|
This study investigated the use of a computerized 1 .3 micron Nd:YAG laser to seal
approximated wound edges in pig skin. The medical laser system used was the DLS
Type 1 , 1 .32 micron Nd:YAG laser (Laser Surgery Software, Inc.). The purpose of this
study was to evaluate the effectiveness of laser assisted skin closure using the DLS YAG
laser in a large animal model. Effectiveness was judged on the basis of wound
dehiscence, infection, unusual healing result and consistency of results. Comparative
cosmetic result was also evaluated.
In this study, the DLS YAG laser was used to close scalpel-induced, full-thickness
wounds. The pig model was chosen for its many integumentary similarities to man.
Controls included scalpel-induced wounds closed using suture, staple and some with norepair.
After adequate anesthesia was achieved, the dorsum of Yucutan pigs (approximately 75-
100 pounds) each was clipped with animal hair clippers from the shoulder area to the
hind legs. The area was then shaved with a razor blade, avoiding any inadvertent cuts or
abrasions of the skin. The dorsum was divided into four rows of four parallel incisions
made by a #15 scalpel blade. Full-thickness incisions, 9 cm long, were placed over the
dorsum of the pigs and then closed either with one loosely approximating Prolene"
suture (the "no repair' group), multiple interrupted 6-0 nylon sutures, staples or laser. The
experimental tissue sealing group consisted of 1 69 laser assisted closures on 1 3 pigs.
Sutured control wounds were closed with 6-0 nylon, full thickness, simple, interrupted
sutures. Eight sutures were placed 1 cm apart along the 9 cm incision. Stapled control
wounds were approximated using two evenly spaced 3-0 VicryP' sub-dermal sutures and
the dermis closed using Proximate' skin staples. Eight staples were placed 1 cm apart
along the 9 cm incision. The no-repair incisions were grossly approximated using a
single 2-0 Prolene full thickness, simple, interrupted suture located at the center of the
9 cm incision. Experimental wounds were approximated using two evenly spaced subdermal
3.0 Vicryl' sutures and the dermis closed by laser sealing using the DLS YAG
laser. Wounds were examined daily for the first seven days and followed for up to 20
months postoperatively. To facilitate wound edge approximation, surgical tape that is
relatively transparent to 1.3 micron irradiation was used to hold the wound edges
approximated while laser application occurred. Surgical tape was also applied to the
"no-repair" suture and staple closures at the end of each procedure.
|
