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Tensile Strength vs Healing Time for Wounds Closed Under Tension

MAJ Bradley P. Pickett, MC; LTC Lawrence P. A. Burgess, MC; MAJ George H. Livermore, MC; Thomas L. Tzikas, MD; Jafar Vossoughi, PhD

Arch Otolaryngol Head Neck Surg. 1996;122(5):565-569.

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)

Author Affiliations
USA; USA; USA

From the Otolaryngology–Head and Neck Surgery Service, Walter Reed Army Medical Center, Washington, DC (Dr Pickett), Tripler Army Medical Center, Honolulu, Hawaii (Dr Burgess), and Winn Army Hospital, Fort Stewart, Ga (Dr Livermore); and Engineering Resource Center, University of the District of Columbia, Washington (Dr Vossoughi). Dr Tzikas is in private practice, Thessaloniki, Greece. Dr Pickett is now with the Hearing Institute for Children and Adults, San Jose, Calif.

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