皮肤正交各向异性及扩张器力学特性对皮肤扩张的影响(1)
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[摘要]目的：研究皮肤正交各向异性及扩张器力学特性对皮肤扩张的影响，为临床扩张器置入及扩张皮瓣的设计提供参考。方法：以朗格氏线(Langer's lines)为X轴，Y轴垂直于朗格氏线，测量计算注水前后两轴单位皮肤扩张量，测量分析扩张器囊壁的张力特征。结果：Y轴单位皮肤扩张量注水前后明显大于X轴；扩张器其囊壁在各个方向上单位延展量与其形状有关。结论：皮肤扩张时，在各个方向上扩张效率并不一致，沿朗格氏线方向扩张效率最低，而沿垂直于朗格氏线方向扩张效率最高，扩张期张力特性对皮肤扩张存在较大影响。
[关键词]正交各向异性；皮肤扩张；扩张器
[中图分类号]R622 [文献标识码]A [文章编号]1008-6455(2012)03-0369-03
The skin's orthotropy and the tension character of the tissue expander affect the expanding of the skin
FAN Peng-ju1,LONG Jian-hong1,GAO Guang-jun2
(1.Department of Plastic & Aesthetic Surgery,Xiangya Hospital of Central South University,Changsha 410008,Hunan,China;2.School of Traffic And Transportation Engineering of Central South University)
Abstract: Objective Investigate how the skin's orthotropy and the tension character of the tissue expander affect the expanding of the skin, and to suggest how to embed the tissue expander and to design expanding flap. Methods The coordinate was constructed with Langer's line as the X-axis and the Y-axis perpendicular to the Langer's line. The quantity of the expanded skin was measured before and after injecting saline. The stress character of the wall of the tissue expander was also measured and analyzed. Results The expanded skin per unit in the Y-axis orientation is more than in the X-axis. The per unit extending quantity of the wall of the tissue expander is related to the shape of the tissue expander. Conclusion There is different skin expanding efficiency in the different orientations when the skin is expanded because of the skin's orthotropy. Generally, the minimum skin expanding efficiency lies in the langer's line, while the maximum in the line perpendicular to the former. The tension character of the tissue expander has large effect on the skin expanding.
Key words:orthotropy;expanding of skin;tissue expander
皮肤软组织扩张技术应用已有30余年的历史，它的出现及发展对推动现代整形外科发展具有重要推动作用，国内外学者对其进行了大量的临床及实验研究。皮肤具有张力正交各向异性，这一特性及扩张器自身力学特性对皮肤扩张影响如何，文献未见类似报告。
1 资料
以我科2009年3～5月采用皮肤扩张治疗的患者为研究对象，共5名，年龄8～26岁，男女不限，扩张部位为颈部、额部、及面部，共11个扩张器，扩张器总注水量不超过其标准容量；另外取11个扩张器体外注水测量。
2 测量方法
2.1 注水前后X-轴及Y轴的单位皮肤扩张量：扩张皮肤上建立坐标轴，以朗格氏线为X-轴(注：朗格氏线和Borges 提出的松弛皮肤张力线类同，且Borges方法简单易用，所以采用Borges方法确定朗格氏线)[1]，垂直于朗格氏线的线条为Y-轴，于X-轴及Y-轴上各取两点，扩张器注水前后在可弯曲、伸展性小的纸片上标记两点间距离，游标卡尺分别测量纸片上注水前后两点间距离 ......
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