Closure of skin incisions by 980-nm diode laser welding

Abstract

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.

In vitro large diameter bowel anastomosis using a temperature controlled laser tissue soldering system and albumin stent

“…Clinical and experimental use of lasers in bonding have been carried out on numerous types of tissues, including urinary tract [9,10], blood vessels [11], skin [12,13], and dura [14]. A variety of different techniques, lasers, solders and their parameters have been used in these studies.…”

Clinical Assessment of Tissue Healing of Extracted Sockets Irradiated with 940 Nm Diode Laser

“…treatment, no secondary bleeding, precision of cut, calculated depth of cut, reduced application of drugs (antibiotics, analgesics ), only minimal destruction of adjacent tissues, uncomplicated handling, high patient acceptance, low level of scar forming, use on patients with haemorrhagic diathesis without or only with little substitution, good handling due to fiberoptics, reduction of needed instruments (change of parameters-different effects), treatment duration shorter ( no suture, not often change of instrument..), biostimulation of the surrounding tissue (10,11,14) . Diode laser wavelength is very well absorbed in pigment, melanin and most importantly for hemostasis by the hemoglobin molecule (13) .…”

Closure of skin incisions by laser-welding with a combination of two near-infrared diode lasers: preliminary study for determination of optimal parameters

“…The major disadvantage is thermal damage to the surrounding tissue which should be minimized with the correct selection of laser wavelength, operation mode, and irradiation dose. 17,18 In the present study, aiming to achieve a full-thickness closure of incision, the ability and efficiency of skin welding with a combination of two near-infrared lasers (980 and 1064-nm lasers) was investigated using rat skin models, which have been widely used to simulate human conditions, [14][15][16]18 and compared with the suturing technique.…”

“…Then, histological examinations were performed as described in previous works. [14][15][16] For tensile strength measurements, 20 rats (10 from each group: laser welding and suture) were anesthetized with ketamine, and 1 cm×3 cm strips with the incisions in the center were cut off. Then, the measurements were performed immediately (within 10 min after the cut) in order to minimize drying of the tissues.…”

“…13 The skinwelding ability of a 980-nm diode laser was investigated because of its relatively higher absorption by water than other near infrared lasers, and good closure ability was reported in the early days of the healing period. [14][15][16] In all of these previous works, however, a good deal of attention was paid to the skinwelding ability of a single laser, and little was paid to skin welding with more than one laser, as far as we know.…”