Week 5

Another week of office hours, surgeries, and lab work, another week of being immersed. This week I was able to observe a case that directly utilized engineering and mechanobiology concepts. Surgeries generate a wound whenever incisions are made, making wound closure a procedure that is common to almost all surgeries. It is important that the incision is closed properly so it can heal and aid in recovery. Plastic and reconstructive surgeons place emphasis on this part of the surgery to minimize scarring and preserve optimal function. Some procedures complicate or prevent wound closure, such as when a large void in tissue is created. In the case I observed, much of the tissue was necrotic and had to be debrided. Because of this, there wasn’t enough tissue left to suture and cover the wound. One common remedy to this issue is the use of skin grafts, in which tissue from another part of the body is grafted onto the defect site. However, this creates another wound at the donor site, and the graft itself may not survive. An alternative to this technique utilizes a device known as DermaClose. This device generates tension on tissue flaps that border the wound using wires attached to a stretch generator. The device is gradually tightened after being placed, increasing the strain that the tissue experiences. This strain prompts the tissue to stretch and expand, inducing increased cell proliferation, ECM deposition, and increased vascularity. Eventually the tissue will have expanded enough so that they can be sutured shut and completely cover the wound site. Additionally, the increased vascularity will aid in healing the incision site. Although this technique takes time, it avoids the need for a skin graft and the complications that may come with it. This is just one example of how engineering can draw on the underlying biology to create tools that can aid in healthcare.


Above: Image of DermaClose being used. Obtained from http://dermaclose.com/dermaclose-vs-vessel-loops/.