Wound healing and collagen thermal damage in 7.5-?sec pulsed CO2 laser skin incisions

Sanders, David; Reinisch, Lou

doi:10.1002/(sici)1096-9101(2000)26:1<22::aid-lsm5>3.0.co;2-r

Cited by 43 publications

(26 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The use of PIRL can open up new surgical methods where scar tissue formation is particularly debilitating [16]. This approach may have general applications in reducing hyperplastic scarring and also cosmetic application in the revision of existing hyperplastic scars.…”

Section: Resultsmentioning

confidence: 99%

Ultrafast Mid-IR Laser Scalpel: Protein Signals of the Fundamental Limits to Minimally Invasive Surgery

et al. 2010

View full text Add to dashboard Cite

Lasers have in principle the capability to cut at the level of a single cell, the fundamental limit to minimally invasive procedures and restructuring biological tissues. To date, this limit has not been achieved due to collateral damage on the macroscale that arises from thermal and shock wave induced collateral damage of surrounding tissue. Here, we report on a novel concept using a specifically designed Picosecond IR Laser (PIRL) that selectively energizes water molecules in the tissue to drive ablation or cutting process faster than thermal exchange of energy and shock wave propagation, without plasma formation or ionizing radiation effects. The targeted laser process imparts the least amount of energy in the remaining tissue without any of the deleterious photochemical or photothermal effects that accompanies other laser wavelengths and pulse parameters. Full thickness incisional and excisional wounds were generated in CD1 mice using the Picosecond IR Laser, a conventional surgical laser (DELight Er:YAG) or mechanical surgical tools. Transmission and scanning electron microscopy showed that the PIRL laser produced minimal tissue ablation with less damage of surrounding tissues than wounds formed using the other modalities. The width of scars formed by wounds made by the PIRL laser were half that of the scars produced using either a conventional surgical laser or a scalpel. Aniline blue staining showed higher levels of collagen in the early stage of the wounds produced using the PIRL laser, suggesting that these wounds mature faster. There were more viable cells extracted from skin using the PIRL laser, suggesting less cellular damage. β-catenin and TGF-β signalling, which are activated during the proliferative phase of wound healing, and whose level of activation correlates with the size of wounds was lower in wounds generated by the PIRL system. Wounds created with the PIRL systsem also showed a lower rate of cell proliferation. Direct comparison of wound healing responses to a conventional surgical laser, and standard mechanical instruments shows far less damage and near absence of scar formation by using PIRL laser. This new laser source appears to have achieved the long held promise of lasers in minimally invasive surgery.

show abstract

Section: Resultsmentioning

confidence: 99%

Ultrafast Mid-IR Laser Scalpel: Protein Signals of the Fundamental Limits to Minimally Invasive Surgery

et al. 2010

View full text Add to dashboard Cite

show abstract

“…7,19,27,30,36 Another way to cleanse infected wounds is with the CO 2 laser. 1,8,10,11,19,22,25,26 A previous study found that the CO 2 laser promotes, on soft tissues, a more rapid reepithelialization, with increased neovascularization and improved collagen synthesis by fibroblasts. 34 The use of the CO 2 laser does not result in postsurgical bacteremia, which is an important factor in treating elderly patients, patients with cancer, or patients with some kind of immunosuppression.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Effects of the CO₂Laser and Chlorohexidine on the Decontamination of Infected Cutaneous Wounds: A Histologic Study in Rats

Pinheiro

Neves

Castro

et al. 2002

Journal of Clinical Laser Medicine & Surgery

View full text Add to dashboard Cite

The results of this study show that infected wounds treated with 4% chlorohexidine show a more pronounced inflammatory reaction when compared to that observed when the CO2 laser is used, especially when surface debris are removed; surface debris removal on laser-treated wounds results in better and more rapid healing; the surface debris may act as a culture medium for bacterial growth or, because of its characteristics, it may act as a local irritant and delay healing.

show abstract

“…27 Due to this fundamental difference, it was initially hypothesized that 6.45 μ m may target protein bands more effectively than 6.10 μ m, and this superior targeting may lead to greater disruption of the tissue matrix, less violent tissue removal, and less collateral damage. 14 With this in mind, the structural failure of proteins was investigated by analyzing ablation plumes and ejected tissue fragments. 8,27 In contrast, more recent evidence suggests that 6.1 μ m is superior, because it gives lower ablation thresholds, higher ablation yields, and less collateral tissue damage in biological tissues.…”

Section: Introductionmentioning

confidence: 99%

In-vivo optical imaging of hsp70 expression to assess collateral tissue damage associated with infrared laser ablation of skin

et al. 2008

View full text Add to dashboard Cite

Laser surgical ablation is achieved by selecting laser parameters that remove confined volumes of target tissue and cause minimal collateral damage. Previous studies have measured the effects of wavelength on ablation, but neglected to measure the cellular impact of ablation on cells outside the lethal zone. In this study, we use optical imaging in addition to conventional assessment techniques to evaluate lethal and sublethal collateral damage after ablative surgery with a free-electron laser (FEL). Heat shock protein (HSP) expression is used as a sensitive quantitative marker of sublethal damage in a transgenic mouse strain, with the hsp70 promoter driving luciferase and green fluorescent protein (GFP) expression (hsp70A1-L2G). To examine the wavelength dependence in the mid-IR, laser surgery is conducted on the hsp70A1-L2G mouse using wavelengths targeting water (OH stretch mode, 2.94 μm), protein (amide-II band, 6.45 μm), and both water and protein (amide-I band, 6.10 μm). For all wavelengths tested, the magnitude of hsp70 expression is dose-dependent and maximal 5 to 12 h after surgery. Tissues treated at 6.45 μm have approximately 4× higher hsp70 expression than 6.10 μm. Histology shows that under comparable fluences, tissue injury at the 2.94-μm wavelength was 2× and 3× deeper than 6.45 and 6.10 μm, respectively. The 6.10-μm wavelength generates the least amount of epidermal hyperplasia. Taken together, this data suggests that the 6.10-μm wavelength is a superior wavelength for laser ablation of skin.

show abstract

Wound healing and collagen thermal damage in 7.5-?sec pulsed CO2 laser skin incisions

Cited by 43 publications

References 21 publications

Ultrafast Mid-IR Laser Scalpel: Protein Signals of the Fundamental Limits to Minimally Invasive Surgery

Ultrafast Mid-IR Laser Scalpel: Protein Signals of the Fundamental Limits to Minimally Invasive Surgery

Comparison of the Effects of the CO₂Laser and Chlorohexidine on the Decontamination of Infected Cutaneous Wounds: A Histologic Study in Rats

In-vivo optical imaging of hsp70 expression to assess collateral tissue damage associated with infrared laser ablation of skin

Contact Info

Product

Resources

About

Wound healing and collagen thermal damage in 7.5-?sec pulsed CO2 laser skin incisions

Cited by 43 publications

References 21 publications

Ultrafast Mid-IR Laser Scalpel: Protein Signals of the Fundamental Limits to Minimally Invasive Surgery

Ultrafast Mid-IR Laser Scalpel: Protein Signals of the Fundamental Limits to Minimally Invasive Surgery

Comparison of the Effects of the CO2Laser and Chlorohexidine on the Decontamination of Infected Cutaneous Wounds: A Histologic Study in Rats

In-vivo optical imaging of hsp70 expression to assess collateral tissue damage associated with infrared laser ablation of skin

Contact Info

Product

Resources

About

Comparison of the Effects of the CO₂Laser and Chlorohexidine on the Decontamination of Infected Cutaneous Wounds: A Histologic Study in Rats