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A Journal on Otorhinolaryngology, Head and Neck Surgery,
Plastic Reconstructive Surgery, Otoneurosurgery
Indexed/Abstracted in: EMBASE, Scopus
Otorinolaringologia 1999 June;49(2):75-8
Quantitative efficacy of subgaleal disconnection in transposition of scalp flaps in plastic and reconstructing surgery
Raposio E., Panarese P., Cella A., Gualdi A., Caregnato P., Barabino P., Faggioni M., Renzi M., Santi P. L.
Università degli Studi - Genova Cattedra di Chirurgia Plastica e Ricostruttiva Istituto Nazionale per la Ricerca sul Cancro
Background. While to formulate an accurate preoperative planning when performing plastic surgery procedures the biomechanical properties of the soft-tissues involved should be always take into account, no study has yet been carried out regarding the tensionmetric peculiarities of the human scalp. The aim of the present study was to measure the load-elongation properties of the human scalp, in an attempt to characterize it through the constants of a stress-strain theory, thus providing plastic surgeons information needed to test the soundness of the various surgical techniques currently adopted as well as to better plan a reconstructive or aesthetic procedure on the scalp.
Methods. Data were collected by stepwise loading twenty scalp flaps, obtained by a reversed-Y scalp incision down to and through the galea aponeurotica, together with one-centimeter undermining, on the subgaleal layer, along both sides of the sagittal scalp incision.
Results. The tissue’s stress response to displacement was visualized as a three-phase characteristic. Initially linear (load range: 0 to 500 g), the scalp’s compliance gradually reduced (load range: 500 g to 1500 g) and eventually demonstrated an exponential stress-strain characteristic of rapidly increasing stiffness (load range: 1500 g to 5000 g). The Young’s modulus E was derived from the mean-values curve, and was found to be equal to 117.1 g/mm.
Conclusions. These data have practical implication for studying the effects of complex surgical closures on the one-dimensional stress distribution of the scalp, while allowing the use of analytical methods to predict the consequences of closure design in various plastic surgery procedures on the scalp.