Influence of the V-Y advancement flap geometry on the wound closure maximal force

Abstract

International audienceIn clinical practice, the V-Y advancement flap is a widely used technique to cover human skin defect, which consists in incising; advancing and suturing a triangular flap adjacent to the base of a rectangular defect (see Figure 1a). A previous geometrical study of the V-Y flap technique allowed us to find a good compromise between the flap size and the defect width [1]. However, the geometrical approach does not consider the mechanical properties of the human skin by assuming rigid-body behaviour of the skin. The aim of the present paper deals with a numerical analysis as a complement to the geometrical one to highlight the major role of the skin elasticity in the V-Y advancement flap. A compromise between the size of the flap and the level of the closure force value has been found when varying the angle at the flap apex, noted . The sensitivity to the mechanical parameters makes the closure force dependent on the size to be covered. At the end, the successive actions of the surgeon are analyzed