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Kanevsky et al. Plast Aesthet Res 2016;3:351-8 Plastic and
DOI: 10.20517/2347-9264.2016.27
Aesthetic Research

www.parjournal.net
Original Article Open Access

Development and assessment of a cutaneous

tissue stretch device as a novel scar therapy

Jonathan Kanevsky , Joshua Vorstenbosch , Julian Diaz-Abele , Tyler Safran , Markus Prinz , Youssef Tahiri ,
5
4
2
1
3
2
Mirko Gilardino , Satya Prakash 6
1
1 Division of Plastic and Reconstructive Surgery, McGill University Health Centre, Montreal, QC H3G 1B3, Canada.
2 Section of Plastic and Reconstructive Surgery, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
3 McGill Medical School, McGill University, Montreal, QC H3G 2M1, Canada.
4 Division of General Surgery, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada.
5 Division of Plastic and Reconstructive Surgery, Indiana University, Indianapolis, IN 46202, USA.
6 Biomedical Engineering Department, Artificial Cells and Organs Research Centre, Montreal, QC H3A 2B4, Canada.
Correspondence to: Prof. Satya Prakash, Biomedical Engineering Department, Artificial Cells and Organs Research Centre, Duff Medical
Building, 3775 University Street, Room 311, Montreal, QC H3A 2B4, Canada. E-mail: satya.prakash@mcgill.ca
How to cite this article: Kanevsky J, Vorstenbosch J, Diaz-Abele J, Safran T, Prinz M, Tahiri Y, Gilardino M, Prakash S. Development and
assessment of a cutaneous tissue stretch device as a novel scar therapy. Plast Aesthet Res 2016;3:351-8.
ABSTRACT
Article history: Aim: Scar prevention and reduction is an area of therapeutic opportunity and unmet medical
Received: 15-04-2016 need. With no current effective scar therapy, patients are often disappointed in their appearance
Accepted: 27-10-2016 post surgery and re-present to surgeons, only to be turned away. The purpose of this study was
Published: 15-11-2016 to develop and test a device that produces intermittent parallel stretch on new scars and to
analyze its potential to reduce scarring. Methods: Mice were randomized into 5 scar stretch
Key words: treatment groups: 1 control, 1 sham, and 3 stretch models (0.5×, 1×, or 2× device strength) and
Mechanotransduction, treated for 10 days. Scars were scored using the Vancouver Scar Scale. Scar tissue samples were
scar therapy, compared by histology and transforming growth factor beta 1 (TGF-β1) expression between
hypertrophic scar, control and treatment groups. Results: Scar scores of 0.5× and 1× groups were significantly
skin stretch lower than the control group (P < 0.05). Scar scores from the 1× treatment group were also
significantly lower than the 0.5× group (P < 0.05). Sham, control scar and 2× groups showed
more collagen deposition and a thicker dermal scar than the 0.5× and 1× groups. Unstretched
scars had fewer fibroblasts with more collagen deposition than the 0.5× and 2× groups. TGF-β1
levels were significantly lower in the 0.5× (342.1 ± 9.2) and 1× (254.1 ± 3.1) groups than in
the control group (P < 0.05). TGF-β1 levels in the 1× treatment group were also significantly
lower than the 0.5× treatment group (P < 0.05). Conclusion: Intermittent cutaneous tissue
stretch parallel to scars during the proliferative phase of wound healing decreases fibrosis on a
macroscopic, microscopic and biochemical level.

INTRODUCTION in loss of function, restriction of movement, adverse
psychological effects due to appearance and reduced
Scar formation can be a debilitating consequence of quality of life. [1-5] Patients across wide demographic
surgery, burns, trauma, or disease. Scarring can result groups, gender, age, ethnicity, and geographic region
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