The effect of mechanical stress on healing skin wounds: an experimental study in rabbits using tissue expansion

In rabbits, skin wounds were expanded by inflation of a subcutaneously implanted tissue expander in order to study the effect of mechanical stress on wound healing. Biomechanical and histomorphological properties of both expanded and non-expanded control wounds were evaluated. Expanded wounds demonstrated a significant increase in maximum load (80%) and energy absorption at maximum load (95%), when compared to non-expanded control wounds. Histomorphologically, the expanded wounds were stretched in comparison to the control wounds. The collagen in expanded wounds showed an orientation parallel to the direction of force, and displayed a more organised configuration. It is concluded that the use of tissue expanders permits the standardisation of the mechanical stress applied to experimental skin wounds. It is found that mechanical stress accelerates wound healing by producing stronger and more organised scars, however, at the expense of scar stretching. © 1991 The Trustees of British Association of Plastic Surgeons. All rights reserved.