Effect of CO2 milliwatt laser on peripheral nerves: Part I. A dose‐response study

Menovsky, Thomas; Weerman, Marius van den Bergh; Beek, Hans van

doi:10.1002/(sici)1098-2752(1996)17:10<562::aid-micr6>3.3.co;2-7

Cited by 8 publications

(16 citation statements)

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“…CO 2 welding has been shown to be advantageous compared with direct suturing in animals, as it reduces local trauma, neuroma formation, scar formation, foreign body reactions and aberrant axonal sprouting, while being faster and less invasive [5,40]. Menovsky and colleagues studied the effects of CO 2 laser on rat sciatic nerves and found pathological changes were dependent on energy delivered: at higher power, there was significant neural destruction with only minimal healthy fibres remaining, while at lower powers, a small degree of WDG was present with oedema, yet, the centre of the nerve was unaffected [53]. However, what has proved particularly beneficial is the speed of anastomosis, especially in restricted surgical fields, such as cranial nerve surgery [56].…”

Section: Laser Tissue Weldingmentioning

confidence: 99%

Nerve repair: toward a sutureless approach

et al. 2014

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Peripheral nerve repair for complete section injuries employ reconstructive techniques that invariably require sutures in their application. Sutures are unable to seal the nerve, thus incapable of preventing leakage of important intraneural fluids from the regenerating nerve. Furthermore, sutures are technically demanding to apply for direct repairs and often induce detrimental scarring that impedes healing and functional recovery. To overcome these limitations, biocompatible and biodegradable glues have been used to seal and repair peripheral nerves. Although creating a sufficient seal, they can lack flexibility and present infection risks or cytotoxicity. Other adhesive biomaterials have recently emerged into practice that are usually based on proteins such as albumin and collagen or polysaccharides like chitosan. These adhesives form their union to nerve tissue by either photothermal (tissue welding) or photochemical (tissue bonding) activation with laser light. These biomaterial adhesives offer significant advantages over sutures, such as their capacity to unite and seal the epineurium, ease of application, reduced invasiveness and add the potential for drug delivery in situ to facilitate regeneration. This paper reviews a number of different peripheral nerve repair (or reconstructive) techniques currently used clinically and in experimental procedures for nerve injuries with or without tissue deficit.

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Section: Laser Tissue Weldingmentioning

confidence: 99%

Nerve repair: toward a sutureless approach

et al. 2014

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“…However, laser thermal damage (65-70°C) has often caused loss of axon myelination and coagulation of the perineurium. 10,11 Reduction of the activation temperature of solders is required to make such surgical procedures safe and reliable. In promising recent studies, it has been shown that a novel chitosan adhesive bonded well to rat sciatic nerves (ϳ13 KPa) when laser-activated at a fluence of ϳ65 J/cm 2 (laser energy over 1 cm 2 of adhesive), producing local temperatures in the range from 60-65°C.…”

Section: Introductionmentioning

confidence: 99%

Sutureless Nerve Repair with Laser-Activated Chitosan Adhesive: A Pilot in Vivo Study

Lauto

Foster

Avolio

et al. 2008

Photomedicine and Laser Surgery

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“…In addition, suture material has been associated with the generation of scar tissue though the exact detrimental effects, if any, on axon regeneration are not known [13]. Although suturing in some form remains widely accepted, alternate techniques are continually being developed with hopes of improving outcomes and surgical efficiency [7,[16][17][18]20].…”

Section: Discussionmentioning

confidence: 99%

“…Alternative repair techniques have been introduced with variable degrees of success and acceptance amongst surgeons. Current alternate techniques include fibrin "glue" applied as a cocoon around approximated nerve ends, use of laser-assisted protein "welds," and, more recently, the use of nerveconnecting conduits [7,[16][17][18]20]. Though in most of these techniques, the use of sutures (and the expense, time, and skill associated with their usage) is not avoided, the overall number of sutures is decreased and suture placement may be directed away from the critical nerve end.…”

Section: Introductionmentioning

confidence: 99%