๐ ็ธฝ็ฎ้ ๏ฝ ๐ ่ฑๆๅๆ๏ผๆฌ็ฏ๏ผ ๏ฝ ๐ ๅฎๆด็ฟป่ญฏ ๏ฝ โญ ็ฒพ่ฏ็ญ่จ
Tissue dynamics
Tissue dynamics
The elastic properties of the skin are important to consider when planning a closure.
Skin is naturally pliant, and can tolerate a certain degree of tension or compression while maintaining a smooth, flat surface. However, the skin has defined limits of malleability, which vary with age, location, and actinic damage.1 As stated previously, when the imposed forces which are required for closure surpass the skinโs intrinsic elastic properties, dog ears can develop.1
Because each layer of skin is anchored to the structures beneath it, undermining is an essential method for augmenting the skinโs functional pliability. As an ellipse is closed, the edges pull on the underlying tissue, compressing the tissue at the base of the wound and causing vertical displacement of the wound edges.1,2 Undermining can release the wound edges from the anchored tissues beneath, mitigating the compression by allowing lateral dissipation of pressure as the skin is stretched.2,5