Charting a finite element, mechanical atlas of dermatologic wound closure

TL;DR

This paper develops a finite element model to analyze how wound geometry and skin properties influence mechanical stress propagation during wound closure, aiding clinical understanding and surgical planning.

Contribution

It introduces a detailed two-layer, orthotropic, hyperelastic finite element model of skin for studying wound closure mechanics, with open-source implementation.

Findings

Model captures effects of wound geometry and skin anisotropy.

Provides a framework for understanding stress distribution in wound healing.

Highlights assumptions and areas for future model improvements.

Abstract

Wound geometry and the mechanical properties of human skin govern the failure modes of partially healed or scarred tissue. Though dermatologists and surgeons develop an intuitive understanding of the mechanical characteristics of skin through clinical practice, finite element models of wounds can aid in formalizing intuition. In this work, we explore the effect of wound geometry and primary intention closure on the propagation of mechanical stresses through skin. We use a two-layer, orthotropic, hyperelastic model of the epidermis, dermis, and subcutis to accurately capture the mechanical and geometric effects at work. We highlight the key assumptions which must be made when modeling closure of wounds by primary intention, clearly delineating promising areas for model improvement. Models are implemented in DOLFINx, an open-source finite element framework, and reference code is provided for reproducible and extensible science.