10.1155/2013/841217] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Accepted: 07/10/2013] [Indexed: 11/17/2022]
Abstract
From an engineering standpoint, both the skin and subcutaneous tissue act as interconnected load-transmitting structures. They are subject to a variety of intrinsic and environmental influences. Changes in the cutaneous viscoelasticity represent an important aspect in a series of skin conditions. The aim of this work was to explore the methodology of biomechanical measurements in order to better appreciate the evolution and severity of some connective tissue diseases. The Cutometer MPA 580 (C+K electronic) was used in the steep and progressive suction procedures. Adapting measurement modalities was explored in order to mitigate any variability in data collection. The repeat steep suction procedure conveniently reveals the creep phenomenon. By contrast, the progressive suction procedure highlights the hysteresis phenomenon. These viscoelastic characteristics are presently described using the 2 and 4 mm probes on normal skin and in scleroderma, acromegaly, corticosteroid-induced dermatoporosis, and Ehlers-Danlos syndrome. The apposition of an additional outer contention on the skin altered differently the manifestations of the creep extension and hysteresis among the tested skin conditions. Any change in the mechanical test procedure affects the data. In clinical and experimental settings, it is mandatory to adhere to a strict and controlled protocol.
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Jor JWY, Parker MD, Taberner AJ, Nash MP, Nielsen PMF. Computational and experimental characterization of skin mechanics: identifying current challenges and future directions. WILEY INTERDISCIPLINARY REVIEWS-SYSTEMS BIOLOGY AND MEDICINE 2013; 5:539-56. [PMID: 23757148 DOI: 10.1002/wsbm.1228] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 04/25/2013] [Accepted: 04/26/2013] [Indexed: 12/21/2022]
Abstract
The characterization of skin mechanics has many clinical implications and has been an active area of research for the past few decades. Biomechanical models have evolved from earlier empirical models to state-of-the-art structural models that provide linkage between tissue microstructure and macroscopic stress-strain response. To maximize the accuracy and predictive capabilities of such computational models, there is a need to reliably identify often a large number of unknown model parameters. This is critically dependent on the availability of experimental data that cover an extensive range of different deformation modes, and quantification of internal structural features, such as collagen orientation. To this end, future challenges should include the ongoing development of noninvasive instrumentation and imaging modalities for in vivo skin measurements. We highlight the important concept of tightly integrating computational models, instrumentation, and imaging modalities into a single platform to investigate skin biomechanics.
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Affiliation(s)
- Jessica W Y Jor
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
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