Methods and devices are disclosed to reduce the tissue trauma that occurs when a physician retracts or otherwise deforms a patient's tissues for surgery or other medical procedures. In one part, methods and devices are disclosed for controlling the force and pace of retraction to reduce tissue trauma. In another part, methods and devices are disclosed for applying an oscillating load when opening. In another part, pads that cool the tissue around the incision are disclosed. In another part, pads that elute drugs into the tissues of the tissue margin are disclosed. In another part, methods and devices are disclosed that self-align components of the retractor and engage hard tissues directly to avoid soft tissue damage. In another part, pads that engage tissues to cushion, to sense tissue state, and to modulate tissue state are disclosed.