Langer's lines, Langer lines of skin tension, or sometimes called cleavage lines, are topological lines drawn on a map of the human body. They are parallel to the natural orientation of

collagen Collagen () is the main structural protein in the extracellular matrix found in the body's various connective tissues. As the main component of connective tissue, it is the most abundant protein in mammals, making up from 25% to 35% of the whol ...

fibers in the

dermis The dermis or corium is a layer of skin between the epidermis (with which it makes up the cutis) and subcutaneous tissues, that primarily consists of dense irregular connective tissue and cushions the body from stress and strain. It is divided ...

, and generally perpendicular to the underlying muscle fibers. Langer's lines have relevance to forensic science and the development of surgical techniques.

History

The lines were first discovered in 1861 by

Austria Austria, , bar, Östareich officially the Republic of Austria, is a country in the southern part of Central Europe, lying in the Eastern Alps. It is a federation of nine states, one of which is the capital, Vienna, the most populous ...

anatomist Anatomy () is the branch of biology concerned with the study of the structure of organisms and their parts. Anatomy is a branch of natural science that deals with the structural organization of living things. It is an old science, having it ...

Karl Langer Karl Langer, Ritter von Edenberg (15 April 1819, Vienna – 8 December 1887) was an Austrian anatomist. He is known for his work in the field of topographical anatomy. He studied medicine at the Universities of Vienna and Prague, afterwards w ...

(1819–1887), though he cited the surgeon Baron Dupuytren as being the first to recognise the phenomenon. Langer punctured numerous holes at short distances from each other into the skin of a

cadaver A cadaver or corpse is a dead human body that is used by medical students, physicians and other scientists to study anatomy, identify disease sites, determine causes of death, and provide tissue to repair a defect in a living human being. Stud ...

with a tool that had a circular-shaped tip, similar to an

ice pick The ice pick is a pointed metal tool used from the 1800s to the 1900s to break, pick or chip at ice. The design consists of a sharp metal spike attached to a wooden handle. The tool's design has been relatively unchanged since its creation. The ...

. He noticed that the resultant punctures in the skin had

ellipsoidal An ellipsoid is a surface that may be obtained from a sphere by deforming it by means of directional scalings, or more generally, of an affine transformation. An ellipsoid is a quadric surface; that is, a surface that may be defined as the z ...

shapes. From this testing he observed patterns and was able to determine "line directions" by the longer axes of the ellipsoidal holes and lines.

Application

Knowing the direction of Langer's lines within a specific area of the skin is important for

surgical Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...

operations, particularly

cosmetic surgery Plastic surgery is a surgical specialty involving the restoration, reconstruction or alteration of the human body. It can be divided into two main categories: reconstructive surgery and cosmetic surgery. Reconstructive surgery includes cranio ...

. If a surgeon has a choice about where and in what direction to place an incision, they may choose to cut in the direction of Langer's lines. Incisions made parallel to Langer's lines may heal better and produce less scarring than those that cut across. Conversely, incisions perpendicular to Langer's lines have a tendency to pucker and remain obvious, although sometimes this is unavoidable. The orientation of

stab wound A stab wound is a specific form of penetrating trauma to the skin that results from a knife or a similar pointed object. While stab wounds are typically known to be caused by knives, they can also occur from a variety of implements, including brok ...

s relative to Langer's lines can have a considerable impact upon the presentation of the wound. Langer's lines include breast static tension lines, which mark a guide for

breast surgery Breast surgery is a form of surgery performed on the breast. Types Types include: *Breast reduction surgery *Augmentation mammoplasty * Mastectomy *Lumpectomy *Breast-conserving surgery, a less radical cancer surgery than mastectomy *Mastopexy, ...

incisions.

Keloid Keloid, also known as keloid disorder and keloidal scar, is the formation of a type of scar which, depending on its maturity, is composed mainly of either type III (early) or type I (late) collagen. It is a result of an overgrowth of granulation ...

s are more common when incision is given across Langer's lines. Sometimes the exact direction of the collagen fibers are unknown, because in some regions of the body there are differences between different individuals. Also, the lines described by Kraissl differ in some ways from Langer's lines, particularly on the face.

Alternatives

Other authors have created topological skin maps. Kraissl's lines differ from Langer's lines in that while Langer's lines were defined in cadavers, Kraissl's lines have been defined in living individuals. Also, the method used to identify Kraissl's lines is not traumatic.

References

{{Authority control Dermatologic signs Skin lines

History

Application

Alternatives

See also

References