title: A surgical simulation system of skin sutures using a three-dimensional finite element method.
abstract: OBJECTIVE
  To establish a surgical simulation system of skin sutures using a three-dimensional finite element method.
  
  
  METHODS
  Three-dimensional finite element models were developed from point data obtained with a rapid three-dimensional surface-measuring device and postoperative profiles were evaluated using these models.
  
  
  BACKGROUND
  Since suturing a wound may result in undesirable skin extrusion, it is important to make the extrusion as inconspicuous as possible. We have investigated a means of determining appropriate suture methods to decrease the extrusion.
  
  
  METHODS
  Affected body parts were measured non-invasively with a rapid three-dimensional surface-measuring device. Finite element models were prepared, and an appropriate method for reducing skin extrusion was evaluated by attempting various suturing methods.
  
  
  RESULTS
  Two kinds of finite element models were prepared: a conventional spindle model and a modified S-shape model. The height of the extrusion of the modified S-shape model was decreased by 40% in comparison with that of the spindle model. These results agreed with clinical findings.
  
  
  CONCLUSIONS
  Due to this surgical simulation system of skin sutures, with a rapid three-dimensional surface-measuring device and three-dimensional finite element analysis, it was possible to design an appropriate suturing method and to evaluate the postoperative skin profiles. The modified S-shape suture method would be a recommendable method.
  
  
  CONCLUSIONS
  Using this surgical simulation system of skin sutures, a surgeon can evaluate an appropriate suturing method before operation. It is expected that this system will reduce a surgeon's labor.
authors.affiliation: Department of Medical Simulation Engineering, Institute for Frontier Medical Sciences, Kyoto University, 53 Kawahara-cho Shogoin Sakyo-ku, 606-8507, Kyoto, Japan. yoshida@frontier.kyoto-u.ac.jp
authors.forename: H
authors.initials: H
authors.lastname: Yoshida
authors.forename: S
authors.initials: S
authors.lastname: Tsutsumi
authors.forename: M
authors.initials: M
authors.lastname: Mizunuma
authors.forename: A
authors.initials: A
authors.lastname: Yanai
mesh_terms: D003198:Computer Simulation; D062109:Dermatologic Surgical Procedures; D004954:Esthetics; D020342:Finite Element Analysis; D006801:Humans; D021621:Imaging, Three-Dimensional; D008954:Models, Biological; D013536:Suture Techniques