Skin Mechanobiology: From Basic Science to Clinical Applications

Understanding the mechanobiology of the human skin at both the macroscopic and microscopic scales not only serves a basic science objective. Such understanding is also essential for protecting the integrity and viability of the skin of patients in hospital and community settings. This chapter demonstrates the translation of knowledge related to skin mechanobiology into clinical skin and wound care, with a particular focus on achieving more effective pressure ulcer/injury prevention using prophylactic dressings, and as related to repairing damaged skin by promoting dermal fibroblast migration into a wound site using contemporary negative-pressure wound therapy systems. Our bioengineering work conducted and published for the last two decades utilizes an integrated approach including studies of skin physiology and microclimate conditions, e.g., by means of infrared thermography, subepidermal moisture measurements, analysis of skin inflammatory markers, anatomically realistic computer modeling and simulations, cell culture studies including microscopy and image processing methods, and, importantly, a combination of all of these together, to form a hierarchical description of the mechanobiology of human skin, from the cell to the organ level. As the above research methods continue to improve and reveal the mechanobiology of skin in health and disease, bioengineers can now develop better skin and wound care technologies, including enhanced dressings for prophylaxis and treatment of wounds, non-dressing-based skin protection methods, novel negative-pressure wound therapy systems for superior wound closure, etc.