Numerical analysis of the V-Y shaped advancement flap.
The V-Y advancement flap is a usual technique for the closure of skin defects. A triangular flap is incised adjacent to a skin defect of rectangular shape. As the flap is advanced to close the initial defect, two smaller defects in the shape of a parallelogram are formed with respect to a reflection symmetry. The height of the defects depends on the apex angle of the flap and the closure efforts are related to the defects height. Andrades et al. 2005 have performed a geometrical analysis of the V-Y flap technique in order to reach a compromise between the flap size and the defects width. However, the geometrical approach does not consider the mechanical properties of the skin. The present analysis based on the finite element method is proposed as a complement to the geometrical one. This analysis aims to highlight the major role of the skin elasticity for a full analysis of the V-Y advancement flap. Furthermore, the study of this technique shows that closing at the flap apex seems mechanically the most interesting step. Thus different strategies of defect closure at the flap apex stemming from surgeon's know-how have been tested by numerical simulations.
University of Franche-Comté, 1 rue Claude Goudimel, Besançon Cedex 25030, France; Department of Applied Mechanics, FEMTO-ST Institute, CNRS UMR 6174, 24 rue de l'Épitaphe, Besançon 25000, France; University Bourgogne Franche-Comté (UBFC), France. Electronic address: dj.remache@gmail.com.
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Remache
University of Franche-Comté, 1 rue Claude Goudimel, Besançon Cedex 25030, France; Department of Applied Mechanics, FEMTO-ST Institute, CNRS UMR 6174, 24 rue de l'Épitaphe, Besançon 25000, France; University Bourgogne Franche-Comté (UBFC), France. Electronic address: jerome.chambert@univ-fcomte.fr.
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Chambert
University of Franche-Comté, 1 rue Claude Goudimel, Besançon Cedex 25030, France; Orthopedic, Traumatology, Aesthetic, Plastic, Reconstructive and Hand Surgery Unit, University Hospital of Besançon, 3 bd Alexandre Fleming, Besançon 25030, France; Research Unit, EA 4268 I4S IFR 133 INSERM, Besançon 25030, France. Electronic address: julien.pauchot@gmail.com.
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Pauchot
University of Franche-Comté, 1 rue Claude Goudimel, Besançon Cedex 25030, France; Department of Applied Mechanics, FEMTO-ST Institute, CNRS UMR 6174, 24 rue de l'Épitaphe, Besançon 25000, France; University Bourgogne Franche-Comté (UBFC), France. Electronic address: emmanuelle.jacquet@univ-fcomte.fr.
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Jacquet
D003198:Computer Simulation; D062109:Dermatologic Surgical Procedures; D004548:Elasticity; D020342:Finite Element Analysis; D006801:Humans; D008954:Models, Biological; D012879:Skin Physiological Phenomena; D013524:Surgical Flaps
Finite element method; Human skin; Hyperelasticity; V-Y advancement flap