Association of Electrochemical Therapy With Optical, Mechanical, and Acoustic Impedance Properties of Porcine Skin

Abstract

The classic management of burn scars and other injuries to the skin has largely relied on soft-tissue transfer to resurface damaged tissue with local tissue transfer or skin graft placement. In situ generation of electrochemical reactions using needle electrodes and an application of current may be a new approach to treat scars and skin.OBJECTIVE To examine the changes in optical, mechanical, and acoustic impedance properties in porcine skin after electrochemical therapy. DESIGN, SETTING, AND PARTICIPANTSThis preclinical pilot study, performed from August 1, 2015, to November 1, 2016, investigated the effects of localized pH-driven electrochemical therapy of ex vivo porcine skin using 24 skin samples. Platinum-plated needle electrodes were inserted into fresh porcine skin samples. A DC power supply provided a voltage of 4 to 5 V with a 3-minute application time. Specimens were analyzed using optical coherence tomography, optical coherence elastography, and ultrasonography. Ultrasonography was performed under 3 conditions (n = 2 per condition), optical coherence tomography was performed under 2 conditions (n = 2 per condition), and optical coherence elastography was performed under 2 conditions (n = 2 per condition). The remaining samples were used for the positive and negative control groups (n = 10).EXPOSURES Platinum-plated needle electrodes were inserted into fresh porcine skin samples. A DC power supply provided a voltage of 4 to 5 V with a 3-minute application.MAIN OUTCOMES AND MEASURES Tissue softening was observed at the anode and cathode sites as a result of electrochemical modification. Volumetric changes were noted using each optical and acoustic technique. RESULTS A total of 24 ex vivo porcine skin samples were used for this pilot study. Optical coherence tomography measured spatial distribution of superficial tissue changes around each electrode site. At 4 V for 3 minutes, a total volumetric effect of 0.47 mm 3 was found at the anode site and 0.51 mm 3 at the cathode site. For 5 V for 3 minutes, a total volumetric effect of 0.85 mm 3 was found at the anode site and 1.05 mm 3 at the cathode site. CONCLUSIONS AND RELEVANCEElectrochemical therapy is a low-cost technique that is on par with the costs of suture and scalpel. The use of electrochemical therapy to create mechanical and physiologic changes in tissue has the potential to locally remodel the soft-tissue matrix, which ultimately may lead to an inexpensive scar treatment or skin rejuvenation therapy.LEVEL OF EVIDENCE NA.

Multiphoton Microscopy of Collagen Structure in Ex Vivo Human Skin Following Electrochemical Therapy

“…Often, these remnants are also injected with lidocaine and epinephrine prior to surgery. This immediate introduction of water can potentially reverse some of the effects of ECT as the primary mechanism of ECT is the localized hydrolysis of water . Some concerns may understandably be raised regarding a potential temperature effect due to resistive heating, but no temperature elevation was measured in this study or any other studies using cartilage, porcine skin, and fat .…”

“…Previous studies in our lab have demonstrated collagen structural change in the rabbit cartilage and pig skin [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]. This study is the first to characterize the redoxinduced alteration in the optical and mechanical behavior in the human skin.…”

“…Pursuing this further, we demonstrated preliminary findings in ex vivo porcine skin suggesting that the tissue softened, presumably as a consequence of matrix collagen undergoing changes due to pH perturbations. Initial studies with OCT, OCE, and high‐frequency ultrasound suggested localized softening of the tissue .…”

“…Furthermore, the entire system was controlled using a MATLAB program and PC workstation, and current was recorded during the entire process. These parameters were identified based upon the previous work . After voltage application, electrodes were removed and the specimens were immediately analyzed using various imaging techniques outlined below.…”

“…While the exact mechanism of ECT is not currently understood, it likely creates an in situ electrochemical cell using tissue fluid as the electrolyte . When an external voltage is applied to the two platinum‐plated electrodes (anode and cathode) that are inserted into the hydrated tissue, the electrolysis of water occurs.…”