Langerʼs Lines: To Use or Not to Use
Thirty-six differently named guidelines have developed as surgeons have searched for an ideal guide for elective incisions. Many surgeons prefer Langer's lines. These lines were developed by Karl Langer, an anatomy professor, from cadavers in rigor mortis. However, Kraissl preferred lines oriented perpendicular to the action of the underlying muscles. Later, Borges described relaxed skin tension lines, which follow furrows formed when the skin is relaxed and are produced by pinching the skin. However, these are only guidelines; there are many contributors to the camouflaging of scars, including wrinkle and contour lines. Borges's and Kraissl's lines (not Langer's) may be the best guides for elective incisions of the face and body, respectively.
[Show abstract] [Hide abstract] ABSTRACT: With the advent of 3D technology in the design process, a tremendous amount of scanned data is available. However, it is difficult to trace the quantitative skin deformation of a designated location on the 3D body surface data during movement. Without identical landmarks or reflective markers, tracing the same reference points on the different body postures is not easy because of the complex shape change of the body. To find the least deformed location on the body, which is regarded as the optimal position of seams for the various lengths of functional compression pants, landmarks were directly marked on the skin of six subjects and scanned during knee joint flexion. Lines of non-extension (LoNE) and maximum stretch (LoMS) were searched for, both by tracing landmarks and newly drawn guidelines based on ratio division in various directions. Considering the waist as the anchoring position of the pants, holistic changes were quantified and visualized from the waistline in lengthwise and curvilinear deformation along the dermatomes of the lower body for various lengths of pants. Widthwise and unit area skin deformation data of the skin were also provided as guidelines for further use such as streamlined pants or design of other local wearing devices. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.0Comments 0Citations
- "Langer's lines tend to be parallel; however, they form discrete groups that intersect each other. Later, Willhelmi et al. (1999) reported that Langer's lines change with body posture. He suggested alternative guidelines for facial incisions called " Borges' relaxed skin tension lines (RSTLs), " and alternatives for body incisions called " Kraissl's wrinkle lines. "
[Show abstract] [Hide abstract] ABSTRACT: The ultimate goal of tissue engineered skin substitutes used for wound healing is to enhance the healing process. Skin is the largest organ that serves as an outer barrier at the interface between the body and its surrounding environment. Accordingly, it provides a protective barrier against microbial invasion and protects the body against mechanical, chemical, and thermal injury. The most common reason for loss of skin is burns in which a considerable area of skin can be injured without the possibility of tissue regeneration. In the past 30 years, great techniques have been developed to create substitutes that imitate human skin. Engineered cell-free as well as cell-containing skin substitutes provide a possible off-the-shelve solution to the problem of donor graft shortage. Tissue engineering (TE) is a concept whereby cells are taken from a patient, the number of cells is expanded in vitro, and then seeded into a scaffold. The seeded cells proliferate in scaffold and over a time from few days to months, new tissue is formed. Scaffolds are three-dimensional matrixes and act as a template for the regeneration of tissue. The ideal scaffolds must possess proper microstructures that enable the adherence, proliferation, and differentiation of cells. Moreover, it should have mechanical strength and biodegradability. The tissue-engineered skin substitutes serve as protection from fl uid loss and infection. In this entry, we deal with an overview of critical issues related to skin, wound healing, recent advancement in TE, fabrication techniques, and current method employed in aiding in skin regeneration.0Comments 0Citations
- "It also contains hair follicles, sweat glands, sebaceous glands, apocrine glands, and lymphatic and blood vessels. [15,16] "
[Show abstract] [Hide abstract] ABSTRACT: The pathogenesis and ideal treatment of keloid are still largely unknown, and it is essential to develop an objective assessment of keloid severity to evaluate the therapeutic response. We previously reported that our diffuse reflectance spectroscopy (DRS) system could assist clinicians in understanding the functional and structural condition of keloid scars. The purpose of this study was to understand clinical applicability of our DRS system on evaluating the scar severity and therapeutic response of keloid. We analyzed 228 spectral data from 71 subjects with keloid scars. The scars were classified into mild (0-3), moderate (4-7) and severe (8-11) according to the Vancouver scar scale. We found that as the severity of the scar increased, collagen concentration and water content increased, and the reduced scattering coefficient at 800 nm and oxygen saturation (SaO2) decreased. Using the DRS system, we found that collagen bundles aligned in a specific direction in keloid scars, but not in normal scars. Water content and SaO2 may be utilized as reliable parameters for evaluating the therapeutic response of keloid. In conclusion, the results obtained here suggest that the DRS has potential as an objective technique with which to evaluate keloid scar severity. In addition, it may be useful as a tool with which to track longitudinal response of scars in response to various therapeutic interventions.0Comments 2Citations
- "3(e), 5(e), 7(e), and 8(e) show that the V/P ratio of keloids are always significant higher than that of uninjured skin. In addition, based on the pioneering work of Karl Langer , the principal direction of collagen orientation is along Langer's lines, which may explain the V/P ratio of uninjured skin is close to 1, but not exactly equal to 1. It can be seen inFig. "