How to Get that Skin to Stretch

How to get that skin to stretch

A certain amount of intrinsic tension is present in any wound. Tension becomes problematic when it prevents wound closure, stretches the skin so much that dermal circulation is compromised, or interferes with normal function of surrounding structures (such as the eyelids). The skin has inherent elasticity, collagen alignment and regenerative capacities that enable it to stretch in the short, medium and long term. The skin also has connections to the subcutaneous tissue. Undermining skin and dividing these connections allows force to be applied more selectively in the direction that skin mobilization is required. Relaxing incisions abolish selected opposing forces, enabling skin to move towards a deficit. Finally, skin stretching is opposed by cutaneous musculature and connective tissue, and division of these structures can enable flattening out of skin pouches and folds. A combination of skin mobilization, unfolding and skin stretching are used to close defects. […]