Beam-inside-beam contact: Mechanical simulations of slender medical instruments inside the human body.

BACKGROUND AND OBJECTIVE: This contribution presents a rapid computational framework to mechanically simulate the insertion of a slender medical instrument in a tubular structure such as an artery, the cochlea or another slender instrument. METHODS: Beams are employed to rapidly simulate the mechanical behaviour of the medical instrument and the tubular structure. However, the framework's novelty is its capability to handle the mechanical contact between an inner beam (representing the medical instrument) embedded in a hollow outer beam (representing the tubular structure). This "beam-inside-beam" contact framework, which forces two beams to remain embedded, is the first of its kind since existing contact frameworks for beams are "beam-to-beam" approaches, i.e. they repel beams from each other. Furthermore, we propose contact kinematics such that not only instruments and tubes with circular cross-sections can be considered, but also those with elliptical cross-sections. This provides flexibility for the optimization of patient-specific instruments. RESULTS: The results demonstrate that the framework's robustness is substantial, because only a few increments per simulation and a few iterations per increment are required, even though large deformations, large rotations and large curvature changes of both the instrument and tubular structure occur. The stability of the framework remains high even if the modulus of the inner tube is thousand times larger than that of the outer tube. A mesh convergence study furthermore exposes that a relatively small number of elements is required to accurately approach the reference solution. CONCLUSIONS: The framework's high simulation speed originates from the exploitation of the rigidity of the beams' cross-sections to quantify the exclusion between the inner and the hollow outer beam. This rigidity limits the accuracy of the framework at the same time, but this is unavoidable since simulation accuracy and simulation speed are two competing interests. Hence, the framework is particularly attractive if simulation speed is preferred over accuracy.

Skin Microstructure is a Key Contributor to Its Friction Behaviour.

Due to its multifactorial nature, skin friction remains a multiphysics and multiscale phenomenon poorly understood despite its relevance for many biomedical and engineering applications (from superficial pressure ulcers, through shaving and cosmetics, to automotive safety and sports equipment). For example, it is unclear whether, and in which measure, the skin microscopic surface topography, internal microstructure and associated nonlinear mechanics can condition and modulate skin friction. This study addressed this question through the development of a parametric finite element contact homogenisation procedure which was used to study and quantify the effect of the skin microstructure on the macroscopic skin frictional response. An anatomically realistic two-dimensional image-based multilayer finite element model of human skin was used to simulate the sliding of rigid indenters of various sizes over the skin surface. A corresponding structurally idealised multilayer skin model was also built for comparison purposes. Microscopic friction specified at skin asperity or microrelief level was an input to the finite element computations. From the contact reaction force measured at the sliding indenter, a homogenised (or apparent) macroscopic friction was calculated. Results demonstrated that the naturally complex geometry of the skin microstructure and surface topography alone can play as significant role in modulating the deformation component of macroscopic friction and can significantly increase it. This effect is further amplified as the ground-state Young's modulus of the stratum corneum is increased (for example, as a result of a dryer environment). In these conditions, the skin microstructure is a dominant factor in the deformation component of macroscopic friction, regardless of indenter size or specified local friction properties. When the skin is assumed to be an assembly of nominally flat layers, the resulting global coefficient of friction is reduced with respect to the local one. This seemingly counter-intuitive effect had already been demonstrated in a recent computational study found in the literature. Results also suggest that care should be taken when assigning a coefficient of friction in computer simulations, as it might not reflect the conditions of microscopic and macroscopic friction one intends to represent. The modelling methodology and simulation tools developed in this study go beyond what current analytical models of skin friction can offer: the ability to accommodate arbitrary kinematics (i.e. finite deformations), nonlinear constitutive properties and the complex geometry of the skin microstructural constituents. It was demonstrated how this approach offered a new level of mechanistic insight into plausible friction mechanisms associated with purely structural effects operating at the microscopic scale; the methodology should be viewed as complementary to physical experimental protocols characterising skin friction as it may facilitate the interpretation of observations and measurements and/or could also assist in the design of new experimental quantitative assays.