Stretching skin: The physiological limit and beyond.

The goal of this manuscript is to establish a novel computational model for skin to characterize its constitutive behavior when stretched within and beyond its physiological limits. Within the physiological regime, skin displays a reversible, highly nonlinear, stretch locking, and anisotropic behavior. We model these characteristics using a transversely isotropic chain network model composed of eight wormlike chains. Beyond the physiological limit, skin undergoes an irreversible area growth triggered through mechanical stretch. We model skin growth as a transversely isotropic process characterized through a single internal variable, the scalar-valued growth multiplier. To discretize the evolution of growth in time, we apply an unconditionally stable, implicit Euler backward scheme. To discretize it in space, we utilize the finite element method. For maximum algorithmic efficiency and optimal convergence, we suggest an inner Newton iteration to locally update the growth multiplier at each integration point. This iteration is embedded within an outer Newton iteration to globally update the deformation at each finite element node. To illustrate the characteristic features of skin growth, we first compare the two simple model problems of displacement- and force-driven growth. Then, we model the process of stretch-induced skin growth during tissue expansion. In particular, we compare the spatio-temporal evolution of stress, strain, and area gain for four commonly available tissue expander geometries. We believe that the proposed model has the potential to open new avenues in reconstructive surgery and rationalize critical process parameters in tissue expansion, such as expander geometry, expander size, expander placement, and inflation timing.