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Proceedings Paper

Laser-assisted skin closure at 1.32 microns: the use of a software-driven medical laser system
Author(s): Douglas K. Dew M.D.; Tung Mei Hsu D.V.M.; Long S. Hsu; Steven J. Halpern; Charles E. Michaels
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Paper Abstract

This study investigated the use of a computerized 1 .3 micron Nd:YAG laser to seal approximated wound edges in pig skin. The medical laser system used was the DLS Type 1 , 1 .32 micron Nd:YAG laser (Laser Surgery Software, Inc.). The purpose of this study was to evaluate the effectiveness of laser assisted skin closure using the DLS YAG laser in a large animal model. Effectiveness was judged on the basis of wound dehiscence, infection, unusual healing result and consistency of results. Comparative cosmetic result was also evaluated. In this study, the DLS YAG laser was used to close scalpel-induced, full-thickness wounds. The pig model was chosen for its many integumentary similarities to man. Controls included scalpel-induced wounds closed using suture, staple and some with norepair. After adequate anesthesia was achieved, the dorsum of Yucutan pigs (approximately 75- 100 pounds) each was clipped with animal hair clippers from the shoulder area to the hind legs. The area was then shaved with a razor blade, avoiding any inadvertent cuts or abrasions of the skin. The dorsum was divided into four rows of four parallel incisions made by a #15 scalpel blade. Full-thickness incisions, 9 cm long, were placed over the dorsum of the pigs and then closed either with one loosely approximating Prolene" suture (the "no repair' group), multiple interrupted 6-0 nylon sutures, staples or laser. The experimental tissue sealing group consisted of 1 69 laser assisted closures on 1 3 pigs. Sutured control wounds were closed with 6-0 nylon, full thickness, simple, interrupted sutures. Eight sutures were placed 1 cm apart along the 9 cm incision. Stapled control wounds were approximated using two evenly spaced 3-0 VicryP' sub-dermal sutures and the dermis closed using Proximate' skin staples. Eight staples were placed 1 cm apart along the 9 cm incision. The no-repair incisions were grossly approximated using a single 2-0 Prolene full thickness, simple, interrupted suture located at the center of the 9 cm incision. Experimental wounds were approximated using two evenly spaced subdermal 3.0 Vicryl' sutures and the dermis closed by laser sealing using the DLS YAG laser. Wounds were examined daily for the first seven days and followed for up to 20 months postoperatively. To facilitate wound edge approximation, surgical tape that is relatively transparent to 1.3 micron irradiation was used to hold the wound edges approximated while laser application occurred. Surgical tape was also applied to the "no-repair" suture and staple closures at the end of each procedure.

Paper Details

Date Published: 1 June 1991
PDF: 5 pages
Proc. SPIE 1422, Lasers in Dermatology and Tissue Welding, (1 June 1991); doi: 10.1117/12.43946
Show Author Affiliations
Douglas K. Dew M.D., Orlando Regional Medical Ctr. (United States)
Tung Mei Hsu D.V.M., Orlando Regional Medical Ctr. (United States)
Long S. Hsu, Orlando Regional Medical Ctr. (United States)
Steven J. Halpern, Orlando Regional Medical Ctr. (United States)
Charles E. Michaels, Orlando Regional Medical Ctr. (United States)

Published in SPIE Proceedings Vol. 1422:
Lasers in Dermatology and Tissue Welding
Oon Tian Tan M.D.; Rodney A. White M.D.; John V. White M.D., Editor(s)

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