Determining the Differential Effects of Stretch and Growth in Tissue-Expanded Skin: Combining Isogeometric Analysis and Continuum Mechanics in a Porcine Model.

BACKGROUND: The relative effects of skin growth and stretch during tissue expansion have not been studied. The authors use novel analytic techniques that allow calculation of these factors at any point of a skin patch. OBJECTIVE: The authors sought to determine how stretch and growth change with different expansion rates and to correlate these values with histologic and cellular changes in skin. MATERIALS AND METHODS: Two minipigs were implanted with a total of 5 tissue expanders under tattooed skin grids. One pig was expanded over 35 days and the second over 15 days. Isogeometric analysis allowed calculation of growth and stretch. Expanders with similar total deformation were compared between protocols. Regression analysis determined predictive effects of stretch and growth on histologic data from the second animal. RESULTS: Deformation was more attributable to stretch in rapid than in slow expansion (1.40 vs1.12, p

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