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Methylene blue based protein solder for vascular anastomoses: An in vitro burst pressure study
Author(s) -
Birch Jeremy F.,
Mandley David J.,
Williams Sian L.,
Worrall David R.,
Trotter Patrick J.,
Wilkinson Francis,
Bell Peter R.
Publication year - 2000
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(2000)26:3<323::aid-lsm11>3.0.co;2-r
Subject(s) - anastomosis , methylene blue , chromophore , indocyanine green , absorption (acoustics) , soldering , laser , chemistry , materials science , biomedical engineering , analytical chemistry (journal) , surgery , optics , photochemistry , chromatography , medicine , composite material , catalysis , biochemistry , physics , photocatalysis
Background and Objective Attempts at sutureless anastomoses have used protein‐based solders containing chromophores [Oz et al., J Vasc Surg 1990;11:718; Poppas et al., J Urol 1998150:1052] to enhance the strength of laser anastomoses. Reports have described the use of indocyanine green [Oz et al., Surg Forum 1989;316.], fuschin, and fluorescein isothiocyanate as chromophores [Chuck et al., Lasers Surg Med 1989;9:471; Vance et al., Lasers Med Sci 1988;3:219]. Methylene blue (MB) is a chromophore with absorption peaks in the 600–700 nm region whose use has not been reported in laser‐assisted vascular anastomoses. Therefore, we set out to produce and characterise a MB‐containing protein solder. The absorption and burst pressure characteristics have been investigated and described as well as a brief review of the chemical and biological properties of MB. Study Design/Materials and Methods The MB and porcine serum albumin (PSA)–based solder was produced and used to form end‐to‐end anastomoses in porcine splenic arteries. The solder was activated using a laser diode emitting at 670 nm. The burst pressures of the anastomoses were tested, and the results analysed as a function of MB concentration and absorption. In addition, the relationship between MB concentration and absorption was examined. Results A dose‐response relationship was found between the measured absorption of the solder and the burst pressure of the anastomoses formed. Burst pressures exceeding physiological levels were found. Changes in MB concentration revealed a marked negative deviation from Beer's law at 670 nm, owing to the monomer‐dimer‐trimer equilibria. Conclusion PSA with MB solder is able to form high‐quality end‐to‐end anastomoses, with immediate burst pressure profiles similar to those previously described for sutured [Quigley et al., Microsurgery 1985;6:229], lasered [Quigley et al., Microsurgery 1985;6:229], and soldered anastomoses [Small et al., J Clin Laser Med Surg 1997;15:205]. The relationship between burst pressure strength and chromophore absorption is discussed. Lasers Surg. Med. 26:323–329, 2000. © 2000 Wiley‐Liss, Inc.