Computational modelling of wound healing insights to develop new treatments

About 1% of the population will suffer a severe wound during their life. Thus, it is really important to develop new techniques in order to properly treat these injuries due to the high socioeconomically impact they suppose. Skin substitutes and pressure based therapies are currently the most promising techniques to heal these injuries. Nevertheless, we are still far from finding a definitive skin substitute for the treatment of all chronic wounds. As a first step in developing new tissue engineering tools and treatment techniques for wound healing, in silico models could help in understanding the mechanisms and factors implicated in wound healing. Here, we review mathematical models of wound healing. These models include different tissue and cell types involved in healing, as well as biochemical and mechanical factors which determine this process. Special attention is paid to the contraction mechanism of cells as an answer to the tissue mechanical state. Other cell processes such as differentiation and proliferation are also included in the models together with extracellular matrix production. The results obtained show the dependency of the success of wound healing on tissue composition and the importance of the different biomechanical and biochemical factors. This could help to individuate the adequate concentration of growth factors to accelerate healing and also the best mechanical properties of the new skin substitute depending on the wound location in the body and its size and shape. Thus, the feedback loop of computational models, experimental works and tissue engineering could help to identify the key features in the design of new treatments to heal severe wounds

Tension lines of the skin

Skin tension lines are natural lines of tension that occur within the skin as a result of growth and remodeling mechanisms. Researchers have been aware of their existence and their surgical implications for over 150 years. Research in the twentieth century showed clearly, through destructive mechanical testing, that the orientation of skin tension lines greatly affects the mechanical response of skin in situ. More recent work has determined that this anisotropic response is, at least in part, due to the structural arrangement of collagen fibres within the dermis. This observation can be incorporated into mathematical and mechanical models using the popular Gasser-Ogden-Holzapfel constitutive equation. Advances in non-invasive measurement techniques for the skin, such as those based on elastic wave propagation, have enabled patient-specific identification of skin tension lines in an accurate and rapid manner. Using this technique on humans, we show that there is considerable variation in the level of anisotropy as the skin ages. Furthermore, we identify that both the structural arrangement of fibres and the in vivo levels of pre-strain play a significant role in the anisotropic behavior of skin.Peer reviewed2021-05-2

Tension lines of the skin

Skin tension lines are natural lines of tension that occur within the skin as a result of growth and remodeling mechanisms. Researchers have been aware of their existence and their surgical implications for over 150 years. Research in the twentieth century showed clearly, through destructive mechanical testing, that the orientation of skin tension lines greatly affects the mechanical response of skin in situ. More recent work has determined that this anisotropic response is, at least in part, due to the structural arrangement of collagen fibres within the dermis. This observation can be incorporated into mathematical and mechanical models using the popular Gasser-Ogden-Holzapfel constitutive equation. Advances in non-invasive measurement techniques for the skin, such as those based on elastic wave propagation, have enabled patient-specific identification of skin tension lines in an accurate and rapid manner. Using this technique on humans, we show that there is considerable variation in the level of anisotropy as the skin ages. Furthermore, we identify that both the structural arrangement of fibres and the in vivo levels of pre-strain play a significant role in the anisotropic behavior of skin.Peer reviewed2021-05-2