OPTIMAL PATTERNS FOR SUTURING WOUNDS

A mathematical model for computing stresses in sutured human skin woun ds is presented. The model uses the incremental law of elasticity and elastic constants valid for in vivo orthotropic skin. The model is app lied to compute the principal stress and displacements resulting from suturing small elliptical and circular wounds in a large Bat sheet of skin, in order to determine the optimal suturing patterns. It is obser ved that the average stress index for a circular wound sutured toward the center is almost double that of a wound sutured transverse to the diameter. Thus, the latter type of suturing pattern is preferable. Sim ilarly, suturing an elliptical wound transversely produces a lower ave rage stress index than a circular wound of the same area. It is also f ound that the optimal ratio of semi-major to semi-minor axis of an ell iptical wound is near 3 (for abdominal wounds), i.e., this ratio produ ces the most uniform stresses along the wound edges, where wound heali ng is slowest. Since high stresses have adverse effects on healing and blood flow, this work, depicting regions of high stresses, may be use d along with other biological factors to help predict regions of slowe r healing in sutured wounds. (C) 1998 Elsevier Science Ltd. All rights reserved.