A7 Skin Lines and Wound Healing

Lines of tension in the skin or cleavage lines are named after the Austrian anatomist Karl Langer, who first depicted them. They are remarkably constant between individuals of similar body habitus. In most areas of the body these correspond with the skin creases (Figs. 1 and 2). Skin lines are important when making and closing wounds. Ideally all wounds should be made parallel to Langer’s lines to optimize the cosmetic outcome. Wounds made across the lines of skin tension promote hypertrophic scarring. When the type of surgery necessitates crossing Langer’s lines, oblique or S-shaped incisions may improve cosmesis. Alternatively, Z-plasties may be used.