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Question 405
Pathology → General
Classification
Question
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Two otherwise identical skin incisions are made in different orientations. One lies parallel to the natural skin creases, whereas the other crosses them at right angles. Which outcome is expected for the incision perpendicular to the skin creases?
Question Stem
Select the single best answer.
Options
A
Less gaping because elastin fibres exert no directional effect
B
Greater tendency to gape and less favourable healing
C
Complete prevention of scar formation
D
Conversion from repair to regeneration without collagen deposition
E
No difference because incision orientation has no influence on wound behaviour
Explanation
Skin elasticity is related to elastin fibres running parallel to skin creases. An incision made perpendicular to these lines has a greater tendency to gape and therefore heals less favourably than one appropriately orientated with the skin creases.
Option Validity
A) The directional arrangement of elastic fibres contributes to the behaviour of the wound edges.
C) Incision orientation does not prevent scar formation.
D) Crossing skin creases does not convert repair into pure regeneration.
E) Incision orientation relative to skin creases influences wound gaping and subsequent healing.
Further Reading
Saxena R. Textbook for MRCOG-1. Chapter 5: Pathology. General Pathology, pp.161–175.