BIOMECHANICAL AND CLINICAL ASSESSMENT OF TISSUE HEALING FOLLOWING ADVANCED RECONSTRUCTIVE SURGICAL PROCEDURES

Abstract

Background: The reconstructive surgery is a high technology tissue repair process that is multi-faceted, multi-scale and involves biomechanical integrity, extra-cellular remodelling and cellular mechanotransduction. The standard clinical evaluation procedures are not disposed in terms of reflecting the functional mechanical maturation of the healing tissues.Methods: A longitudinal study of the healing of the tissue after reconstructive surgery was designed as a mixed-method experimental study using quantitative data of the biomechanical tests, constitutive models, the high-resolution imaging and clinical outcome measurements. The anisotropic stiffness indices and relaxation constants were found to be nonlinear viscoelastic parameters whose value was similar to that of the clinical recovery parameters.Findings: The results showed that there were some mechanical properties that were comparable to the healing period where an early viscous pre-eminence was followed by a smooth stabilization of the elastic properties and increment of anisotropy due to the reorganization of the extra-cellular matrix. All the datasets showed good fit of the constitutive models with a small error in the residual. The results of the multivariate analysis showed that the clinical outcomes, i.e. the mechanical competence is closely correlated with the functional recovery are closely related to biomechanical parameters. The heterogeneous healing and energy loss graphical models were also demonstrated to be the tendencies in connection with the reconstructed tissues.Conclusion: The results suggest that both the biomechanical and the clinical assessment would offer potentially valuable information on the process of the tissue healing and a potent tool in the form of predicting the outcome of the reconstruction. The research suggests objective biomechanical results in the clinical assessment to inform patient-specific surgery and regeneration intervention.