Improving electrophysiologic and histologic outcomes by photochemically sealing amnion to the peripheral nerve repair site

Henry, Francis P.; Goyal, Namita; David, William S.; Wes, David; Bujold, Kenneth E.; Randolph, Mark A.; Winograd, Jonathan M.; Kochevar, Irene E.; Redmond, Robert W.

doi:10.1016/j.surg.2008.11.005

Cited by 59 publications

(49 citation statements)

References 34 publications

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“…Photochemical tissue bonding (PTB) creates a covalently bonded nerve wrap around a nerve coaptation, using an Nd/YAG laser, photoactive dye, and a nonimmunogenic amnion wrap [60–63]. The problems of unintended thermal injury to nerve tissue from traditional laser techniques are avoided.…”

Section: Translational Research In Peripheral Nerve Repairmentioning

confidence: 99%

Peripheral Nerve Reconstruction after Injury: A Review of Clinical and Experimental Therapies

Grinsell

Keating

2014

BioMed Research International

793

694

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Unlike other tissues in the body, peripheral nerve regeneration is slow and usually incomplete. Less than half of patients who undergo nerve repair after injury regain good to excellent motor or sensory function and current surgical techniques are similar to those described by Sunderland more than 60 years ago. Our increasing knowledge about nerve physiology and regeneration far outweighs our surgical abilities to reconstruct damaged nerves and successfully regenerate motor and sensory function. It is technically possible to reconstruct nerves at the fascicular level but not at the level of individual axons. Recent surgical options including nerve transfers demonstrate promise in improving outcomes for proximal nerve injuries and experimental molecular and bioengineering strategies are being developed to overcome biological roadblocks limiting patient recovery.

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Section: Translational Research In Peripheral Nerve Repairmentioning

confidence: 99%

Peripheral Nerve Reconstruction after Injury: A Review of Clinical and Experimental Therapies

Grinsell

Keating

2014

BioMed Research International

793

694

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“…We have recently developed a light-activated technique called photochemical tissue bonding (PTB) as a platform technology for repair of tissues including skin, cornea, peripheral nerve, blood vessels, and tendon [1][2][3][4][5]. To seal a skin incision, a photosensitizing dye is applied to the wound walls and the skin surface is treated with green (532 nm) light (Fig.…”

Section: Introductionmentioning

confidence: 99%

Phototoxicity is not associated with photochemical tissue bonding of skin

et al. 2010

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Background and Objective: We have developed a lightactivated method called photochemical tissue bonding (PTB) for closing wounds using green light and a photosensitizing dye (Rose Bengal-RB) to initiate photochemical crosslinking of wound surface proteins. These studies were designed to determine whether RB causes phototoxicity during closure of skin incisions with PTB. Study Design/Materials and Methods: RB phototoxicity was evaluated after sealing incisions in porcine skin ex vivo and rabbit skin in vivo using PTB (1 mM RB, 100 J/cm 2 , 532 nm, 0.3 or 0.5 W/cm 2 .) Dead cells were identified by pyknotic nuclei and eosinophilic cytoplasm on H&E-stained sections. The influence on RB phototoxicity of penetration of RB into the wound wall (by confocal microscopy), RB concentration in the tissue (by extraction), and fluence of 532 nm reaching depths in skin (calculated from skin optical properties) were investigated. Results: No significant differences were found in the percent dead cells in PTB-treated and control incisions in porcine skin at 24 hours or in rabbit skin at 2 hours and 3 and 7 days after surgery. RB was retained in a $100 mm wide band next to the wound wall. The mean RB concentration within this band was 0.42 AE 0.03 mM. Monte Carlo modeling of light distribution indicated that the fluence rate decreased from the subsurface peak to 0.5 W/ cm 2 in the mid-dermis ($350 mm.) In vitro RB phototoxicity to dermal fibroblasts yielded an LD 50 of 0.50 AE 0.09 J/cm 2 when the cells contained 0.46 mM RB. Conclusions: PTB does not cause phototoxicity when used to repair skin wounds even though the RB concentration and 532 nm fluence in the mid-dermis during PTB are much greater than the LD 50 for RB phototoxicity in vitro. These results indicate that phototoxicity is not a concern when using PTB for tissue repair.

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“…Photochemical tissue bonding has long been known to create a watertight seal between tissues and has been used successfully in neurorrhaphy. 9,23 By creating a tightly woven interface between the implant and host tissue, we may block the mast cells, lymphocytes, and macrophages that contribute to the early phases of capsule formation. In fact, fascial flaps, placed around implants, have been used to decrease capsule formation in rabbits.…”

Section: Discussionmentioning

confidence: 99%