INTRODUCTION Advanced understanding of stem cell lineages, biomolecular signaling cascades, cellular responses, and wound healing ki- netics has shed much insight into the mechanism of wound healing. Relaxed skin tension lines (RSTL) versus other skin lines. Linearity and Surface Anatomy of the Face: From Embryo to Senescence. If you have already registered, please login. eCollection 2021. Aged skin: a study by light, transmission electron, and scanning electron microscopy. Keywords: Langer's lines; elective surgical incisions; plastic surgery; relaxed skin tension lines. 2021 Oct 22;9:749492. doi: 10.3389/fbioe.2021.749492. Daily free limit of specialist articles reached, cleft lines of the skin; Long lines; relaxed skin tension lines; Skin cleft lines. Prior to surgery a vertical line was marked on the skin through the centre of each naevus. and transmitted securely. National Library of Medicine Lines were most similar in thin individuals and deviated more in individuals suffering from disease. Dynamic characteristics of skin reaction force in different body postures. J Mech Phys Solids. Wilhelmi BJ, Blackwell SJ, Phillips LG. The site is secure. Twenty-nine wounds maintained the same orientation of distortion in all of the facial expressions. Skin tension lines commonly depicted in textbooks. Today, elective surgical incisions may not follow Langer lines in all body areas, and other guides, such as relaxed skin tension lines running perpendicular to the direction of muscle contraction, may serve patients better. In the area of the joints, they take an individual course. Incisions around the Shoulder | ShoulderDoc The site is secure. On the trunk and extremities, they run largely horizontally. 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Many surgeons prefer Langer's lines. Disclaimer. Introduction Skin grafting is the gold standard for covering large-area skin defects when there are partial-thickness defects with intact underlying musculatures [ 1 ]. Rather, it is common that relaxed skin tension lines provide a guide for cosmetically pleasing surgical results. PDF Overview of Surgical Scar Prevention and Management - Semantic Scholar Bookshelf The effects of mechanical force on fibroblast behavior in cutaneous injury. In the reticular dermis of the normal adult human, skin tension lines have an anatomical counterpart consisting of a preferential parallel orientation and a straightening of thin collagen bundles and elastic fibers. Accessibility & Tsokos, M. Skin tension and cleavage lines (Langers lines) causing distortion of ante- and postmortem wound morphology. Relaxed skin tension lines (RSTL) versus other skin lines. 2021 Jan-Mar;14(1):47-54. doi: 10.4103/JCAS.JCAS_41_20. Lacerations against Langer's lines: to glue or suture? Continuous NPWT Regulates Fibrosis in Murine Diabetic Wound Healing. Bookshelf 2022 Apr 25;10:874840. doi: 10.3389/fcell.2022.874840. 2023 American Medical Association. This site needs JavaScript to work properly. Relaxed skin tension lines are determined at the time of operation by pinching the skin and observing the linear creases. Epub 2023 Jun 1. Were sorry, something doesn't seem to be working properly. In these circumstances, it is necessary to raise skin flaps while protecting the circulation of the skin. Biodynamic excisional skin tension lines - PMC - National Center for The https:// ensures that you are connecting to the 8600 Rockville Pike The assessment of individual wounds at autopsy may be complicated by the superimposition of a number of injuries or damage to tissues that occurred after death, either of which has the potential to distort the morphology of the initial injury. eCollection 2022. 11 Incisions made parallel to lines of maximal tension will gap to a lesser extent and heal with a finer scar than incisions made at right or oblique angles to them. Full-Thickness Skin Graft according to Surrounding Relaxed Skin Tension Line Improves Scar Quality in Facial Defect Coverage: A Retrospective Comparative Study. Excision; Langers lines; Skin; Skin cancer; Skin tension. The tangled web of Langer's lines - PubMed On the face, skin tension lines follow the mimic musculature. official website and that any information you provide is encrypted Unable to load your collection due to an error, Unable to load your delegates due to an error. In the glabellar area, cleavage lines were vertical and extended to the forehead. If the skin is disrupted parallel to the long axis of the fibers, the wound tends to reapproximate. Cheng M, Zhuang Y, Zhao H, Li M, Fan L, Yu H. Int J Comput Assist Radiol Surg. Overview of Surgical Scar Prevention and Management - PMC Enhance your listing: The two most widely recognised are Langers lines (also known as cleavage lines) and relaxed skin tension lines. Epub 2009 Feb 20. J.F. Rather, it is common that relaxed skin tension lines provide a guide for cosmetically pleasing surgical results. Altun G, Durmus-Altun G (2003) Confirmation of alleged fallanga torture by bone scintigraphycase report. Wolters Kluwer Health Zhonghua Kou Qiang Yi Xue Za Zhi. FOIA Langer's lines, Langer lines of skin tension, or sometimes called cleavage lines, are topological lines drawn on a map of the human body. MeSH Originally published in Hockberger R, Marx J, Walls R. Biodynamic excisional skin tension lines mapped during study (anterior). Epub 2021 Nov 9. In fact, Guillaume Dupuytren, a French anatomist and military surgeon, had made this observation earlier, as early as 1834. Pulsenotes uses cookies. This site needs JavaScript to work properly. FOIA The orientation of surgical incisions over the skin is widely considered to affect scarring and the final cosmetic outcome for patients. . Correspondence to Please login to access all articles, images, and functions. Disclaimer. There are different types of skin tension lines. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Keywords: Paul SP. The Compressiometer: Toward a New Skin Tensiometer for Research and Surgical Planning. All Rights Reserved. your institution. This study sought to determine the directions of wound closure that would result in least wound ten-sion after skin lesion excisions. government site. Please try after some time. Recently, it has been questioned whether measurements of cadaveric skin can provide accurate representations of living skin tension lines [3,4]. Accessibility Wrinkle lines of the skin caused by the alignment of the elastic and collagen fiber systems of the skin. Aligning surgical incisions or excisions with these lines produces less tension, optimal scar formation, and ultimately a better cosmetic result. Revisiting the Skin Lines on the Forehead and Glabellar Area Relaxed Skin Tension Lines - ScienceDirect Results Biodynamic excisional skin tension lines have a clear directional preference: scalp-coronal direction, limbs--vertical orientation of ellipses and trunk - mostly horizontal except oblique at the shoulder and scapular regions. Three autopsy cases are reported to demonstrate once more how wound morphology may be altered by such factors. Curr Probl Dermatol. Differing depictions of "Langer's Lines" on the head and neck. 8600 Rockville Pike Pawlaczyk M, Lelonkiewicz M, Wieczorowski M. Postepy Dermatol Alergol. Lesions such as lipomas, which entail incisional rather than excisional surgery (i.e. Int J Leg Med 114:346348, Brinkmann B, Kleiber M (1978) Zur Morphologie von Schraubenzieher-Stichverletzungen. The best defined lines occur when the skin is pinched perpendicular to the line of optimum incision. Langer lines run in the direction of the underlying collagen fibers (least skin tension) and play an important diagnostic role for some exanthematous skin diseases. Nagle M, Price S, Trotta A, Destrade M, Fop M, N Annaidh A. Ann Biomed Eng. official website and that any information you provide is encrypted notes. Biodynamic Excisional Skin Tension (BEST) Lines: Revisiting Langer's Lines, Skin Biomechanics, Current Concepts in Cutaneous Surgery, and the (lack of) Science behind Skin Lines used for Surgical Excisions. Malgaigne confirmed these findings and observed from his experience as a surgeon that the retraction of wounds differed with the direction of incisions.3, Abyaneh MY, Griffith R, Falto-Aizpurua L, Nouri K. Famous Lines in History: Langer Lines. Epub 2013 Aug 27. doi: 10.1111/1523-1747.ep12468934. 2008;61(5):529-34. doi: 10.1016/j.bjps.2007.06.004. Br J Plast Surg 1978;31:93-106]. Four major groups of linear patterns can be distinguished: Langer lines, dermatomes, Blaschko lines and exogenous patterns. Skin tension lines essentially refer to the direction of maximal skin tension at different body sites. Small circular wounds are likely to shrink, not gape. Thirty-six differently named guidelines have developed as surgeons have searched for an ideal guide for elective incisions. Instead, skin lines have been used as surrogate indicators of tension vectors. In the remaining wounds the long axis of the wound rotated by up to 90 degrees . Andermahr J, Jubel A, Elsner A, Schulz-Algie PR, Schiffer G, Koebke J. Orthopade. They correspond to the natural orientation of collagen fibers in the dermis, and are generally parallel to the orientation of the underlying muscle fibers. You can read the full text of this article if you: David H. Song, M.D., M.B.A. is the President-elect of the American Society of Plastic Surgeons (ASPS). Langer Lines Historically used to determine optimal incision line Based on biopsy procedures on cadavers Worse cosmetic result than with Skin Tension Lines Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Relaxed Skin Tension Lines." Epub 2007 Jul 24. Materials and methods Full-Thickness Skin Graft according to Surrounding Relaxed Skin Tension Skin tension lines | DermNet Results: 2017 Dec 22;5(12):e1614. Isotopic response, Kbner phenomenon and Renbk phenomenon - PubMed Biodynamic excisional skin tension lines for surgical excisions This has not been helped by the (hitherto) lack of large in vivo biomechanical studies, and because incisional lines and excisional lines have not been considered separately in surgical practice. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. Int J Leg Med 114:267268, Bajanowski T, Khler H, Schmidt PF, von Saldern CF, Brinkmann B (2001b) The cloven hoof in legal medicine. All Rights Reserved, 2014;150(10):1087. doi:10.1001/jamadermatol.2014.659, Challenges in Clinical Electrocardiography, Clinical Implications of Basic Neuroscience, Health Care Economics, Insurance, Payment, Scientific Discovery and the Future of Medicine. J Plast Reconstr Aesthet Surg. Arnold, London, Schmidt U, Faller-Marquardt M, Tatschner T, Walter K, Pollak S (2004) Cuts to the offenders own handsunintentional self-infliction in the course of knife attacks. Yin C, Zhang S, Ya C, Wang C, Liang Y, Wang C. Acta Biochim Biophys Sin (Shanghai). Microsc Res Tech. Clipboard, Search History, and several other advanced features are temporarily unavailable.