Laser-Induced Alteration of Collagen Substructure Allows Microsurgical Tissue Welding

Schober, R.; Frank, Ulrich; Sander, T.; Durselen, H; Hessel, Stefan

doi:10.1126/science.3715454

Cited by 302 publications

(124 citation statements)

References 15 publications

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“…The laser-induced alteration of the collagen substructure at the CME www.expert-reviews.com microstructural level was analyzed by Schober et al [200]. They studied the effect of the irradiation from a Nd:YAG laser operating at a wavelength of 1.319 µm on collagen in welded tissues.…”

Section: Microstructural Effect Of Laser Welding On Collagenmentioning

confidence: 99%

Tissue adhesives in ocular surgery

Park

Champakalakshmi

Panengad

et al. 2011

Expert Review of Ophthalmology

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Section: Microstructural Effect Of Laser Welding On Collagenmentioning

confidence: 99%

Tissue adhesives in ocular surgery

Park

Champakalakshmi

Panengad

et al. 2011

Expert Review of Ophthalmology

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“…Different study groups have analyzed the 3-D conformation of laser-irradiated tissues, reporting either a loosening and some sort of interaction between collagen strands [9] or an unraveling of collagen bundles and subsequent partial interdigitation [14]. Although undoubtedly existent, the reported changes as well as the loss of the birefringence in the phase contrast light microscopy remain descriptive in nature and cannot be used on their own to quantify the responsible forces in laser tissue welding and soldering.…”

Section: -D Conformation Changes Of Collagen Moleculesmentioning

confidence: 99%

“…On the other hand, laser tissue welding and soldering with high cellular/matrix ratio in tissues like skin, blood vessels, intestinal submucosa and kidneys demonstrated a superior tensile strength upon laser tissue welding [4,5,9,10,[15][16][17][18][19][20]. These observations raise the question whether intracellular cytoplasm components might be the one delivering the necessary "ingredients" for tensile strength induction in thermal tissue connection.…”

Section: -D Conformation Changes Of Collagen Moleculesmentioning

confidence: 99%

“…To date, the laserinduced conformational alterations of collagen molecules have been believed to be the main effect of laser irradiation on tissues, leading to the observed tensile strengths. Two mechanisms have so far been discussed [7][8][9]: interdigitation of collagen fibrils as seen on electron microscopy studies, suggesting changes in the 3-D conformation of the molecules, and the induction of new covalent bonds between collagen molecules. The studies analyzing the covalent forces after laser irradiation using the sodium dodecylsulfate polyacrylamide gel electrophoresis (SDS-PAGE) technique were performed with collagen-rich substrates containing more or less cellular components.…”

Section: Introductionmentioning

confidence: 99%

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Effect of laser soldering irradiation on covalent bonds of pure collagen

et al. 2006

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Laser tissue welding and soldering is being increasingly used in the clinical setting for defined surgical procedures. The exact induced changes responsible for tensile strength are not yet fully investigated. To further improve the strength of the bonding, a better understanding of the laser impact at the subcellular level is necessary. The goal of this study was to analyze whether the effect of laser irradiation on covalent bonding in pure collagen using irradiances typically applied for tissue soldering. Pure rabbit and equine type I collagen were subjected to laser irradiation. In the first part of the study, rabbit and equine collagen were compared using identical laser and irradiation settings. In the second part of the study, equine collagen was irradiated at increasing laser powers. Changes in covalent bonding were studied indirectly using the sodium dodecylsulfate polyacrylamide gel electrophoresis (SDS-PAGE) technique. Tensile strengths of soldered membranes were measured with a calibrated tensile force gauge. In the first experiment, no differences between the species-specific collagen bands were noted, and no changes in banding were found on SDS-PAGE after laser irradiation. In the second experiment, increasing laser irradiation power showed no effect on collagen banding in SDS-PAGE. Finally, the laser tissue soldering of pure collagen membranes showed virtually no determinable tensile strength. Laser irradiation of pure collagen at typical power settings and exposure times generally used in laser tissue soldering does not induce covalent bonding between collagen molecules. This is true for both rabbit and equine collagen proveniences. Furthermore, soldering of pure collagen membranes without additional cellular components does not achieve the typical tensile strength reported in native, cell-rich tissues. This study is a first step in a better understanding of laser impact at the molecular level and might prove useful in engineering of combined collagen-soldering matrix membranes for special laser soldering applications.

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“…It offers several advantages over common suture anastomosis including faster healing with less inflammation, precise application, and shorter procedure times [15]. During the laser welding process a homogenizing change of collagen with interdigitation of altered individual fibrils seems to be the underlying mechanism for tissue welding [16,17]. To increase initial tensile strength of the wound solders have successfully been applied improving laser-mediated tissue welding through denaturation and bond formation [18].…”

Section: Introductionmentioning

confidence: 99%

Laser‐mediated fixation of collagen‐based scaffolds to dermal wounds

et al. 2010

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Background and Objective: Collagen scaffolds are popular for the reconstitution of dermal equivalents. Usually, these scaffolds are fixed with sutures or staples and in many cases these devices have to be removed in a second procedure. Laser-mediated tissue welding in a wet environment is a potential alternative for collagen scaffold fixation and may be advantageous to suture, staple, and tissue glue fixation. Materials and Methods: Welding was performed with a continuous-wave diode laser system emitting radiation at a wavelength of 968 nm. Tensile strength after fixation to porcine skin and laser parameters were determined in vitro. In vivo, 24 excisional deep partial thickness wounds were created on flanks of two Goettingen mini pigs and covered with collagen scaffolds. These were randomized and fixated with either (1) staples, (2) fibrin glue, or (3) laser-mediated welding. Tissue biopsies for histological analysis were periodically performed and analyzed for wound healing progression, epidermal thickness, and extracellular matrix formation. Results: Biomechanical stability after laser welding was time dependent. A dwell time of up to 10 seconds led to a strong bonding with a tensile strength of more than 30 g. In vivo, the wound healing process was macroscopically comparable in all groups and showed no significant differences. Microscopic analysis determined a more progressed and quicker wound closure in both the laser and staples group compared to the fibrin glue fixated scaffold. Laser-mediated fixation led to a significantly reduced epidermal thickness when compared with stapling or fibrin glue (P < 0.05). Conclusions: Laser tissue welding is a feasible approach for temporary fixation of collagen scaffolds to the wound bed. It improves wound healing properties and may lead to faster wound healing and cosmetically better scarring. Laser tissue welding is thus a very interesting and promising alternative to currently established fixation methods in a single step, no touch procedure

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Laser-Induced Alteration of Collagen Substructure Allows Microsurgical Tissue Welding

Cited by 302 publications

References 15 publications

Tissue adhesives in ocular surgery

Tissue adhesives in ocular surgery

Effect of laser soldering irradiation on covalent bonds of pure collagen

Laser‐mediated fixation of collagen‐based scaffolds to dermal wounds

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