Dynamic mechanical testing of human skin 'in vivo'

An open source pipeline for design of experiments for hyperelastic models of the skin with applications to keloids

The aim of this work is to characterize the mechanical parameters governing the in-plane behavior of human skin and, in particular, of a keloid-scar. We consider 2D hyperelastic bi-material model of a keloid and the surrounding healthy skin. The problem of finding the optimal model parameters that minimize the misfit between the model observations and the in vivo experimental measurements is solved using our in-house developed inverse solver that is based on the FEniCS finite element computational platform. The paper focuses on the model parameter sensitivity quantification with respect to the experimental measurements, such as the displacement field and reaction force measurements. The developed tools quantify the significance of different measurements on different model parameters and, in turn, give insight into a given model's ability to capture experimental measurements. Finally, an a priori estimate for the model parameter sensitivity is proposed that is independent of the actual measurements and that is defined in the whole computational domain. This estimate is primarily useful for the design of experiments, specifically, in localizing the optimal displacement field measurement sites for the maximum impact on model parameter inference.

Tensile behavior and structural characterization of pig dermis

Skin, the outermost layer of the body, fulfills a broad range of functions, protecting internal organs from damage and infection, while regulating the body's temperature and water content via the exchange of heat and fluids. It must be able to withstand and recover from extensive deformation and damage that can occur during growth, movement, and potential injuries. A detailed investigation of the evolution of the collagen architecture of the dermis as a function of deformation is conducted, which reveals new aspects that help us to understand the mechanical response of skin. Juvenile pig is used as a model material because of its similarity to human skin. The dermis is found to have a tridimensional woven structure of collagen fibers, which evolves with deformation. After failure, we observe that the fibers have straightened and aligned in the direction of tension. The effects of strain-rate change, cyclic loading, stress relaxation, and orientation are quantitatively established. Digital image correlation techniques are implemented to quantify skin's anisotropy; measurements of the Poisson ratio are reported. This is coupled with transmission electron microscopy which enables obtaining quantitative strain parameters evaluated through the orientation and curvature of the collagen fibers and their changes, for the first time in all three dimensions of the tissue. A model experiment using braided human hair in tension exhibits a similar J-curve response to skin, and we propose that this fiber configuration is at least partially responsible for the monotonic increase of the tangent modulus of skin with strain. The obtained results are intended to serve as a basis for structurally-based models of skin. STATEMENT OF SIGNIFICANCE: Our study reveals a new aspect of the dermis: it is comprised of a tridimensional woven structure of collagen fibers, which evolves with deformation. This is enabled by primarily two techniques, transmission electron microscopy on three perpendicular planes and confocal images with second harmonic generation fluorescence of collagen, captured at different intervals of depth. After failure, the fibers have straightened and aligned in the direction of tension. Digital image correlation techniques are implemented to quantify skin's anisotropy; measurements of the Poisson ratio are reported. A model experiment using braided human hair in tension exhibits a similar J-curve response to skin, and we propose that this fiber configuration is at least partially responsible for the monotonic increase of the tangent modulus of skin with strain.

Surface deformation tracking and modelling of soft materials

Many computer vision algorithms have been presented to track surface deformations, but few have provided a direct comparison of measurements with other stereoscopic approaches and physics-based models. We have previously developed a phase-based cross-correlation algorithm to track dense distributions of displacements over three-dimensional surfaces. In the present work, we compare this algorithm with one that uses an independent tracking system, derived from an array of fluorescent microspheres. A smooth bicubic Hermite mesh was fitted to deformations obtained from the phase-based cross-correlation data. This mesh was then used to estimate the microsphere locations, which were compared to stereo reconstructions of the microsphere positions. The method was applied to a 35 mm × 35 mm × 35 mm soft silicone gel cube under indentation, with three square bands of microspheres placed around the indenter tip. At an indentation depth of 4.5 mm, the root-mean-square (RMS) differences between the reconstructed positions of the microspheres and their identified positions for the inner, middle, and outer bands were 60 µm, 20 µm, and 19 µm, respectively. The usefulness of the strain-tracking data for physics-based finite element modelling of large deformation mechanics was then demonstrated by estimating a neo-Hookean stiffness parameter for the gel. At the optimal constitutive parameter estimate, the RMS difference between the measured microsphere positions and their finite element model-predicted locations was 143 µm.

Making a point: shared mechanics underlying the diversity of biological puncture

A viper injecting venom into a target, a mantis shrimp harpooning a fish, a cactus dispersing itself via spines attaching to passing mammals; all these are examples of biological puncture. Although disparate in terms of materials, kinematics and phylogeny, all three examples must adhere to the same set of fundamental physical laws that govern puncture mechanics. The diversity of biological puncture systems is a good case study for how physical laws can be used as a baseline for comparing disparate biological systems. In this Review, I explore the diversity of biological puncture and identify key variables that influence these systems. First, I explore recent work on biological puncture in a diversity of organisms, based on their hypothesized objectives: gripping, injection, damage and defence. Variation within each category is discussed, such as the differences between gripping for prey capture, gripping for dispersal of materials or gripping during reproduction. The second half of the Review is focused on specific physical parameters that influence puncture mechanics, such as material properties, stress, energy, speed and the medium within which puncture occurs. I focus on how these parameters have been examined in biology, and how they influence the evolution of biological systems. The ultimate objective of this Review is to outline an initial framework for examining the mechanics and evolution of puncture systems across biology. This framework will not only allow for broad biological comparisons, but also create a baseline for bioinspired design of both tools that puncture efficiently and materials that can resist puncture.

Biomechanical Modeling of Human Skin Tissue Surrogates

Surrogates, which precisely simulate nonlinear mechanical properties of the human skin at different body sites, would be indispensable for biomechanical testing applications, such as estimating the accurate load response of skin implants and prosthetics to study the biomechanics of static and dynamic loading conditions on the skin, dermatological and sports injuries, and estimating the dynamic load response of lethal and nonlethal ballistics. To date, human skin surrogates have been developed mainly with materials, such as gelatin and polydimethylsiloxane (PDMS), based on assumption of simplified mechanical properties, such as an average elastic modulus (estimated through indentation tests), and Poisson’s ratio. In addition, pigskin and cowhides, which have widely varying mechanical properties, have been used to simulate human skin. In the current work, a novel elastomer-based material system is developed, which precisely mimics the nonlinear stress–stretch behavior, elastic modulus at high and low strains, and fracture strengths of the natural human skin at different body sites. The manufacturing and fabrication process of these skin surrogates are discussed, and mechanical testing results are presented.

Quantification of gravity-induced skin strain across the breast surface

BACKGROUND

Quantification of the magnitude of skin strain in different regions of the breast may help to estimate possible gravity-induced damage whilst also being able to inform the selection of incision locations during breast surgery. The aim of this study was to quantify static skin strain over the breast surface and to estimate the risk of skin damage caused by gravitational loading.

METHODS

Fourteen participants had 21 markers applied to their torso and left breast. The non-gravity breast position was estimated as the mid-point of the breast positions in water and soybean oil (higher and lower density than breast respectively). The static gravity-loaded breast position was also measured. Skin strain was calculated as the percentage extension between adjacent breast markers in the gravity and non-gravity loaded conditions.

FINDINGS

Gravity induced breast deformation caused peak strains ranging from 14 to 75% across participants, with potentially damaging skin strain (>60%) in one participant and skin strains above 30% (skin resistance zone) in a further four participants. These peak strain values all occurred in the longitudinal direction in the upper region of the breast skin. In the latitudinal direction, smaller-breasted participants experienced greater strain on the outer (lateral) breast regions and less strain on the inner (medial) breast regions, a trend which was reversed in the larger breasted participants (above size 34D).

INTERPRETATION

To reduce tension on surgical incisions it is suggested that preference should be given to medial latitudinal locations for smaller breasted women and lateral latitudinal locations for larger breasted women.

Multidirectional In Vivo Characterization of Skin Using Wiener Nonlinear Stochastic System Identification Techniques

A triaxial force-sensitive microrobot was developed to dynamically perturb skin in multiple deformation modes, in vivo. Wiener static nonlinear identification was used to extract the linear dynamics and static nonlinearity of the force-displacement behavior of skin. Stochastic input forces were applied to the volar forearm and thenar eminence of the hand, producing probe tip perturbations in indentation and tangential extension. Wiener static nonlinear approaches reproduced the resulting displacements with variances accounted for (VAF) ranging 94-97%, indicating a good fit to the data. These approaches provided VAF improvements of 0.1-3.4% over linear models. Thenar eminence stiffness measures were approximately twice those measured on the forearm. Damping was shown to be significantly higher on the palm, whereas the perturbed mass typically was lower. Coefficients of variation (CVs) for nonlinear parameters were assessed within and across individuals. Individual CVs ranged from 2% to 11% for indentation and from 2% to 19% for extension. Stochastic perturbations with incrementally increasing mean amplitudes were applied to the same test areas. Differences between full-scale and incremental reduced-scale perturbations were investigated. Different incremental preloading schemes were investigated. However, no significant difference in parameters was found between different incremental preloading schemes. Incremental schemes provided depth-dependent estimates of stiffness and damping, ranging from 300 N/m and 2 Ns/m, respectively, at the surface to 5 kN/m and 50 Ns/m at greater depths. The device and techniques used in this research have potential applications in areas, such as evaluating skincare products, assessing skin hydration, or analyzing wound healing.

Computational and experimental characterization of skin mechanics: identifying current challenges and future directions

The characterization of skin mechanics has many clinical implications and has been an active area of research for the past few decades. Biomechanical models have evolved from earlier empirical models to state-of-the-art structural models that provide linkage between tissue microstructure and macroscopic stress-strain response. To maximize the accuracy and predictive capabilities of such computational models, there is a need to reliably identify often a large number of unknown model parameters. This is critically dependent on the availability of experimental data that cover an extensive range of different deformation modes, and quantification of internal structural features, such as collagen orientation. To this end, future challenges should include the ongoing development of noninvasive instrumentation and imaging modalities for in vivo skin measurements. We highlight the important concept of tightly integrating computational models, instrumentation, and imaging modalities into a single platform to investigate skin biomechanics.

Skin wrinkling morphology changes suddenly in the early 30s

BACKGROUND/PURPOSE

Does the morphology of wrinkles alter gradually with aging or suddenly at a certain age? On the basis of the theoretic wrinkle simulation of ideal skin, we have suggested that the wrinkle morphology suddenly changes from stratum corneum wrinkling to epidermis wrinkling; the former induces shallow fine furrows, and the latter induces deep prominent wrinkles. To examine the existence of drastic change in wrinkling morphology, we developed a new measurement system for facial skin wrinkling test.

METHODS

The mechanical compression test of facial skin was carried out for 102 Japanese women aged 25-56 years. The test was performed on the right temple area skin, and the area of wrinkles induced by the compression was measured using a digital video camera. The rate of increase in wrinkle area during compression was defined as the skin wrinkling rate, and it was calculated for all subjects automatically by image processing.

RESULTS

The test results showed that the skin wrinkling rate underwent a step increase at the age 33, which means that the wrinkling morphologies of young and old skins are completely different, and so it changes suddenly in the early 30s.

CONCLUSION

A new skin measurement system was developed to validate our theory of wrinkle formation mechanism with aging. The results demonstrated the wrinkling morphology changes suddenly at early 30s.

Rotational Skin Stretch Feedback: A Wearable Haptic Display for Motion

We present a wearable haptic feedback device that imparts rotational skin stretch to the hairy skin, along with the results of psychophysical tests to determine its resolution and accuracy for motion display. Tracking experiments with visual markers reveal the pattern of skin motion and strain imparted by the device, confirming subjective impressions that the design represents a trade-off between perception at low stimulus levels and comfort at maximum stimulus levels. In an isolated environment, users were able to discriminate between different rotational displacements of stretch within two to five degrees, depending on the reference stimulus. In a more realistic setting, subjects were able to use feedback from the device to control the positioning of a virtual object within six degrees or ±6.5 degrees of the total range of motion. When subjects were passive and exposed to arbitrary rotations of the device, the accuracy was poorer, although it improved with training. The results suggest that wearable skin stretch devices can be an effective means of providing feedback about a user's controlled joint or limb motions for motion training and similar applications.

Tissue elasticity and the ageing elastic fibre

The ability of elastic tissues to deform under physiological forces and to subsequently release stored energy to drive passive recoil is vital to the function of many dynamic tissues. Within vertebrates, elastic fibres allow arteries and lungs to expand and contract, thus controlling variations in blood pressure and returning the pulmonary system to a resting state. Elastic fibres are composite structures composed of a cross-linked elastin core and an outer layer of fibrillin microfibrils. These two components perform distinct roles; elastin stores energy and drives passive recoil, whilst fibrillin microfibrils direct elastogenesis, mediate cell signalling, maintain tissue homeostasis via TGFβ sequestration and potentially act to reinforce the elastic fibre. In many tissues reduced elasticity, as a result of compromised elastic fibre function, becomes increasingly prevalent with age and contributes significantly to the burden of human morbidity and mortality. This review considers how the unique molecular structure, tissue distribution and longevity of elastic fibres pre-disposes these abundant extracellular matrix structures to the accumulation of damage in ageing dermal, pulmonary and vascular tissues. As compromised elasticity is a common feature of ageing dynamic tissues, the development of strategies to prevent, limit or reverse this loss of function will play a key role in reducing age-related morbidity and mortality.

Scar assessment tools: implications for current research

Scarring is considered a major medical problem that leads to cosmetic and functional sequelae. Scar tissue is clinically distinguished from normal skin by an aberrant color, rough surface texture, increased thickness (hypertrophy), occurrence of contraction, and firmness. Marked histologic differences are the change in dermal architecture and the presence of cells such as the myofibroblast. Many assessment tools are available for analysis of pathologic conditions of the skin; however, there is no general agreement as to the most appropriate tools for evaluation of scar tissue. This review critically discusses currently available objective measurement tools, subjective assessment tools, and potential devices that may be available in the future for scar assessment.

Effect of gel re-organization and tensional forces on alpha2beta1 integrin levels in dermal fibroblasts

Mechanical forces are known to play an important role in regulating cell function in a wide range of biological systems. This is of particular relevance to dermal fibroblast function, given that the skin is known to be held under an intrinsic natural tension. To understand more about the generation of force by dermal fibroblasts and their ability to respond to changes in it, we have studied the role of the beta1 integrin receptors expressed by dermal fibroblasts in their ability to generate tensional forces within a collagen type I matrix and the effect of altered tensional force on integrin expression by dermal fibroblasts. Using a purpose-built culture force monitor, function-blocking antibodies directed towards the beta1 receptors dramatically reduced the tensional forces generated by dermal fibroblasts in a 3D collagen I matrix. However, the specific involvement of alpha1 or alpha2 subunits could not be demonstrated. Analysis of cellular response demonstrated that cells isolated from contracting collagen gels expressed fourfold higher levels of alpha2 mRNA than cells isolated from fully restrained gels. The levels of beta1 messenger RNA were relatively unaffected by reductions in force. Cells exposed to single reductions in force, however, did not exhibit alterations in either alpha1 or beta1 mRNA levels. We propose, therefore that alpha2beta1 integrin receptor levels in dermal fibroblasts are not altered in response to single reductions of gel tension, but do change following a continual change in force and associated matrix re-organization

A silicon-based tactile sensor for finger-mounted applications

This paper presents a silicon-based force sensor packaged in a flexible package and describes the sensors performance on human subjects. The sensing element consists of a circular silicon diaphragm (200-micron thick with a 2-mm radius) over a 10-micron sealed cavity with a solid Torlon dome providing force-to-pressure transduction to the diaphragm. Two dome heights (0.5 and 1.5 mm) were compared. The sensor with the taller dome showed improved sensitivity. Dynamic calibration and tracking experiments are performed with the sensor mounted on the dominant thumb of five human subjects. Both force and loading direction are statistically significant (P < 0.05). Subject variability accounted for 8.7% of the variance, while loading direction accounted for 1.9% of the variance. Average errors for the tracking experiment range from-2.8 to 1.0 N and are subject dependent. Three out of four subjects showed increasing negative error with increasing load.

A method for determination of the anisotropic properties of biomembranes

A methodology was developed for potential determination of the anisotropic properties of biomembranes. This method is based on the theoretical discretization of a continuous membrane used for finite element analysis and the simultaneous measurement of the displacement of nodes on the surface of a membrane. From the given loads and measured nodal displacements, one can assemble the resulting stiffness matrix and approximate the material properties associated with the membrane. Mathematical estimations and computer simulations were performed to determine the perturbation of load and displacement errors on the resulting material properties. The results indicated that the material properties are particularly sensitive to displacement errors. The displacement measurements may require an accuracy of 20 microns for a 4 x 4 cm2 specimen. Significant inaccuracies occur close to the points of load application.

Constitutive equations for fibrous connective tissues

A general multiaxial theory for the constitutive relations in fibrous connective tissues is developed on the basis of microstructural and thermodynamic considerations. It is compatible with existing general material theories. In elastic tissues, the theory considers the strain-energy function to be the sum of strain-energies of the tissue's components. The stresses are derived from this strain-energy function. Viscoelastic constitutive relations are obtained in an analogous manner. Few examples are developed in detail. The results of the present strain-energy based theory are identical with those of the author's previous structural models (Lanir, 1979a, b) which are based on detailed equilibrium analysis. It turns out, however, that the analytical work involved in solving boundary value problems is considerably shorter if the present theory is used. The advantages of structural theories in avoiding ambiguity in material characterization and in offering an insight into the function, structure and mechanics of tissue components are discussed.

Directional variations of mechanical parameters in rat skin depending on maturation and age

Mechanical properties of rat back skin at low loads and at failure were studied in 2 directions, e.g., perpendicular and longitudinal to body axis beginning with early maturation (from 1 week onwards) until senescence (at 24 mo). Anisotropic behavior, known for human skin, has also been found in rats. Surprisingly, the changes due to maturation and aging were not the same for one area of skin regardless of the direction. Ultimate extension was more influenced by the aging process in samples perpendicular to the body axis than in those parallel to body axis. Elongation at zero load, that means load not measurable under the described conditions, was higher in the longitudinal samples than in the perpendicular ones in young and very old animals, whereas this difference was absent in mature animals. In contrast, ultimate load, tensile strength and modulus of elasticity were higher in perpendicular samples than in samples longitudinal to the body axis for young and very old, but not for mature animals. Elongation at low loads or low stresses shows a different pattern than at medium loads or medium stresses when both directions are compared. Apparently, elements contributing to the mechanical properties in the various directions are differently influenced by the maturation and aging processes. Moreover, the elements contributing to the changes at low loads react differently to the aging process from those responsible for the effects at medium and high loads.

Mechanical properties and Young's modulus of human skin in vivo

The mechanical properties of the in vivo dermis were measured by means of a torque applied to the skin. The resulting deformation of 2-6 degrees, including the immediate and delayed visco-elastic components, as well as the relaxation were measured, and the raw values corrected for a constant skin thickness. The experiment performed on 138 individuals from 3 to 89 years old revealed a diminished elasticity and stretchability after the age of 30, associated with an increase in the visco-elastic component. The Young's modulus doubles with age. The results are discussed in terms of the various models proposed to explain dermal structure.

The time-dependent mechanical properties of skin

The mechanical properties of the skin were investigated by applying a torsional deformation to a circumscribed area. Results of the tests indicate that the skin is nonlinear and time dependent. The dynamic response shows that the phase angle is insensitive to frequency below 1 Hz; the peak torque amplitude increases slowly above 0.004 Hz. A self-consistent description is presented utilizing continuous relaxation spectra. The technique describes the stress relaxation data and predicts the form of the dynamic response.