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Effects of temperature on tissue thermal injury and wound strength after photothermal wound closure
Author(s) -
Fung Leo C.,
Mingin Gerald C.,
Massicotte Mathieu,
Felsen Diane,
Poppas Dix P.
Publication year - 1999
Publication title -
lasers in surgery and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 112
eISSN - 1096-9101
pISSN - 0196-8092
DOI - 10.1002/(sici)1096-9101(1999)25:4<285::aid-lsm3>3.0.co;2-s
Subject(s) - soldering , necrosis , apoptosis , wound healing , materials science , fragmentation (computing) , medicine , surgery , chemistry , composite material , biology , ecology , biochemistry
Background and Objectives Our goal was to determine the effect of temperature on the induction of tissue damage after laser‐welded wound closure with and without albumin solder. Study Design/Materials and Methods Multiple full‐thickness skin incisions were made in a porcine model. Incisions were repaired by using a 1.32‐μm laser at temperatures of 65°C, 75°C, 85°C, or 95°C with and without a 50% human albumin solder. The rate of apoptosis (programmed cell death) was quantified by counting the proportion of cells that stained positively for nuclear DNA fragmentation (nick end labeling). The distance that necrosis extended from the wound edge was also measured. The strength of the weld was measured with a tensiometer. Results For laser‐welded repairs with solder, the amount of apoptosis at 65°C and 75°C was comparable to that of controls but became significantly elevated at 85°C and 95°C. The extent of necrosis was similar to that of controls at low temperature but also increased at 95°C. Incisions repaired without solder showed increased necrosis compared with those repaired with solder at temperatures of 65°C, 75°C, and 95°C at 0–0.5 mm from the incision. Wounds repaired at 85°C and 95°C showed more apoptosis in the absence of solder. The increased cell death at higher temperatures correlated with significantly decreased wound strengths at 3 days after repair in the solder group. A lower rate of cell death was observed in the solder group, which correlated with superior wound strength when compared with repairs without solder at days 0 (65–95°C) and 3 (95°C). Conclusion Both apoptotic and necrotic cell death were used as quantitative measures of tissue injury and were accurate predictors of short‐term wound strength. The addition of albumin solder decreased overall tissue injury. These results suggest that temperatures of 65–75°C with solder provide the optimal conditions for maximizing acute wound strength and minimizing tissue injury. Lasers Surg. Med. 25:285–290, 1999. © 1999 Wiley‐Liss, Inc.