Jun 21 • General discussion
Skin incision
Langer's lines and BEST (Biodynamic Excisional Skin Tension) lines are both related to skin tension and surgical incisions, but they differ in their origins and applications. Langer's lines, based on cadaver studies, indicate the direction of collagen fiber orientation and are often used as a guide for incisions. BEST lines, on the other hand, are determined by measuring skin tension in living individuals during surgery and are considered more accurate for guiding excisions.
Here's a more detailed breakdown:
Langer's Lines:
Origin:
Determined by Karl Langer in the 19th century by studying how cadavers' skin split when struck with a spike.
Characteristics:
Represent the orientation of collagen fibers in the skin.
Application:
Traditionally used as a guide for surgical incisions, especially in facial surgery.
Limitations:
Not always accurate for excisions, especially those involving deeper tissue or larger wounds.
BEST Lines:
Origin:
Identified by a modern study measuring skin tension in living subjects during surgical excisions.
Characteristics:
Reflects the actual tension in the skin during movement and is considered more accurate for guiding excisions.
Application:
Recommended for guiding excisions, especially in the lower limbs and other areas where wound closure tension is a concern.
Advantages:
Reduces wound closure tension and promotes better healing compared to using Langer's lines for excisions.
Key Differences:
Static vs. Dynamic:
Langer's lines are static, based on cadaver studies, while BEST lines are dynamic, based on measurements in living individuals.
Incision vs. Excision:
Langer's lines are more suitable for incisions, while BEST lines are recommended for excisions, particularly in areas with high tension.
Accuracy:
BEST lines are considered more accurate for guiding excisions, leading to less wound tension and better healing.
In essence, while Langer's lines are a historical landmark, BEST lines represent a more modern and practical approach to surgical planning, particularly for excisions.
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Skin incision
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