Association of Electrochemical Therapy With Optical, Mechanical, and Acoustic Impedance Properties of Porcine Skin

Moy, Wesley J.; Su, Erica; Chen, Jason J.; Oh, Connie J.; Jing, Joe; Qu, Yueqiao; He, Youmin; Chen, Zhongping; Wong, Brian J. F.

doi:10.1001/jamafacial.2017.0341

Cited by 13 publications

(26 citation statements)

References 38 publications

(151 reference statements)

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“…Often, these remnants are also injected with lidocaine and epinephrine prior to surgery. This immediate introduction of water can potentially reverse some of the effects of ECT as the primary mechanism of ECT is the localized hydrolysis of water . Some concerns may understandably be raised regarding a potential temperature effect due to resistive heating, but no temperature elevation was measured in this study or any other studies using cartilage, porcine skin, and fat .…”

Section: Discussionmentioning

confidence: 90%

“…Previous studies in our lab have demonstrated collagen structural change in the rabbit cartilage and pig skin [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]. This study is the first to characterize the redoxinduced alteration in the optical and mechanical behavior in the human skin.…”

Section: Introductionmentioning

confidence: 76%

“…Pursuing this further, we demonstrated preliminary findings in ex vivo porcine skin suggesting that the tissue softened, presumably as a consequence of matrix collagen undergoing changes due to pH perturbations. Initial studies with OCT, OCE, and high‐frequency ultrasound suggested localized softening of the tissue .…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the entire system was controlled using a MATLAB program and PC workstation, and current was recorded during the entire process. These parameters were identified based upon the previous work . After voltage application, electrodes were removed and the specimens were immediately analyzed using various imaging techniques outlined below.…”

Section: Methodsmentioning

confidence: 99%

“…While the exact mechanism of ECT is not currently understood, it likely creates an in situ electrochemical cell using tissue fluid as the electrolyte . When an external voltage is applied to the two platinum‐plated electrodes (anode and cathode) that are inserted into the hydrated tissue, the electrolysis of water occurs.…”

Section: Introductionmentioning

confidence: 99%

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Multiphoton Microscopy of Collagen Structure in Ex Vivo Human Skin Following Electrochemical Therapy

Hong

Toubat

et al. 2019

Lasers Surg Med

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Objectives Injury to healthy dermis and the dermoepidermal junction initiates a robust healing process consisting of fibrous tissue overgrowth, collagen deposition, and scar formation. The conventional management of scars and other skin injuries has largely relied upon surgical soft tissue transfer to resurface and/or replace damaged and dysmorphic tissue with new skin. However, these strategies are invasive, expensive, and may further exacerbate integumentary injury. In this study, we examine the creation of in situ redox generated pH changes in fresh human skin. We believe this process of “electrochemical therapy” (ECT) leads to changes in collagen matrix structure. Our objective is to map local tissue pH landscapes and image changes in collagen structure of non‐injured skin following ECT. Study Design Ex vivo human study involving ECT of human skin. Methods Remnant fresh ex vivo human facial skin from facelift operations was enveloped in saline‐soaked gauze for a maximum of 2 hours prior to ECT and imaging. ECT was performed by inserting platinum‐plated needle electrodes connected to a DC power supply. Voltage (4, 5, or 6 V) and time (3, 4, or 5 minutes) were varied systematically. High frequency ultrasound (25 MHz) was performed immediately after ECT on each sample. Treated samples were also imaged using multiphoton microscopy (MPM) with second harmonic generation (SHG) to specifically visualize collagen fibers in the dermis. The pH landscapes were mapped using indicator dyes in bisected specimens and the MPM images were compared with histologic findings. Results Above 4 V and 3 minutes, a profound reduction in dermal collagen SHG signal was observed at the anode. Although there was less blunting of SHG signal seen at the cathode, a decrease in the fluorescence of the dermoepidermal junction was observed. The pH application suggests ECT spatial selectivity and a direct relationship between voltage and application time. Ultrasound demonstrated gas formation between the anode and cathode, which is consistent with ECT's mechanism of action. Importantly, these electrochemical changes occurred without disrupting dermal and epidermal histologic architecture. Conclusion ECT alters tissue pH leading to dermal collagen structural change. These results offer additional insight into the translational potential of ECT to locally remodel the soft‐tissue matrix. Future directions aim to expand into a skin injury model to determine if similar collagen effects are observed in vivo. ECT is incredibly inexpensive (~$5) and may be a means to treat soft tissue injuries using simple needle‐based devices and DC battery power supplies. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Multiphoton Microscopy of Collagen Structure in Ex Vivo Human Skin Following Electrochemical Therapy

Hong

Toubat

et al. 2019

Lasers Surg Med

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Electrochemical Therapy of In Vivo Rabbit Cutaneous Tissue

et al. 2021

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Objectives: To examine the acid-base and histological changes in in vivo rabbit cutaneous tissue after electrochemical therapy.Study Design: In vivo rabbit tissue study.Methods: The shaved skin on the backs of female Oryctolagus cuniculi were assigned to treatments with or without tumescence with normal saline. Two platinum-needle electrodes were inserted into each treatment area and connected to a direct current (DC) power supply. Voltage (3-5 V) was varied and applied for 5 minutes. The wound-healing process was monitored via digital photography and ultrasonography until euthanasia at day 29. Treatment areas were biopsied, and specimens were sectioned through a sagittal midline across both electrode insertion sites. Samples were then evaluated utilizing light microscopy (hematoxylin and eosin, Masson's Trichrome, and Picrosirius red).Results: Treatment sites developed mild inflammation that dissipated at lower voltages or became scabs at higher voltages. Ultrasonography demonstrated acoustic shadowing with spatial spread that increased with increasing voltage application. The 4-and 5-V sites treated with saline had localized areas of increased tissue density at day 29. Although specimens treated with 3 V did not look significantly different from control tissue, 4-and 5-V samples with and without saline tumescence had finer, less-organized collagen fibers and increased presence of fibrocytes and inflammatory infiltrates.Conclusions: Electrochemical therapy caused localized injury to in vivo rabbit cutaneous tissue, prompting regenerative wound repair. With future development, this technology may offer precise, low-cost rejuvenation to restore the functionality and appearance of dermal scars and keloids.

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In vivo electrochemical lipolysis of fat in a Yucatan pig model: A proof of concept study

et al. 2022

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Objectives Traditional fat contouring is now regularly performed using numerous office‐based less invasive techniques. However, some limitations of these minimally invasive techniques include high cost or limited selectivity with performing localized contouring and reduction of fat. These shortcomings may potentially be addressed by electrochemical lipolysis (ECLL), a novel approach that involves the insertion of electrodes into tissue followed by application of a direct current (DC) electrical potential. This results in the hydrolysis of tissue water creating active species that lead to fat necrosis and apoptosis. ECLL can be accomplished using a simple voltage‐driven system (V‐ECLL) or a potential‐driven feedback cell (P‐ECLL) both leading to water electrolysis and the creation of acid and base in situ. The aim of this study is to determine the long‐lasting effects of targeted ECLL in a Yucatan pig model. Methods A 5‐year‐old Yucatan pig was treated with both V‐ECLL and P‐ECLL in the subcutaneous fat layer using 80:20 platinum:iridium needle electrodes along an 8 cm length. Dosimetry parameters included 5 V V‐ECLL for 5, 10, and 20 minutes, and −1.5 V P‐ECLL, −2.5 V P‐ECLL, −3.5 V P‐ECLL for 5 minutes. The pig was assessed for changes in fat reduction over 3 months with digital photography and ultrasound. After euthanasia, tissue sections were harvested and gross pathology and histology were examined. Results V‐ECLL and P‐ECLL treatments led to visible fat reduction (12.1%–27.7% and 9.4%–40.8%, respectively) and contour changes across several parameters. An increased reduction of the superficial fat layer occurred with increased dosimetry parameters with an average charge transfer of 12.5, 24.3, and 47.5 C transferred for 5 V V‐ECLL for 5, 10, and 20 minutes, respectively, and 2.0, 11.5, and 24.0 C for −1.5 V P‐ECLL, −2.5 V P‐ECLL, −3.5 V P‐ECLL for 5 minutes, respectively. These dose‐dependent changes were also evidenced by digital photography, gross pathology, ultrasound imaging, and histology. Conclusions ECLL results in selective damage and long‐lasting changes to the adipose layer in vivo. These changes are dose‐dependent, thus allowing for more precise contouring of target areas. P‐ECLL has greater efficiency and control of total charge transfer compared to V‐ECLL, suggesting that a low‐voltage potentiostat treatment can result in fat apoptosis equivalent to a high‐voltage DC system.

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Association of Electrochemical Therapy With Optical, Mechanical, and Acoustic Impedance Properties of Porcine Skin

Cited by 13 publications

References 38 publications

Multiphoton Microscopy of Collagen Structure in Ex Vivo Human Skin Following Electrochemical Therapy

Multiphoton Microscopy of Collagen Structure in Ex Vivo Human Skin Following Electrochemical Therapy

Electrochemical Therapy of In Vivo Rabbit Cutaneous Tissue

In vivo electrochemical lipolysis of fat in a Yucatan pig model: A proof of concept study

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