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Wound Healing: Tensile Strength vs Healing Time for Wounds Closed Under Tension

Wound Healing: Tensile Strength vs Healing Time for Wounds Closed Under Tension Abstract Objectives: To measure tensile strength of wounds closed with and without tension in rats, delineating the postoperative time interval when tensile strength is equal. To study patterns of growth in tensile strength. Design: Transverse incisions on the backs of control rats were closed with minimal tension. In experimental animals, after excision of skin from the back, wounds were closed with closing tensions in excess of 70 g. Animals were killed at designated healing intervals for tensile-strength testing of wounds. Subjects: One hundred Sprague-Dawley rats were divided into 5 groups, days 5, 7, 10, 14, and 21, with equal numbers of control and experimental animals in each group. Wounds from 94 animals were available for break-load testing. Intervention: Closing tensions were measured for transverse incisions on the backs of control animals before closure and after removal of 50 to 60 mm of skin from the backs of experimental animals. Results: Tensile strength was not significantly different on day 5. However, wounds closed under tension showed significantly higher tensile strength on days 7, 10, 14, and 21. Polynomial regression suggests a cubic relationship between healing time and tensile strength. Conclusions: Results suggest that tensile strength of wounds closed under tension exceeds that of tensionless wounds as early as day 7 following surgery. This study also illustrates the 2 periods of rapid increase in wound tensile strength that probably coincide with specific stages of wound healing.(Arch Otolaryngol Head Neck Surg. 1996;122:565-568) References 1. Borgstrom S, Sandblom P. Suture technique and wound healing . Ann Surg . 1939;38:934-945. 2. Levenson SM, Geever EF, Crowley LV, Oates JF, Berard CW, Rosen H. The healing of rat skin wounds . Ann Surg . 1965;161:293-308.Crossref 3. Morin G, Rand M, Burgess LPA, Vossoughi J, Graeber GM. Wound healing: relationship of wound closing tension to tensile strength in rats . Laryngoscope . 1989;99:783-788.Crossref 4. Sussman MD. Effect of increased tissue traction upon tensile strength of cutaneous incisions in rats . Proc Soc Exp Biol Med . 1966;123:38-41.Crossref 5. Beard CW, Woodward SC, Hermann JB, Pulaski EJ. Healing of incisional wounds in rats: the relationship of tensile strength and morphology to the normal skin tension lines . Ann Surg . 1964;159:260-270.Crossref 6. Watts GT. Wound shape and tissue tension in healing . Br J Surg . 1960;47: 555-561.Crossref 7. Glaser AA, Marangoni RD, Must JS, et al. Effect of storage and handling techniques on skin tissue properties . Ann N Y Acad Sci . 1966;136:441-453.Crossref 8. Vossoughi J. Thickness measurement for soft materials . Exp Technol . 1984; 8:32-33.Crossref 9. Thorngate S, Ferguson DJ. Effect of tension on healing of aponeurotic wounds . Surgery . 1958;44:619-624. 10. Brunius U, Ahran C. Healing of skin incisions during reduced tension of the wound area . Acta Chir Scand . 1969;135:383-390. 11. Mason ML, Allen HS. The rate of healing tendons . Ann Surg . 1941;113:424-459.Crossref 12. Myers MB, Cherry G, Heimburger S. Augmentation of wound tensile strength by early removal of sutures . Am J Surg . 1969;117:338-341.Crossref 13. Stryer L. Biochemistry . New York, NY: WH Freeman & Co; 1988:261-274. 14. Carrico TJ, Mehrhof Al, Cohen IK. Biology of wound healing . Surg Clin North Am . 1984;64:721-733. 15. Arem AJ, Madden JW. Effects of stress on healing wounds, I: intermittent noncyclical tension . J Surg Res . 1976;20:93-102.Crossref 16. Van Royen BJ, O'Driscoll SW, Dhert WJA, Salter RB. A comparison of the effects of immobilization and continuous passive motion on surgical wound healing in mature rabbits . Plast Reconstr Surg . 1986;78:360-366.Crossref 17. Douglas DM, Forrester JC, Ogilvie RR. Physical characteristics of collagen in the later stages of wound healing . Br J Surg . 1969;56:219-222.Crossref 18. Burgess LPA, Morin GV, Rand M, Vossoughi J, Hollinger JO. Wound healing: relationship of wound closing tension to scar width in rats . Arch Otolaryngol Head Neck Surg . 1990;116:798-802.Crossref 19. Madden JW, Peacock EE. Studies on the biology of collagen during wound healing, I: rate of collagen synthesis and deposition in cutaneous wounds of the rat . Surgery . 1968;64:288-295. 20. Peterson JM, Barbul A, Breslin RJ, Wasserkrug HL, Efron G. Significance of T-lymphocytes in wound healing . Surgery . 1987;102:300-305. 21. Barbul A, Shawe T, Rotter SM, Efron JE, Wasserkrug HL, Badawy SB. Wound healing in nude mice: a study on the regulatory role of lymphocytes in fibroplasia . Surgery . 1989;105:764-769. 22. Newberger B. Early postoperative walking . Surgery . 1943;13:692-695. 23. Stephens FO, Hunt TK, Dunphy JE. Study of traditional methods of care on the tensile strength of skin wounds in rats . Am J Surg . 1971;122:78-80.Crossref 24. Nilsson T. Abdominal wound repair: an experimental study of the wound healing mechanism in the rabbit . Dan Med Bull . 1983;30:394-407. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology - Head & Neck Surgery American Medical Association

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References (27)

Publisher
American Medical Association
Copyright
Copyright © 1996 American Medical Association. All Rights Reserved.
ISSN
0886-4470
eISSN
1538-361X
DOI
10.1001/archotol.1996.01890170097017
Publisher site
See Article on Publisher Site

Abstract

Abstract Objectives: To measure tensile strength of wounds closed with and without tension in rats, delineating the postoperative time interval when tensile strength is equal. To study patterns of growth in tensile strength. Design: Transverse incisions on the backs of control rats were closed with minimal tension. In experimental animals, after excision of skin from the back, wounds were closed with closing tensions in excess of 70 g. Animals were killed at designated healing intervals for tensile-strength testing of wounds. Subjects: One hundred Sprague-Dawley rats were divided into 5 groups, days 5, 7, 10, 14, and 21, with equal numbers of control and experimental animals in each group. Wounds from 94 animals were available for break-load testing. Intervention: Closing tensions were measured for transverse incisions on the backs of control animals before closure and after removal of 50 to 60 mm of skin from the backs of experimental animals. Results: Tensile strength was not significantly different on day 5. However, wounds closed under tension showed significantly higher tensile strength on days 7, 10, 14, and 21. Polynomial regression suggests a cubic relationship between healing time and tensile strength. Conclusions: Results suggest that tensile strength of wounds closed under tension exceeds that of tensionless wounds as early as day 7 following surgery. This study also illustrates the 2 periods of rapid increase in wound tensile strength that probably coincide with specific stages of wound healing.(Arch Otolaryngol Head Neck Surg. 1996;122:565-568) References 1. Borgstrom S, Sandblom P. Suture technique and wound healing . Ann Surg . 1939;38:934-945. 2. Levenson SM, Geever EF, Crowley LV, Oates JF, Berard CW, Rosen H. The healing of rat skin wounds . Ann Surg . 1965;161:293-308.Crossref 3. Morin G, Rand M, Burgess LPA, Vossoughi J, Graeber GM. Wound healing: relationship of wound closing tension to tensile strength in rats . Laryngoscope . 1989;99:783-788.Crossref 4. Sussman MD. Effect of increased tissue traction upon tensile strength of cutaneous incisions in rats . Proc Soc Exp Biol Med . 1966;123:38-41.Crossref 5. Beard CW, Woodward SC, Hermann JB, Pulaski EJ. Healing of incisional wounds in rats: the relationship of tensile strength and morphology to the normal skin tension lines . Ann Surg . 1964;159:260-270.Crossref 6. Watts GT. Wound shape and tissue tension in healing . Br J Surg . 1960;47: 555-561.Crossref 7. Glaser AA, Marangoni RD, Must JS, et al. Effect of storage and handling techniques on skin tissue properties . Ann N Y Acad Sci . 1966;136:441-453.Crossref 8. Vossoughi J. Thickness measurement for soft materials . Exp Technol . 1984; 8:32-33.Crossref 9. Thorngate S, Ferguson DJ. Effect of tension on healing of aponeurotic wounds . Surgery . 1958;44:619-624. 10. Brunius U, Ahran C. Healing of skin incisions during reduced tension of the wound area . Acta Chir Scand . 1969;135:383-390. 11. Mason ML, Allen HS. The rate of healing tendons . Ann Surg . 1941;113:424-459.Crossref 12. Myers MB, Cherry G, Heimburger S. Augmentation of wound tensile strength by early removal of sutures . Am J Surg . 1969;117:338-341.Crossref 13. Stryer L. Biochemistry . New York, NY: WH Freeman & Co; 1988:261-274. 14. Carrico TJ, Mehrhof Al, Cohen IK. Biology of wound healing . Surg Clin North Am . 1984;64:721-733. 15. Arem AJ, Madden JW. Effects of stress on healing wounds, I: intermittent noncyclical tension . J Surg Res . 1976;20:93-102.Crossref 16. Van Royen BJ, O'Driscoll SW, Dhert WJA, Salter RB. A comparison of the effects of immobilization and continuous passive motion on surgical wound healing in mature rabbits . Plast Reconstr Surg . 1986;78:360-366.Crossref 17. Douglas DM, Forrester JC, Ogilvie RR. Physical characteristics of collagen in the later stages of wound healing . Br J Surg . 1969;56:219-222.Crossref 18. Burgess LPA, Morin GV, Rand M, Vossoughi J, Hollinger JO. Wound healing: relationship of wound closing tension to scar width in rats . Arch Otolaryngol Head Neck Surg . 1990;116:798-802.Crossref 19. Madden JW, Peacock EE. Studies on the biology of collagen during wound healing, I: rate of collagen synthesis and deposition in cutaneous wounds of the rat . Surgery . 1968;64:288-295. 20. Peterson JM, Barbul A, Breslin RJ, Wasserkrug HL, Efron G. Significance of T-lymphocytes in wound healing . Surgery . 1987;102:300-305. 21. Barbul A, Shawe T, Rotter SM, Efron JE, Wasserkrug HL, Badawy SB. Wound healing in nude mice: a study on the regulatory role of lymphocytes in fibroplasia . Surgery . 1989;105:764-769. 22. Newberger B. Early postoperative walking . Surgery . 1943;13:692-695. 23. Stephens FO, Hunt TK, Dunphy JE. Study of traditional methods of care on the tensile strength of skin wounds in rats . Am J Surg . 1971;122:78-80.Crossref 24. Nilsson T. Abdominal wound repair: an experimental study of the wound healing mechanism in the rabbit . Dan Med Bull . 1983;30:394-407.

Journal

Archives of Otolaryngology - Head & Neck SurgeryAmerican Medical Association

Published: May 1, 1996

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