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Proceedings Paper

Comparison of CO2 laser welding with suture technique for repair of tendons
Author(s): Neven A. Popovic; Frederic L. Johnstone; Francis X. Kilkelly; LuAnn McKinney; Willem Pieter Van De Merwe; Allan C. Smith
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Paper Abstract

The purpose of this study was to evaluate the efficacy, histology, and strength of laser welding in repair of sharply transected rat Achilles tendons. In 26 adult, male Sprague-Dawley rats, the severed tendons were repaired with a 7-0 nylon, modified Kessler core suture followed by either a running 9-0 nylon epitendinous suture or a circumferential CO2 laser epidendinous weld using 25% human albumin as a solder. All repairs were timed and post- operative tensile strength was analyzed with material testing equipment. In addition, histologic testing was performed on both types of repairs. The mean time to complete the epitendinous repair in the laser group was 3.5 minutes and in the suture group, 8 minutes. The mean ultimate tensile strength in 6 normal tendons was 40.9 Newtons (N) with group standard deviation of 5.2 N. When compared with normal controls, post-operatively both types of tendon repairs resulted in tensile failure at lower forces. The ultimate tensile strength for the epitendinous suture repair and the laser welds were 13% and 6% of normal controls, respectively. Twenty tendons with epidendinous suture repair had mean ultimate tensile strength of 5.4 (+/- 1.2) N, while the 17 tendons with laser wends failed at 2.6 (+/- 0.9) N. Histologic evaluation of tendons repaired with CO2 laser revealed areas of coagulation and edema on the surface of tendon edges. Post-operatively, greater tissue changes were noted in laser treated tendons than those repaired with sutures. Laser welding of epitenon is possible and can be completed faster than the suture repair. The repaired tendon surface appears smoother and less bulky after laser treatment. However, significantly decreased immediate post-operative strength was demonstrated by the use of Kruskal-Wallis one way analysis of variance and Turkey's pairwise comparison.

Paper Details

Date Published: 12 May 1995
PDF: 6 pages
Proc. SPIE 2395, Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems V, (12 May 1995); doi: 10.1117/12.209138
Show Author Affiliations
Neven A. Popovic, Walter Reed Army Medical Ctr. (United States)
Walter Reed Army Institute of Research (United States)
Uniformed Services Univ. of the Health Sciences (United States)
Frederic L. Johnstone, Walter Reed Army Medical Ctr. (United States)
Walter Reed Army Institute of Research (United States)
Uniformed Services Univ. of the Health Sciences (United States)
Francis X. Kilkelly, Walter Reed Army Medical Ctr. (United States)
Walter Reed Army Institute of Research (United States)
Uniformed Services Univ. of the Health Sciences (United States)
LuAnn McKinney, Walter Reed Army Medical Ctr. (United States)
Walter Reed Army Institute of Research (United States)
Uniformed Services Univ. of the Health Sciences (United States)
Willem Pieter Van De Merwe, Walter Reed Army Medical Ctr. (United States)
Walter Reed Army Institute of Research (United States)
Uniformed Services Univ. of the Health Sciences (United States)
Allan C. Smith, Walter Reed Army Medical Ctr. (United States)
Walter Reed Army Institute of Research (United States)
Uniformed Services Univ. of the Health Sciences (United States)


Published in SPIE Proceedings Vol. 2395:
Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems V
R. Rox Anderson; Graham M. Watson; Rudolf W. Steiner; Douglas E. Johnson; Stanley M. Shapshay; Michail M. Pankratov; George S. Abela; Lawrence S. Bass; John V. White; Rodney A. White; Kenneth Eugene Bartels; Lloyd P. Tate; C. Thomas Vangsness, Editor(s)

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