The following skin diseases are aligned according to the tension lines of the skin. Unable to load your collection due to an error, Unable to load your delegates due to an error. Shear wave elastography-based skin assessment system for systemic sclerosis: a supplement or alternative to conventional ultrasound? Wang K, Wen D, Xu X, Zhao R, Jiang F, Yuan S, Zhang Y, Gao Y, Li Q. 8600 Rockville Pike Langer's lines, Langer lines of skin tension, or sometimes called cleavage lines, are topological lines drawn on a map of the human body. National Library of Medicine These lines run in the same direction as Langers lines in many areas of the body. FOIA Their course depends on the patient's age, nutritional status, general condition and anatomical peculiarities, if any. In the thoracodorsal region, the distribution of the . A skin graft can be performed faster than a local flap, and it has the advantage that it has less donor site morbidity and can be repeatedly implemented. Other articles in this journal by Albert F. Borges, M.D. Rechtsmedizin 1:131134, Bajanowski T, Karger B, Brinkmann B (2001a) Scratched pustule or gunshot wound? The orientation of the long axis of each wound, in relation to the previously marked vertical line, was measured with a goniometer with the volunteer at rest and holding their face in five standardised facial expressions: mouth open, smiling, eyes tightly shut, frowning and eyebrows raised. sharing sensitive information, make sure youre on a federal The aim was to measure the orientation of the long axis of the wound with the face at rest and subsequent rotation of the wound with facial movement. Malgaigne confirmed these findings and observed from his experience as a surgeon that the retraction of wounds differed with the direction of incisions.3, Abyaneh MY, Griffith R, Falto-Aizpurua L, Nouri K. Famous Lines in History: Langer Lines. Find out more here. The https:// ensures that you are connecting to the 2008;61(5):529-34. doi: 10.1016/j.bjps.2007.06.004. Rather, it is common that relaxed skin tension lines provide a guide for cosmetically pleasing surgical results. 2023 American Medical Association. Have comments about these notes? Rather, it is common that relaxed skin tension lines provide a guide for cosmetically pleasing surgical results. Langer lines run in the direction of the underlying collagen fibers (least skin tension) and play an important diagnostic role for some exanthematous skin diseases. You may be trying to access this site from a secured browser on the server. ABSTRACT OBJECTIVE There remains confusion between Langer's lines and wrinkle lines with respect to the optimal orientation of ellipti-cal excisions on the trunk. Revisiting the Skin Lines on the Forehead and Glabellar Area Bookshelf Pawlaczyk M, Lelonkiewicz M, Wieczorowski M. Postepy Dermatol Alergol. 2022 Mar;28(2):236-245. doi: 10.1111/srt.13116. Relaxed skin tension lines have been found to be more reliable than Langer's lines in assessing the optimum position for a cosmetic incision. Pulsenotes uses cookies. Langer's lines of skin tension are important only from a historical point of view. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). You can read the full text of this article if you: David H. Song, M.D., M.B.A. is the President-elect of the American Society of Plastic Surgeons (ASPS). This site needs JavaScript to work properly. Skin tension lines, also known as Langer's lines or lines of cleavage, are linear clefts in the skin that indicate the direction of orientation of the underlying collagen fibers. Dtsch Z Gerichtl Med 13:1627, Cox HT (1941) The cleavage lines of the skin. 1999 Jul;104(1):208-14. 2023 Mar 8;10:1132353. doi: 10.3389/fmolb.2023.1132353. Simon HK, Zempsky WT, Bruns TB, Sullivan KM. Twenty-nine wounds maintained the same orientation of distortion in all of the facial expressions. stretch) can be reduced by creating an incision parallel to relaxed skin tension lines. 8600 Rockville Pike When the skin is folded, the tension lines become clear. Full-Thickness Skin Graft according to Surrounding Relaxed Skin Tension Line Improves Scar Quality in Facial Defect Coverage: A Retrospective Comparative Study. Skin tension lines essentially refer to the direction of maximal skin tension at different body sites. Relaxed skin tension lines refer to furrows that are created when the skin is pinched and relaxed. In 1834, Dupuytren reported seeing a young man who had attempted to commit suicide by stabbing himself over the heart 3 times. 8600 Rockville Pike Epub 2023 May 19. Dermatology. PlasticSurgery.org/GetConnect. Interestingly, Karl Langer was not the first to describe the property of skin that leads to the lines he depicted, nor are these lines in common use today. may email you for journal alerts and information, but is committed Each line represents a different excision with no specific colour scheme, Biodynamic excisional skin tension lines mapped during study (posterior). This section has been translated automatically. Would you like email updates of new search results? The vessels pass vertically from the posterior humeral circumflex artery through the septa in the muscle to the overlying dermis rather than follow in an oblique course. Microsc Res Tech. National Library of Medicine The seven best known skin tension lines are presented. Anterior to pectoralis major, the skin is very mobile in relation to underlying muscle. HHS Vulnerability Disclosure, Help Relaxed skin tension lines (RSTL) versus other skin lines. Int J Leg Med 116:262266, DiMaio DJ, DiMaio VJM (1989) Forensic pathology. Skin tension lines commonly depicted in textbooks. by the American Society of Plastic Surgeons. This has not been helped by the (hitherto) lack of large in vivo biomechanical studies, and because incisional lines and excisional lines have not been considered separately in surgical practice. your institution. 2023 Apr 18;10:1167067. doi: 10.3389/fsurg.2023.1167067. Clipboard, Search History, and several other advanced features are temporarily unavailable. Biodynamic Excisional Skin Tension (BEST) Lines: Revisiting Langer's The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Materials and methods Some 1181 consecutive skin lesion excisions were investigated (age range 13-95 years, median 64 years) using a tensiometer to determine directions of least wound tension. Skin tension measurements of skin lines (relaxed skin tension lines (RSTL) versus BEST) and vertical closure (BEST) versus vertical closure with a parallel relaxing incision were undertaken and followed by statistical analyses utilizing the paired t test and the unpaired Student's t tests. Langer's Lines | SpringerLink After excision elliptical distortion was seen in 171 of the 175 wounds at rest. Langer's lines, Langer lines of skin tension, or sometimes called cleavage lines, are topological lines drawn on a map of the human body. eCollection 2017 Dec. Bush J, Ferguson MW, Mason T, McGrouther G. J Plast Reconstr Aesthet Surg. Closure was undertaken in the direction of least tension (biodynamic excisional skin tension line) and this was illustrated. Berry CE, Downer M Jr, Morgan AG, Griffin M, Liang NE, Kameni L, Laufey Parker JB, Guo J, Longaker MT, Wan DC. Evidence suggests that the facial musculature in cadavers is not always relaxed, as some cadavers . This study sought to determine the directions of wound closure that would result in least wound tension after skin lesion excisions. 2021 Oct 22;9:749492. doi: 10.3389/fbioe.2021.749492. In case 3, the effects of either cleavage lines or skin tension could be demonstrated on excised wounds from a 43-year-old man whose body had also been found in a river; tensile forces easily changed circular into slit-like wounds. Linear patterns of the skin and their dermatoses FOIA Keywords: Langer's lines; elective surgical incisions; plastic surgery; relaxed skin tension lines. official website and that any information you provide is encrypted Kraissl's lines - Wikipedia Consequently, on the head and face, relaxed skin tension lines become BEST lines, but this is not necessarily the case elsewhere, such as on the neck or lower limbs. Four major groups of linear patterns can be distinguished: Langer lines, dermatomes, Blaschko lines and exogenous patterns. Nevertheless, Langer did conduct extensive studies on human skin that remain as a scholarly body of work. By continuing to use our site, or clicking "Continue," you are agreeing to our, To register for email alerts, access free PDF, and more, Get unlimited access and a printable PDF ($40.00), 2023 American Medical Association. Relaxed skin tension lines have been found to be more reliable than Langer's lines in assessing the optimum position for a cosmetic incision. The author undertakes a detailed literature. Development of a maxillofacial virtual surgical system based on biomechanical parameters of facial soft tissue. Instead, skin lines have been used as surrogate indicators of tension vectors. Br J Plast Surg 1978;31:1-2]. The underlying convexities have the most influence on skin stress. A punch excision in . Philos Trans R Soc Lond B Biol Sci. Search Bing for all related images, Search other sites for 'Relaxed Skin Tension Lines', Skin Tension Lines followed during elective incision, Historically used to determine optimal incision line, Worse cosmetic result than with Skin Tension Lines. All Rights Reserved. Arnold, London, Schmidt U, Faller-Marquardt M, Tatschner T, Walter K, Pollak S (2004) Cuts to the offenders own handsunintentional self-infliction in the course of knife attacks. Clipboard, Search History, and several other advanced features are temporarily unavailable. They correspond to the natural orientation of collagen fibers in the dermis, and are generally parallel to the orientation of the underlying muscle fibers. Int J Leg Med 114:346348, Brinkmann B, Kleiber M (1978) Zur Morphologie von Schraubenzieher-Stichverletzungen. Epub 2009 Feb 20. Springer, Berlin Heidelberg New York, pp 187191, Karger B, Bratzke H, Gra H, Lasczkowski G, Lessig R, Monticelli F, Wiese J, Zweihoff RF (2004) Crossbow homicides. The https:// ensures that you are connecting to the Significant findings in basic science research have been translated into clinical applications. Bethesda, MD 20894, Web Policies Lesions such as lipomas, which entail incisional rather than excisional surgery (i.e. Finding the Optimal Surgical Incision Pattern-A Biomechanical Study. sharing sensitive information, make sure youre on a federal The conventional wisdom is that Langer identified the existence of skin tension lines in 1861. In the area of the joints, they take . in 1984 Broges described simple method to determine the Relaxed Skin Tension Lines (RSTL) by pinching skin and observing the formed furrows and ridges rather than furrows formed by. PubMed From the Department of Plastic and Reconstructive Surgery at the Fairfax Hospital. 2023 Jul 1;13(7):4405-4414. doi: 10.21037/qims-22-1267. Wolters Kluwer Health Scheepens KMJ, Marsidi N, Genders RE, Horeman-Franse T. IEEE J Transl Eng Health Med. the line connecting the two vertices of the ellipse) are aligned they are considered Langers lines. sncRNA changes induced by tension in hypertrophic scar. This process was repeated in all cases where body site and direction of closure was mapped. This study sought to determine the directions of wound closure that would result in least wound tension after skin lesion excisions. One hundred and seventy-five naevi were excised from the face and neck of 72 volunteers using circular dermal punch biopsies. He also noticed that these clefts had different orientations in different parts of the body.

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