A 980-nm diode laser is proposed to be an alternative welding laser in dermatology due to its optimal penetration in tissue. An in vivo predosimetry study was done to estimate the optimal laser energy delivery conditions (6 W, 400 ms). Next, in vivo experiments were comparatively performed to examine healing of wounds closed either with suture or laser welding. One-centimeter-long, full-thickness incisions were done on the dorsal side of Wistar rats. Wounds were surgically removed at 1, 4, 7, 14, and 21 days postoperatively. Macroscopic examinations showed that welding had minimal scarring and a fine quality healing. According to histological (hematoxylin and eosin staining) results, change of epidermal thickness and granulation tissue formation through 21 days of healing period showed similarities in both methods. Epidermal thickness of welded wounds decreased from 62.46+/-6.87 microm (first day) to 36.49+/-0.92 microm (21st day) and that of sutured wounds decreased from 62.94+/-13.53 microm (first day) to 37.88+/-7.41 microm (21st day). At day 14, epidermal thickness of sutured wounds (61.20+/-6.60 microm) were higher than welded wounds (49.69+/-6.31 microm) (p<0.05). Besides, granulation values were greater for the sutured wounds but the difference was statistically significant (p<0.05) only for the seventh day (197,190.29+/-.89,554.96 microm(2) for sutured wounds, 138,433.1+/-51,077.17 microm(2) for welded wounds). Those differences indicate a faster recovery with laser welding. It is concluded that tissue welding with a 980-nm diode laser can be a good candidate for tissue welding applications with accelerated and improved healing, but further investigations are in progress for clinical use.
The skin closure abilities of near infrared lasers and suturing were compared by histological examination and mechanical tensile tests during a 21-day healing period. One-centimeter incisions on the dorsal skin of Wistar rats were treated by one of the closing techniques: (a) soldering, using an 809 nm diode laser (0.5 W, 5 s) with 25% bovine serum albumin (BSA) and 2.5 mg/ml indocyanine green (ICG); (b) direct welding with a 980 nm diode laser (0.5 W, 5 s); (c) direct welding with a 1,070 nm fiber laser (0.5 W, 5 s); (d) suturing. Six spots (79.61 J/cm(2) for each spot) were applied through the incisions. Healing was inspected on the 1st, 4th, 7th, 14th, and 21st post-operative days. The closure index (CI), thermally altered area (TAA), granulation area (GA) and epidermal thickness (ET) were determined by histological examination. Tensile tests were performed at a 5 mm/min crosshead speed up to the first opening along the incision. Immediate superficial closure with high CI values was found for the laser-irradiated incisions at the early phase of recovery. Clear welds without thermal damage were observed for the group irradiated at 1,070 nm. For the sutured group, the incisions remained unclosed for the first day, and openings through the incision were observed. At the end of the 21-day recovery period, no differences between experimental groups were observed in terms of the CI, GA and ET values. However, the tensile strength of the groups irradiated at 980 nm and 1,070 nm was found to be higher than that of the sutured incisions. The laser welding techniques were found to be reliable in terms of immediate and mechanically strong closure compared with suturing. Of them, 1,070 nm laser welding yielded noticeably stronger bonds, with minimal scarring at the end of the 21-days of recovery.
Results emphasized the significance of mode of operation as well as the other laser parameters. Modulated mode was found to be a promising regime for safer laser surgery.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.