Photochemical Sealing Improves Outcome Following Peripheral Neurorrhaphy

OʼNeill, Anne C.; Randolph, Mark A.; Bujold, Kenneth E.; Kochevar, Irene E.; Redmond, Robert W.; Winograd, Jonathan M.

doi:10.1016/j.jss.2008.01.025

Cited by 49 publications

(60 citation statements)

References 40 publications

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“…In principle, this conclusion can be extended to cells in others tissues treated with PTB. In fact, our preclinical studies of PTB for closure of corneal incisions and repair of peripheral nerve, tendon, and blood vessels all indicate low inflammation and fibrosis [4,5,27,28].…”

Section: Discussionmentioning

confidence: 95%

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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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Section: Discussionmentioning

confidence: 95%

“…The oxygen level in normal dermis (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)) is lower than that in airsaturated culture medium ($150 mmHg). In addition, the incision severs small blood vessels that immediately close due to formation of fibrin clots.…”

Section: Discussionmentioning

confidence: 99%

Phototoxicity is not associated with photochemical tissue bonding of skin

et al. 2010

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“…Animal studies in rat sciatic nerve and rabbit common peroneal nerve models have demonstrated to improve axon counts at the site of injury and gait function after end-to-end coaptation with a PTB nerve wrap [59]. Improved gait function has also been demonstrated in a one cm rat sciatic nerve graft model [57,58].…”

Section: Nonthermal Laser Amnion Wrapmentioning

confidence: 99%

“…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 [57,58]. The problems of unintended thermal injury to nerve tissue from traditional laser techniques are avoided.…”

Section: Nonthermal Laser Amnion Wrapmentioning

confidence: 99%

Recent Approaches for Augmenting Peripheral Nerve Regeneration: Mini Review

2017

MOJS

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“…Animal studies have demonstrated that this method leads to better functional outcomes and axon counts in both rat and rabbit models of nerve repair when compared with standard suture repair. 48,49 This repair method has not yet been used clinically.…”

Section: Laser Repairmentioning

confidence: 99%

Advances in peripheral nerve regeneration as it relates to VCA

Suchyta

Sabbagh

Morsy

et al. 2016

Vascularized Composite Allotransplantation

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Vascularized composite allotransplant (VCA) offers functional, social, and quality of life improvements for patients who have exhausted traditional reconstructive options. Unlike solid organ transplant, VCA success is not only based upon the quality of perfusion and level of immunosuppression, but also on the success of nerve regeneration within the transplanted part. This paper will summarize the present state of peripheral nerve regeneration in the context of VCA and will explore the latest research advances that will affect the future of the field. These advances offer promising future strategies to improve patient outcomes in VCA.

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Photochemical Sealing Improves Outcome Following Peripheral Neurorrhaphy

Cited by 49 publications

References 40 publications

Phototoxicity is not associated with photochemical tissue bonding of skin

Phototoxicity is not associated with photochemical tissue bonding of skin

Recent Approaches for Augmenting Peripheral Nerve Regeneration: Mini Review

Advances in peripheral nerve regeneration as it relates to VCA

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