PHOTOCHEMICAL TISSUE BONDING: A skin excision two weeks after surgery. Deep sutures were used to bring the sides of the five-centimeter wound together. Then the upper layer of closure was done with sutures on the right side and with light activated technology on the left side. The redness on the right side is caused by the sutures and leads to scarring.
Image: IMAGE COURTESY OF WELLMAN CENTER FOR PHOTOMEDICINE
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When accidents happen, doctors typically rely on sutures, staples or adhesives to fix the damage. These approaches work, of course, but they tend to cause inflammation in the surrounding tissue and leave scars long after a wound has healed. Researchers at Harvard Medical School and the Massachusetts General Hospital Wellman Center for Photomedicine have recently completed a study they hope will shine some light on this problem—laser light, that is.
Through a process called photochemical tissue bonding, a green laser interacts with pink dye placed on a wound to stimulate healing. The researchers are studying the use of this technique to reconnect severed peripheral nerves, blood vessels, tendons and incisions in the cornea. "We set out to develop a technology for tissue repair that would lead to much less scarring and could be done on small structures such as a nerve or blood vessel," says Irene Kochevar, a Harvard Medical School dermatology professor and Wellman Center researcher. "If you don't have to use sutures, you don't stimulate inflammation, which leads to fibrosis and collagen deposits [that create scar tissue]."
Kochevar and Robert Redmond, an associate professor of dermatology and associate chemist at the Wellman Center, began a U.S. Defense Department–sponsored study in early 2008 with Massachusetts General Hospital dermatologist Sandy Tsao, who was removing skin lesions from patients. After an elliptical incision was made to remove the lesion, part of the wound was repaired using sutures, while the rest was treated with photochemical tissue bonding. Months after the incision was made, the researchers found no scarring on the portion of the cut treated by the dye and laser, she says.
The key lies in stimulating the body's own repair mechanisms. When a pink dye known as "rose bengal" is placed on tissue and struck with a green laser beam for three minutes, the dye absorbs the light, causing collagen molecules in the tissue to cross-link and close a wound in a way that more resembles the coming together of Velcro than the zipper-like markings left by sutures.
More recently, Kochevar and Redmond have been applying the technique to repair damaged nerves in animals. "We take a piece of amniotic membrane, which is from the innermost part of the placenta, put the pink dye on that membrane, wrap it around the pieces of the severed nerve and irradiate the membrane," Kochevar explains. "It's like putting a shrink wrap on the pieces that holds them together." In some ways this is a better way to repair nerves than using sutures because nerve material can sometimes sneak out into the surrounding muscle when stitched together. Also, without sutures there's a lower chance of creating inflammation that could retard nerve growth.
Looking forward, Kochevar says she would like to be able to reduce the amount of time the laser needs to be trained on the dye in order for the bonding process to begin—from a few minutes required today to only a few seconds in the future. Kochevar also wants to develop a way increase the number of nano-sized bonds created in the treated area of tissue, strengthening the cross-linking process so that photochemical tissue bonding can be used on parts of the body—such as elbows and knees—that require a lot of flexibility.
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19 Comments
Add CommentWonderful stuff!
Reply | Report Abuse | Link to thisIt was not so long ago that FDA Chair Kessler referred to therapeutic laser treatment as "voodoo medicine." Should he be required to offer a public apology?
Reply | Report Abuse | Link to thisIt was not so long ago that FDA Chair Kessler referred to therapeutic laser treatment of tissue as "voodoo medicine." Should he now offer a public apology?
Reply | Report Abuse | Link to thisDon't we already pay enough for health care in the US? I bet this procedure is more expensive than suturing and there is no reason we should pay any more than we do.
Reply | Report Abuse | Link to thisRequest denied!
What? You know the Senator? I mean, request granted.
Mainly because most of it was/is . . (context is important here)
Reply | Report Abuse | Link to thisThis is using a dye and laser combination to directly and selectively effect the collagen molecules . .
It is not making your hair grow or balancing your "energy flow" . . go on, do a quick search on Google for laser/LED therapy and experience Woo treatments for just about anything and everything.
Also there are real uses for lasers (like this one). Most all use them for selective heating, burning or activation, and most require other elements to help this process along, like dyes or chemicals that activate under that wavelenth/heat.
@reguspatoff
Reply | Report Abuse | Link to thisDo you have a citation for that claim? The only connection I can find between Kessler and lasers is his careful scrutiny of laser eye surgery regulations in the wake of a rash of consumer complaints. I don't see what that has to do with light-activated adhesives.
Everyone, FDA commissioners included, says silly things from time to time. But I suspect this doctor is well aware of the difference between treatments proven to work, treatments proven not to work, and treatments that are still experimental.
to me this looks like a good thing all around...less followups due to infection is a great leap forward....although as RDH states...this had better be cheaper in the long run...
Reply | Report Abuse | Link to thisRDH
Reply | Report Abuse | Link to thisI still have not so great scars from surgery two weeks ago.
Being CHEAP, most times has really BAD outcomes.
Like safety valves on DEEP OIL RIGS, and Pumping salt water into faults most likely caused the recent earthquakes.
When people heal better faster, they get back to life and work faster. Cheap in the long run usually cost more.
Bops...should have left off the oil rigs etc...this about medical and the rest of your post reflect the benefit....lots of other articles for posting the oil rigs stuff...
Reply | Report Abuse | Link to thisReduced inflammation and healing time... sounds like it could reduce healthcare costs in the long run to me.
Reply | Report Abuse | Link to thisThis is a very positive piece of news..getting rid of those staples & stitches may be a "small step for the surgeon",but a "big step for the patient's minimal invasive future surgery scenario".....
Reply | Report Abuse | Link to thisThere are potentially a large number of applications for this kind of treatment. Some treatments are not effective because of scar tissue. For instance, scar tissues as a result of heart surgery can with over repeated surgeries, make the heart weaker.
Reply | Report Abuse | Link to thisPerhaps it might also be useful for plastic surgeries, surgeries on nerves, and surgeries with tendons.
RDH's comment is reffering to the health care bill and how he believes that the government will chose the CHEAP alturnatives at the expense of our health. i was confused too for a minute
Reply | Report Abuse | Link to thisRDH's comment is reffering to the health care bill and how he believes that the government will chose the CHEAP alturnatives at the expense of our health. i was confused too for a minute
Reply | Report Abuse | Link to thisFor me as a physician, this is very advance technology that we should make it available sooner...........
Reply | Report Abuse | Link to thisHi folks. There are plenty of documented uses for Laser therapy. LED, not so much....
Reply | Report Abuse | Link to thisDo a quick medline search on Laser Therapy and you will see plenty. Or check out the Lancet...
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60296-6/fulltext
Laser has suffered from poor regulation, which has allowed these purveyors of crappy products that make claims for all sorts of things to flourish. Stick to the evidence and you will find there is great support in the literature for stimulation of various processes involved in healing by way of laser therapy. Usually with diode lasers in the 600-1000nm range, at relatively low powers..
Do you own a DVD player? How about a microwave? You obviously own a computer. ALL of the these were initially EXTREMELY expensive to develop and use. Now they are dirt cheap. How about x-ray machines? I for one sure am glad they didn't ignore that technology due to expense. And antibiotics. And ibuprofen. All cost hundreds of millions to develop. Yet would we choose to be without them. No. Well, maybe you would, but if you follow your line of thinking you may as well live in a cabin in the mountains with a horse and buggy, because those technologies didn't cost much to develop. Have fun in your cabin!! :-(
Reply | Report Abuse | Link to thisDo you own a DVD player? How about a microwave? You obviously own a computer. ALL of the these were initially EXTREMELY expensive to develop and use. Now they are dirt cheap. How about x-ray machines? I for one sure am glad they didn't ignore that technology due to expense. And antibiotics. And ibuprofen. All cost hundreds of millions to develop. Yet would we choose to be without them. No. Well, maybe you would, but if you follow your line of thinking you may as well live in a cabin in the mountains with a horse and buggy, because those technologies didn't cost much to develop. Have fun in your cabin!! :-(
Reply | Report Abuse | Link to thisthis is wonderful, like the colors of the vast universe full of firey formations and mystic marvels. Mysterious. Unexpected.
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