CAJ | 학술논문

目的探讨建立局部推进皮瓣的三维有限元模型,用以观测计算推进皮瓣手术后手术区域皮肤变形及应力分布情况,以供临床皮瓣设计参考.方法通过人体额部离体头皮的生物力学实验研究获取皮肤的生物力学参数,再利用三维有限元软件MSC Marc/Mentat 2005建立局部推进皮瓣的三维有限元模型,设计同一皮瓣修复不同面积的创面,模拟出皮瓣在不同的抻长比例下,观测手术区域术后皮肤组织的变形情况、相应的应力-应变分布情况.结果皮瓣推进后的抻长比例越大,术后手术区域的应力最大值也随之越大,但不符合线性规律.在不顾及皮瓣血运的条件下,理论上皮瓣抻长比例的最大限度可达到40%,若＞40%,皮肤应力将超过屈服极限.结论利用三维有限元方法及人体皮肤生物力学参数模拟分析推进皮瓣具有可行性,但其抻长比例应控制在40%范围内,以确保安全.
목적 탐토건립국부추진피판적삼유유한원모형,용이관측계산추진피판수술후수술구역피부변형급응력분포정황,이공림상피판설계삼고.방법 통과인체액부리체두피적생물역학실험연구획취피부적생물역학삼수,재이용삼유유한원연건MSC Marc/Mentat 2005건립국부추진피판적삼유유한원모형,설계동일피판수복불동면적적창면,모의출피판재불동적신장비례하,관측수술구역술후피부조직적변형정황、상응적응력-응변분포정황.결과 피판추진후적신장비례월대,술후수술구역적응력최대치야수지월대,단불부합선성규률.재불고급피판혈운적조건하,이론상피판신장비례적최대한도가체도40%,약＞40%,피부응력장초과굴복겁한.결론 이용삼유유한원방법급인체피부생물역학삼수모의분석추진피판구유가행성,단기신장비례응공제재40%범위내,이학보안전.
Objective To build three-dimensional (3-D) finite element models for local advancement skin flap, by which the post-operative local strain and local stress of skin were figured out to assist in the design of skin flap in clinic. Methods The biomechanical parameters of human forehead skin were obtained in vitro from biomechanical experiments. The 3-D finite element model of local advancement skin flap was set up by MSC Marc/Mentat 2005 (3-D finite element software). Six models were built with the same flap but different skin defects, to simulate post-operative local strain of skin and local stress of skin in different models. Results Post-operative local stress of skin increased with the skin flaps stretching, but the relationship between increase and stretching did not meet the linear rule. Skin flap was able to stretch to 40 % of its initial length in theory if we did not consider blood supply of it. When the skin flap stretched over 40 % of its initial length, the maximal stress could exceed the yield limit. Conclusion It is an effective and workable way to simulate local advancement skin flap using 3-Dfinite element model and biomechanical parameters of human skin. The stretch ratio of local advancement skin flap should be not over 40% for safety.