Methods and devices are disclosed to reduce the tissue trauma that occurs when a physician retracts or otherwise deforms a patients tissues for surgery or other medical procedures. In one part, methods and devices are disclosed for cooling the tissue around the incision. In another part, methods and devices are disclosed that elute drugs into the tissues of the tissue margin. In another part, methods and devices are disclosed to engage tissues during retraction to cushion, to sense tissue state, and to modulate tissue state.