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Purpose: The purpose of the study was to determine the optimal indocyanine green dye (ICG) concentration and laser power density (PD) for tissue soldering using an 808-nm diode laser. Methods: Temperature profiles in vitro and in vivo were obtained using the ICG/albumin solder. [ICG] ranged from 0.31 mg/mL to 20 mg/mL while PD ranged from 3.2 to 63.7 W/cm2. Solder color and textural changes were noted. Eighteen rats were subjected to 1.5 cm incisions (N equals 128) created on the dorsal skin followed by closure with LTS at varying PD and [ICG]. Tensile strength profiles using rat skin were taken immediately and 10 days postoperatively. Histological examination was performed at the time of sacrifice. Results: Temperature profiles of the ICG/albumin solder did not differ with varying [ICG], but showed statistically significant variability at different laser PD. Using solder color change as a subjective endpoint, average peak solder temperature ranged from 69 degrees Celsius at a PD of 8.0 W/cm2, 105 degrees Celsius to 120 degrees Celsius at PD 15.9 to 31.8 W/cm2, and greater than 200 degrees Celsius at PD greater than or equal to 47.7 W/cm2. Peak intradermal temperatures remained below 50 degrees Celsius at all PD. The broadest range of color change in the solder was observed at [ICG] of 2.5 mg/mL. Immediate tensile strength data showed a trend towards greater strength at higher [ICG]. The greatest immediate tensile strength was reached at a PD of greater than or equal to 31.8 W/cm2 for all [ICG]. At 10 days an inverse trend existed only between PD (not ICG) and tensile strength, however this was not statically significant. Histologic analysis showed poorer healing and thermal injury to tissue soldered at a PD greater than or equal to 23.9 W/cm2. Conclusions: Based on these findings, optimal laser tissue soldering occurs with an [ICG] of 2.5 mg/ml and a PD of 15.9 W/cm2.
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