Influence of the V-Y advancement flap geometry on the wound closure maximal force

Djamel Remache (1) , Kévin Billon (1) , Florian Gallecier (1) , Julien Pauchot (2) , Jérôme Chambert (1) , Emmanuelle Jacquet (1)

1 FEMTO-ST - Franche-Comté Électronique Mécanique, Thermique et Optique - Sciences et Technologies (UMR 6174)
2 CHU Besançon - Orthopedic, Traumatology, Plastic Reconstructive and Hand Surgery Unit

In clinical practice, the V-Y advancement flap is a widely used technique to cover human skin defect, which consists in incising; advancing and suturing a triangular flap adjacent to the base of a rectangular defect (see Figure 1a). A previous geometrical study of the V-Y flap technique allowed us to find a good compromise between the flap size and the defect width [1]. However, the geometrical approach does not consider the mechanical properties of the human skin by assuming rigid-body behaviour of the skin. The aim of the present paper deals with a numerical analysis as a complement to the geometrical one to highlight the major role of the skin elasticity in the V-Y advancement flap. A compromise between the size of the flap and the level of the closure force value has been found when varying the angle at the flap apex, noted . The sensitivity to the mechanical parameters makes the closure force dependent on the size to be covered. At the end, the successive actions of the surgeon are analyzed.

Domaines: Mécanique [physics.med-ph]

Djamel Remache, Kévin Billon, Florian Gallecier, Julien Pauchot, Jérôme Chambert, et al.. Influence of the V-Y advancement flap geometry on the wound closure maximal force. 1st International Conference of the Czech Society of Biomechanics, Human Skin Engineering and Reconstructive Surgery, Jan 2013, France. pp.1 - 2. ⟨hal-01002402⟩