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Article(id=1246046392255365385, tenantId=1146029695717560320, journalId=1241755870837649424, issueId=1246046388547596731, articleNumber=null, orderNo=null, doi=10.19636/j.cnki.cjsm42-1250/o3.2024.042, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1725552000000, receivedDateStr=2024-09-06, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1775010210336, onlineDateStr=2026-04-01, pubDate=1735056000000, pubDateStr=2024-12-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1775010210336, onlineIssueDateStr=2026-04-01, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1775010210336, creator=13701087609, updateTime=1775010210336, updator=13701087609, issue=Issue{id=1246046388547596731, tenantId=1146029695717560320, journalId=1241755870837649424, year='2024', volume='45', issue='6', pageStart='709', pageEnd='856', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1775010209451, creator=13701087609, updateTime=1775010293319, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1246046740390986227, tenantId=1146029695717560320, journalId=1241755870837649424, issueId=1246046388547596731, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1246046740390986228, tenantId=1146029695717560320, journalId=1241755870837649424, issueId=1246046388547596731, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=795, endPage=807, ext={EN=ArticleExt(id=1246046392498635019, articleId=1246046392255365385, tenantId=1146029695717560320, journalId=1241755870837649424, language=EN, title=Study on Plane Tensile Properties of Skin Suturing Interfaces with Structural Parameterization, columnId=1244229834482757770, journalTitle=Chinese Journal of Solid Mechanics, columnName=Research Paper, runingTitle=null, highlight=null, articleAbstract=

This study examines the tensile properties of skin suturing interfaces created through a silica gel reverse molding process, focusing on the reliability of clinical adhesive properties post-suturing. Four types of skin suturing interfaces, inspired by natural bionic structures, are designed, with primary attention on their tensile stiffness. An equivalent mechanical model is constructed using mechanical theories of suturing interfaces, and a theoretical model is developed to predict the tensile stiffness of each structure. Numerical simulations and physical experiments are conducted to analyze the brittle failure behavior and tensile failure modes of the suturing structures. The influences of shape factor, tooth tip angle, and tip region on the tensile properties of the interface are thoroughly investigated. A parameter mapping model using tensile strength as the evaluation index is constructed for each sensitive factor. It is found that the skin suturing interface exhibits brittle failure behavior, with the zigzag structure showing significantly higher tensile stiffness compared to other suturing structures. As the tooth tip angle increases, the stiffness of the suturing structure decreases, while the tip area enhances the tensile properties of the interface. These results are anticipated to help improve skin wound healing rate after clinical suturing.

, correspAuthors=Xiaogang Ji, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, authorCompany=null, fund=null, authors=null, authorsList=Linlong Xu, Xiaogang Ji, Huabin Li, Hao Jiang), CN=ArticleExt(id=1246046406348227017, articleId=1246046392255365385, tenantId=1146029695717560320, journalId=1241755870837649424, language=CN, title=结构参数化皮肤缝合界面的平面抗拉性能研究, columnId=1241831201896469478, journalTitle=固体力学学报, columnName=研究论文, runingTitle=null, highlight=null, articleAbstract=

针对临床医用粘合剂缝合皮肤创面后缝合伤口抗拉能力的可靠性问题，开展了硅胶倒模成形工艺制备的皮肤缝合界面抗拉性能研究. 以四种类型缝合结构的拉伸刚度研究为主线，利用缝合界面力学理论对皮肤界面构建等效力学模型，得到预测拉伸刚度的数学模型. 结合数值模拟和物理实验，聚焦分析了皮肤缝合结构的脆性破坏行为与试样失效模式. 同时进一步探究了形状因子、齿尖角角度及尖端区域对界面结构抗拉特性的影响规律. 研究结果表明，锯齿形结构较其他缝合结构具有显著的拉伸刚度，随着齿尖角角度增加，缝合结构刚度呈现下降趋势，且尖端区域进一步提高了缝合界面的抗拉性能，可为后续提高临床缝合术后皮肤创面愈合率提供相关参考.

, correspAuthors=纪小刚, authorNote=null, correspAuthorsNote=
** E-mail：.
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Mechanical parameters of skin materials

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系数μ1α1μ2α2μ3α3
数值-1.01-1.080.32-0.0220.72-1.31
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皮肤材料力学参数

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系数μ1α1μ2α2μ3α3
数值-1.01-1.080.32-0.0220.72-1.31
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Mechanical parameters of interfacial materials

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系数弹性模量（MPa）泊松比
数值0.1060.32
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界面材料力学参数

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系数弹性模量（MPa）泊松比
数值0.1060.32
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结构参数化皮肤缝合界面的平面抗拉性能研究
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徐林龙 1 , 纪小刚 1, 2, ** , 李华彬 1 , 江昊 1
固体力学学报 | 研究论文 2024,45(6): 795-807
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固体力学学报 | 研究论文 2024, 45(6): 795-807
结构参数化皮肤缝合界面的平面抗拉性能研究
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徐林龙1, 纪小刚1, 2, ** , 李华彬1, 江昊1
作者信息
  • 1江南大学机械工程学院，无锡，214122
  • 2江苏省食品先进制造装备技术重点实验室，无锡，214122

通讯作者:

Study on Plane Tensile Properties of Skin Suturing Interfaces with Structural Parameterization
Linlong Xu1, Xiaogang Ji1, 2, ** , Huabin Li1, Hao Jiang1
Affiliations
  • 1School of Mechanical Engineering, Jiangnan University, Wuxi, 214122
  • 2Jiangsu Key Laboratory of Advanced Food Manufacturing Equipment Technology, Wuxi, 214122
出版时间: 2024-12-25 doi: 10.19636/j.cnki.cjsm42-1250/o3.2024.042
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摘要
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针对临床医用粘合剂缝合皮肤创面后缝合伤口抗拉能力的可靠性问题，开展了硅胶倒模成形工艺制备的皮肤缝合界面抗拉性能研究. 以四种类型缝合结构的拉伸刚度研究为主线，利用缝合界面力学理论对皮肤界面构建等效力学模型，得到预测拉伸刚度的数学模型. 结合数值模拟和物理实验，聚焦分析了皮肤缝合结构的脆性破坏行为与试样失效模式. 同时进一步探究了形状因子、齿尖角角度及尖端区域对界面结构抗拉特性的影响规律. 研究结果表明，锯齿形结构较其他缝合结构具有显著的拉伸刚度，随着齿尖角角度增加，缝合结构刚度呈现下降趋势，且尖端区域进一步提高了缝合界面的抗拉性能，可为后续提高临床缝合术后皮肤创面愈合率提供相关参考.

皮肤切口  /  缝合界面  /  界面力学  /  抗拉性能

This study examines the tensile properties of skin suturing interfaces created through a silica gel reverse molding process, focusing on the reliability of clinical adhesive properties post-suturing. Four types of skin suturing interfaces, inspired by natural bionic structures, are designed, with primary attention on their tensile stiffness. An equivalent mechanical model is constructed using mechanical theories of suturing interfaces, and a theoretical model is developed to predict the tensile stiffness of each structure. Numerical simulations and physical experiments are conducted to analyze the brittle failure behavior and tensile failure modes of the suturing structures. The influences of shape factor, tooth tip angle, and tip region on the tensile properties of the interface are thoroughly investigated. A parameter mapping model using tensile strength as the evaluation index is constructed for each sensitive factor. It is found that the skin suturing interface exhibits brittle failure behavior, with the zigzag structure showing significantly higher tensile stiffness compared to other suturing structures. As the tooth tip angle increases, the stiffness of the suturing structure decreases, while the tip area enhances the tensile properties of the interface. These results are anticipated to help improve skin wound healing rate after clinical suturing.

skin incision  /  suturing interface  /  interface mechanics  /  tensile properties
徐林龙, 纪小刚, 李华彬, 江昊. 结构参数化皮肤缝合界面的平面抗拉性能研究. 固体力学学报, 2024 , 45 (6) : 795 -807 . DOI: 10.19636/j.cnki.cjsm42-1250/o3.2024.042
Linlong Xu, Xiaogang Ji, Huabin Li, Hao Jiang. Study on Plane Tensile Properties of Skin Suturing Interfaces with Structural Parameterization[J]. Chinese Journal of Solid Mechanics, 2024 , 45 (6) : 795 -807 . DOI: 10.19636/j.cnki.cjsm42-1250/o3.2024.042
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0　引言
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创面缝合手术过程中为了促进伤口愈合[1-2]以及术后疤痕的美观[3-4]，临床上越来越多使用医用粘合剂配合皮下可吸收缝合线来对患者创面进行缝合，然而此种缝合方法虽然实现了术后伤口的美观，但是患者伤口在术后初期受到外部力时由于没有缝线容易产生一定的撕裂. 为了加强缝合伤口的刚度，医生通过在伤口边缘设计各种辅助切口[5-7]，以此来增大其抗拉性能.
皮肤伤口刚度的增加来源于临床所设计的缝合界面通过其几何形状更好分配外部载荷. Li等[8]基于虚功原理，提出了任意缝合界面广义力学模型的构建方法，为缝合切口力学性能研究提供了理论指导. Ortiz等[9]探讨了三角形和矩形两种缝线几何形状和数值复合模型，其特征在于单一重复波. 以预测刚度、强度和局部应力分布来评估变形和失效机制的变化. 得出在三角形几何结构在载荷传递、重量、刚度、强度、能量吸收和疲劳方面优于矩形几何结构. Yaning等[10]建立了弹性确定性分形复合材料力学模型，定量研究了结构层次对缝合接头的刚度、强度和破坏的影响. Huang等[11]评价了垂直颈阔肌肌皮瓣的三种不同切口设计的效果，其研究表明，MacFee切口美观效果最好，T形切口术后颈部瘢痕更明显，MacFee或围裙式切口可用于修复较大的颊粘膜和口底缺损，而T形切口可用于修复较小的口内缺损，尤其是舌侧面缺损. Nikolaus等[12]通过拉伸试验研究了三角形切口、S形切口以及传统直线形切口缝合后的力学性能. 结果表明，三角形切口和S形切口较传统直线形切口都有更好的抗变形能力. 朱恒光等[13]探讨一种全新的保乳手术切口，与传统以病灶为中心的梭形皮肤切口比较，全新手术皮肤切口是以肿瘤体表投影处距肿瘤1-2 cm范围皮肤作梭型切口，结果说明全新切口在术后复发、转移、生存率方面均优于传统梭形皮肤切口. 高海燕等[14]提出了一种“心形”切口缝合方法，该方法在皮下脂肪潜行过程中可以悬挂更多的皮下脂肪组织，明显减小了皮缘的张力，促进上皮细胞再生以及受损血管的修复，能够显著增强局部组织的血液供应，促进伤口的快速愈合.
现阶段缝合界面对结构的增韧效果在仿生材料领域研究广泛[15]，针对术后皮肤伤口运用场合下的切口抗拉性能研究甚少. 因此，本文选用仿皮肤材料，设计不同几何形状的缝合结构；采用缝合界面力学理论构建其力学模型；利用数值模拟与拉伸试验相结合的方法对缝合结构进行抗拉性能表征，深入探究结构的齿尖角角度以及尖端区域与其抗拉性能的关系，确定皮肤缝合切口的最佳几何参数，为皮肤创面缝合术前方案提供参考.
1　皮肤缝合界面设计与力学模型构建
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1.1　皮肤缝合界面的设计与制备
考虑皮肤缝合界面的结构特点以及制备的可行性，同时受自然界中硅藻缝合接口的启发，本文选择四类生物启发的周期性几何形状，包括矩形、反梯形、梯形以及三角形，如图1所示.
单个周期的锯齿形缝合界面可以用波长L、振幅A和界面层宽度g来描述. 界面的刚度和强度从Li等[8]提出的尺度无关模型可知是两个独立的几何参数齿尖角θ和齿的体积分数fv的函数，通过公式1表示.
公式（1）同样适用于具有相同g、L和A的所有一般梯形缝线界面. 对于一般梯形缝合界面，如图2，引入一个几何参数β来量化锯齿的形状，因此β被称为形状因子. 取Y轴为垂直于缝合线轴线的方向，β定义为从Y轴到齿边缘的角度，当顺时针旋转时为正，逆时针旋转时为负. 而波长L、振幅A和齿的体积分数fv固定时，形状因子β在[-θ，θ]的范围内变化.
根据β的不同范围，一般梯形缝合结构分为四种类型：β=0时为矩形，-θ<β<0时为反梯形，0<β<θ时为梯形，β=θ时为锯齿形. 因此，一般梯形缝合界面的几何形状由四个独立参数确定：波长L、振幅A、界面宽度g和形状因子β. 本文依据形状因子β的不同设计出四种几何形状的皮肤缝合界面. 四种缝合结构具有相同的齿体积分数fv、波长λ以及界面层厚度g. 另外，在临床皮肤缝合初期，界面尖端的组织较其他部位难以生长，故本文还需考虑缝合结构是否具有尖端区域，整体模型尺寸如图3所示.
人工硅胶因其易于使用、经济高效和良好的再现性，且材质弹性与生物组织相似，广泛用于皮肤组织医学和生物力学的实验研究中[16-17]. 考虑试验场合及制备的可行性，皮肤材料选用Silicon公司制作的仿人体硅胶，该人工硅胶具有良好的弹性韧性，界面材料选用德品公司制作的透明明胶，该人工明胶具有较高的硬度同时兼具较低的拉伸强度用以表征伤口疤痕增生的初始阶段.
考虑硅胶的凝固成型，选用PLA材料打印制作相应缝合结构的成型摸具，设计模具璧厚2.5 mm，底高1 mm，整体尺寸为85 mm×35 mm×4 mm. 待缝合结构模具制作完成后，分别将两种材料的a、b液称重按1∶1比例进行混合搅拌，得到混合均匀的肤色混合物和透明混合物，将其注入模具中固化6 h. 皮肤与界面材料凝固完全后取出，两者用医用胶水粘接以制作各缝合结构试样，试样整体尺寸为80 mm×350 mm×3 mm，其中界面宽度为1.5 mm，厚度为3 mm，3D打印绿色夹头便于后续拉伸试验夹具对试样的夹取，制作的试样如图4所示.
1.2　缝合界面等效力学模型构建
临床中医用粘合剂配合可吸收缝合线完成对皮肤创面的缝合后，伤口处会逐渐产生疤痕以及新的生物组织. 作为两侧皮肤的主要连接机制，愈合初期阶段伤口处形成的界面层提供支撑以及分配载荷满足日常生活的需要，而在愈合初期缝合界面尖端处的生物组织往往在倾斜界面后增生. 因此，伤口愈合初期更高的界面刚度在伤口受准静态力时能够更好的增生疤痕促进伤口愈合.
为了解决缝合界面平面内的力学行为，通过Li等[8]提出的互补虚功原理推导出的分析模型进一步扩展，以推导缝合界面平面内尖端区域未增生以及尖端区域增生的拉伸模量. 在所有推导中，假设皮肤和界面层在整个界面上完美结合，两者都是是均匀的，倾斜和尖端界面层被认为没有直接的相互作用，图5为一般梯形缝合界面尖端区域未增生以及尖端区域增生的示意图.
由于远场载荷，缝合线界面在张力下由穿过皮肤基部的应力σbase和穿过尖端区域的法向应力σtip来平衡，如图5所示，关系为：
其中tbase=2Atanφ和tgap=λ-2Atanφ分别是齿之间的基部长度和间隙长度；A和λ分别是齿几何形状的振幅和波长. 齿底处的张力σbase进一步被界面剪应力τT和界面法向应力σT以及尖端上的法向应力σtip平衡，平衡关系如下：
由于皮肤属于可变形范畴，使用可变形缝合界面模型表征结构的拉伸刚度，根据Li等[8]的推导不含尖端区域的缝合界面等效刚度表示为：
当β=θ或β=0时：
当β∈（-θ，0）和（0，θ）时：
其中：
式（5）中，E0是界面材料的弹性模量，G0是界面材料的剪切模量，E1是皮肤材料的弹性模量.
不考虑皮肤变形的情况下[18]，缝合结构的界面等效刚度可由公式（9）表示：
其中：
式（9）和（10）中，fs和ft分别是缝合区域中倾斜界面层和尖端界面层的体积分数，并且：
结合尖端区域提供了缝合界面刚度的增加，其可以表示为Eslant与Etip的比率RS：
2　皮肤缝合结构准静态拉伸数值模拟
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2.1　基材力学性能属性参数
为了合理测定皮肤与界面材料的力学性能参数，参照国家标准PLA材料打印哑铃状试样模具倒模后制作对应拉伸试样. 使用CTM2500万能试验机对试样进行单轴拉伸试验，设置拉伸速率为50 mm/min. 由于试样的断裂伸长率均能超过20%，属于大变形范畴，应当对拉伸试验获得的载荷-位移曲线转化为真实应力-真实应变数据，根据大变形后体积不变的假设得到试样的真实应力、真实应变为：
其中：F为拉伸载荷；A0为试样初始横截面积；L0为拉伸试样初始标距，L为拉伸后的标距.
在获得皮肤和界面拉伸试样的真实应力-应变曲线后，对其进行初步拟合以探明两种材料的力学性能，如图6所示. 由于皮肤材料展现出复杂的非线性关系，为了对后续仿真提供必要的材料属性，将拉伸试验时的真实应力-应变数据传输到Abaqus中，其能根据输入的实验数据采用最小二乘法自动识别与计算本构模型的类别及相应参数. 通过识别解析发现三阶Ogden本构模型与材料的实验数据高度吻合，其应变能密度函数如下：
式17中，μi、αi为材料参数；λ1、λ2、λ3分别为对应主方向的伸长率.
Abaqus通过拟合试验数据与本构曲线，输出了三阶Ogden模型参数，如表1，界面材料通过线弹性参数来表征如表2.
2.2　数值模型的建立
基于上述皮肤材料以及界面材料在准静态拉伸试验下获取的力学参数，对不同缝合界面结构进行数值仿真分析. 在ABAQUS中建立与试验试样相同尺寸的缝合模型，包括尖端区域增生与未增生的分析模型. 有限元计算中采用Mise应力表述模型拉伸过程每个单元的应力状态，其等效应力公式如下：
其中，σ1、σ2、σ3分别表示材料在三个不同方向上的正应力.
皮肤采用各向同性的三阶Ogden超弹性本构模型来定义材料属性，由于界面材料的拉伸强度远低于皮肤材料且在缝合结构拉伸过程中其断裂模式属于Ⅰ型张开型破坏，因此在仿真中采用脆性裂纹定义界面材料的失效，允许开裂应变设置为e-5，开裂后直接应力由材料本身杨氏模量及拉伸强度确定，设置为0.104 MPa. 皮肤与界面之间采用Tie接触. 结构统一采用八节点六面体线性网格进行划分，结构上下5 mm的长方体全自由度分别耦合到RP-1和RP-2点，RP-1施加45 mm位移来模拟单轴拉伸试验，RP-2点完全固定约束. 图7为锯齿形无尖端区域的缝合结构有限元模型.
2.3　缝合结构的脆性破坏
根据上述缝合界面模型的建立方法，探究不同缝合结构的载荷传递方式以及界面脆性失效行为，图8显示了梯形与锯齿形界面的脆性破坏过程.
模拟结果表明随着外部载荷逐渐传递到粘接界面层，界面层局部产生较大的应力. 而随着载荷持续增加，界面与皮肤的连接处出现应力集中现象且界面尖端产生紧缩效应，此时载荷由界面材料上下端向中间传递，当达到单元破坏应力时，界面发生脆性断裂，结构强度立即失效. 受皮肤与界面接触方式的影响，锯齿形与梯形结构的倾斜界面在载荷传递过程中能够较好的利用拉伸强度更优的皮肤材料，而减少脆性界面材料的所承受的载荷，因此两者具有较大的拉伸刚度.
图9表明了反梯形与矩形结构的脆性失效行为. 反梯形缝合结构在承受外部载荷时，应力集中在界面齿根处，但由于皮肤材料的延展性较好会使得载荷由齿根逐渐向界面层传递，在达到破坏应力时，界面表现出脆性失效. 而对于矩形缝合界面，界面在纵向张力下处于纯剪切状态，皮肤与界面连接处承受了绝大部分外部载荷. 由于其结构特点，载荷很难进一步向界面层传递，因此界面两侧单元会率先达到破坏应力，从而产生内聚失效. 值得一提的是，反梯形界面虽然在纵向拉伸下也处于拉伸和剪切组合作用的状态，但由于其皮肤齿根处最小的横截面积使得来自远场载荷的力都集中作用在齿根部位，导致皮肤齿根部位呈现应力集中状态，而外部大面积皮肤呈现较小的应力.
3　缝合界面抗拉性能敏感参数研究
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3.1　形状因子的影响分析
数值模拟完成后，为了更直观地评估四种类型皮肤缝合界面拉伸过程的力学响应，从输出数据库中提取模拟过程中RP-1的位移和RP-2点上的反作用力，从而生成对应结构的应力-应变曲线，结果如图10.
可以较为明显的看出，各界面由于几何构型不同，应力应变响应差异显著. 缝合结构拉伸至50%应变下的断裂应力在37 kPa-98 kPa范围之间，β=θ时断裂应力值最大，为97.56 kPa，β<0时断裂应力值最小，为37.32 kPa，表明锯齿形结构具有最大的拉伸刚度.
在图4（a）中的试样制作完成后，依次对各类缝合结构进行准静态单轴拉伸试验，试验设备为CTM2500万能试验机. 实验前考虑到缝合结构拉伸变形的特殊性，为保证其在拉伸过程中受力更为均匀，采用刚性树脂光固化成型制备了夹持板，通过强力胶将夹持板粘接于缝合结构两端，固定于拉伸试验机的专用夹具上. 试验时夹具下端固定上端移动，远程控制系统控制夹具上移直至缝合结构界面处发生断裂. 试验结束后，根据试验机传感器记录的力-位移数据进一步换算以获取缝合结构单轴拉伸过程应力-应变数据，图11（a）为试样单轴拉伸试验效果图. 在完成缝合结构的单轴拉伸试验后，整理试验机拉伸位移—载荷信息，得到图4（a）所示缝合结构在单轴拉伸试验下的应力应变曲线.
由图11（b）可以看出，在齿尖角2θ=45°条件下，四种缝合类型结构几何形状不同，应力应变响应差异较大，其中锯齿形结构在断裂前产生相同应变下所需应力值最大表明其具有最大的拉伸刚度，反梯形结构则相反，梯形与矩形结构应力值介于两者之间，这与数值模拟结果一致. 对比四种结构的断裂位置，可以发现断裂点处锯齿形结构不仅产生最大的应变，且其应力值也最大为95.35 kPa，反梯形结构的断裂应力为43.09 kPa，产生的等效应变为0.28，矩形结构的断裂应力值虽然低于梯形结构，但其可承受较大的变形.
根据缝合界面的设计尺寸，结构界面宽度g=1.5，周期λ=12，由公式（1）可知齿体积分数fv=0.75，皮肤与界面材料的弹性模量由2.1节中拉伸样条曲线的线弹性阶段确定，由公式5至公式7可推导出了在齿尖角角度2θ=45°下四种类型缝合结构的等效刚度. 为了验证理论模型及数值分析的可靠性，将理论计算得到的刚度、模拟及试验得到的拉伸强度进行比较分析，如图12所示. 可以看出试验与数值分析得到的各结构拉伸强度十分接近，且各结构抗拉强度数值大小与计算得到的等效刚度大小趋势具有较好的一致性，从而验证了本文分析方法的准确性.
3.2　齿尖角角度的影响分析
齿尖角角度对皮肤缝合结构抗拉性能的影响不容忽视，确定结构拉伸刚度随齿尖角角度的变化趋势在临床实际中尤为重要，因此合理的齿尖角角度是缝合结构设计的重要参数. 图13为两种齿尖角角度的锯齿形缝合结构模拟过程中的应力应变响应曲线，两者拉伸过程中的力学响应相似，在断裂处均表现出脆性失效，而齿尖角度较小的锯齿形结构展现出更好的抗拉性能. 相比较于齿尖角角度为90°的缝合结构，45°的锯齿形界面增大了倾斜段的体积，因此减小齿尖角度后界面与皮肤的接触面积随之增大，导致可分配的载荷变大，从而提高了结构拉伸刚度.
图4（b）中的试样制作完成后，对各类皮肤界面结构进行准静态单轴拉伸试验，试验完成后提取各结构的应力应变数据.
图14（a）展示了齿尖角2θ=90°下各结构拉伸应力应变曲线. 可以看出，齿尖角角度的改变不会影响四种结构相互之间的应力应变响应，但随着齿尖角角度增加，四种结构的拉伸刚度均降低，锯齿形结构依然拥有最大的拉伸强度. 为了直观表征齿尖角角度对皮肤缝合界面抗拉性能的影响规律，提取不同齿尖角角度的缝合结构断裂点处的应力值，计算其拉伸强度. 图14（b）显示了两种齿尖角角度下各缝合结构的拉伸强度，结果表明，对于同一几何结构的缝合界面，其拉伸强度随着齿尖角角度的增大而减小，锯齿形结构始终表现出最大的拉伸强度且明显大于其他三种结构. 随着齿尖角减小，各结构的拉伸强度都有所上升，但上升的趋势不同，反梯形结构上升速率最大，矩形结构上升速率最小，锯齿形结构的拉伸强度对齿尖角角度的变化较为敏感.
3.3　尖端区域的影响分析
1.2节中分析模型表明皮肤尖端区域增生后，四种类型缝合结构的抗拉性能均会得到提高. 图15显示了锯齿形界面尖端组织增生后结构失效过程. 随着外部载荷逐渐传递到界面层，锯齿形缝合结构的应力集中分布在界面尖端处，当尖端单元达到破坏应力时，载荷无法传递至倾斜界面失效已经产生，表明具有尖端区域的皮肤缝合界面第一次失效将发生在尖端处. 与拉伸刚度预测模型一致，尖端组织界面增加了缝线界面的初始有效刚度，但由于应力集中较大，因此会首先失效. 然而尖端界面中的皮肤组织失效不会导致缝合界面的致命失效，受较大应力使尖端界面失效后，载荷通过倾斜界面传递，倾斜界面控制结构的刚度直至新的尖端组织增生完成.
为了直观量化尖端区域对于缝合结构刚度的提升，将本文皮肤缝合界面参数代入1.2节中式（14），得到比率的具体函数模型如下：
图16展示了45°齿尖角角度下四种类型缝合结构尖端区域增生后拉伸强度的增量以及尖端区域的比率值. 明显看出，尖端区域均一定程度提高了皮肤界面的拉伸强度，不同的是，锯齿形结构拉伸强度增加的幅度较小，而反梯形结构对于尖端区域的出现十分敏感. 仿真结果与预测模型结果趋势一致，四类类型的缝合界面比率分别为0.16、0.42、0.23、0.60，表明尖端区域对于锯齿形结构刚度的提升为16%，而反梯形结构刚度提升达到了60%，原因在于不含有尖端区域的锯齿形结构界面与皮肤已经相对完美的粘合，相反反梯形结构由于其几何特点导致式（19）中tgap参数数值较大，因此尖端区域对其影响显著.
采用相同的方法制备了含有尖端区域的锯齿形缝合结构来验证尖端区域影响分析的准确性. 图17为有无尖端区域锯齿形结构试验所得的应力应变响应对比，可以看出，与分析所得结果趋势一致，尖端区域的出现一定程度上提高了缝合结构的抗拉性能. 同时引入平坦界面进行对比，锯齿形缝合界面在尖端区域增生后对比传统缝合方式在小位移范围内较大程度提高了伤口的抗拉性能.
3.4　缝合界面失效模式分析
在对各缝合结构进行拉伸破坏试验后，发现受几何构型影响试样破坏可以被分为3种类型，图18展示了每种类型下具有可能特征的试样失效情况，图中红色虚线框标出了失效发生的位置，红色箭头表明了结构受载情况.
锯齿形与梯形结构一致，如图18（a）所示，由于结构倾斜段可以使得载荷较好的在界面层中传递，因而界面失效发生在界面材料中间倾斜段. 矩形结构典型的失效模式为内聚失效，由于其在受纵向载荷时界面处于纯剪切状态，应力集中于界面材料与皮肤材料接触处，因此内聚失效主要发生在界面材料的两侧. 对于反梯形结构，其在受载时由于齿根横截面积较小会产生应力集中现象，从而引发齿根失效，这种情况下的失效可能因为硅胶倒模成型时其厚度不足3 mm，降低了皮肤材料承载能力，故此种失效应当避免. 而对于含有尖端区域的缝合结构，在受外部载荷时，应力主要集中在尖端区域，因此尖端失效发生在界面材料尖端处. 所有的失效均表现为脆性断裂，破坏发生时，载荷立即降至0.
4　缝合结构抗拉强度的参数映射模型
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基于上述皮肤界面抗拉性能单因素影响规律研究，以实现提高皮肤缝合界面抗拉性能为目标，综合考虑影响界面抗拉性能的多个参数与其作用机制，确定界面结构性能最佳的参数为较小齿尖角角度的具有尖端区域的锯齿形结构，而在创面愈合初期，锯齿形结构也因其良好的抗拉性能有利于缝合尖端组织再生.
为映射各参数对皮肤缝合界面抗拉性能的影响程度，分别计算试验所得各缝合结构的拉伸强度. 由图19参数映射关系图可知，形状因子对结构拉伸强度影响显著，中其锯齿形界面有最大的拉伸强度. 另外，小的尖角角度与尖端区域对缝合结构的拉伸强度均有所提升. 进一步表明界面结构性能最佳的参数为较小齿尖角角度的具有尖端区域的锯齿形结构，在临床实际皮肤伤口缝合术后，伤口受外界载荷作用下，锯齿形结构有着明显优势.
5　结论
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（1）考虑皮肤缝合界面结构的特点，设计了锯齿形、梯形、反梯形、矩形四种类型的缝合结构. 利用仿皮肤材料与界面材料，制备了四种类型的皮肤缝合结构试样.
（2）所设计的皮肤缝合结构表现出脆性破坏行为，其拉伸刚度高度依赖于形状因子，锯齿型缝合结构具有最佳的抗拉性能，缝合界面抗拉性能均随着齿尖角角度的增加呈现下降趋势且尖端区域可以一定程度提高其拉伸强度.
（3）不同结构的缝合试样在拉伸试验中表现出不同的失效模式，四种类型的皮肤缝合界面在临床术后均有利于创面组织再生.
（4）考虑皮肤缝合界面几何形状可以通过微小的参数变化精确控制术后伤口缝合刚度需求. 另外，所提出的分析模型可以作为设计缝合界面的重要工具，用于特定应用中的轻松优化设计.
基金
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  • 国家自然科学基金项目(52175234; 51105175)
  • 江苏省“六大人才高峰”项目(JXQC-006)
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doi: 10.19636/j.cnki.cjsm42-1250/o3.2024.042
  • 接收时间：2024-09-06
  • 首发时间：2026-04-01
  • 出版时间：2024-12-25
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  • 收稿日期：2024-09-06
基金
国家自然科学基金项目(52175234; 51105175)
江苏省“六大人才高峰”项目(JXQC-006)
作者信息
    1江南大学机械工程学院，无锡，214122
    2江苏省食品先进制造装备技术重点实验室，无锡，214122

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2种不同金属材料的力学参数
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Number of
species		 占总种数比例
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total species (%)		 属
Genus		 种数
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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