Yang Penggao, Yao Min, DeMartelaere Sheri L, Redmond Robert W, Kochevar Irene E
Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.
Lasers Surg Med. 2012 Feb;44(2):163-7. doi: 10.1002/lsm.21137. Epub 2011 Dec 13.
Closing lacerations in thin eyelid and periorbital skin is time consuming and requires high skill for optimal results. In this study we evaluate the outcomes after single layer closure of wounds in thin skin with a sutureless, light-activated photochemical technique called PTB.
STUDY DESIGN/MATERIALS AND METHODS: Dorsal skin of the SKH-1 hairless mouse was used as a model for eyelid skin. Incisions (1.2 cm) were treated with 0.1% Rose Bengal dye followed by exposure to 532 nm radiation (25, 50, or 100 J/cm(2); 0.25 W/cm(2)) for PTB. Other incisions were sutured (five 10-0 monofilament), exposed only to 532 nm (100 J/cm(2)), or not treated. Outcomes were immediate seal strength (pressure causing leakage through incision of saline infused under wound), skin strength at 1, 3, and 7 days (measured by tensiometry), inflammatory infiltrate at 1, 3, and 7 days (histological assessment), and procedure time.
The immediate seal strength, as measured by leak pressure, was equivalent for all PTB fluences and for sutures (27-32 mmHg); these pressures were significantly greater than for the controls (untreated incisions or laser only treatment; P < 0.001). The ultimate strength of PTB-sealed incisions was greater than the controls at day 1 (P < 0.05) and day 3 (P < 0.025) and all groups were equivalent at day 7. Sutures produced greater inflammatory infiltrate at day 1 than observed in other groups (P = 0.019). The average procedure time for sutured closure (311 seconds) was longer than for the PTB group treated with 25 J/cm(2) (160 seconds) but shorter than the group treated with 100 J/cm(2) (460 seconds).
PTB produces an immediate seal of incisions in thin, delicate skin that heals well, is more rapid than suturing, does not require painful suture removal and is easy to apply.
闭合薄眼睑及眶周皮肤的裂伤耗时且需要高超技巧才能获得最佳效果。在本研究中，我们评估了一种名为PTB的无缝合、光激活光化学技术对薄皮肤伤口进行单层闭合后的效果。
研究设计/材料与方法：将SKH - 1无毛小鼠的背部皮肤用作眼睑皮肤模型。切口（1.2厘米）用0.1%孟加拉玫瑰红染料处理，然后暴露于532纳米辐射（25、50或100焦/平方厘米；0.25瓦/平方厘米）以进行PTB处理。其他切口进行缝合（五针10 - 0单丝缝线），仅暴露于532纳米（100焦/平方厘米），或不进行处理。观察指标包括即时封闭强度（通过伤口下方注入生理盐水时导致切口渗漏的压力）、第1、3和7天的皮肤强度（通过张力测定法测量）、第1、3和7天的炎症浸润（组织学评估）以及操作时间。
通过渗漏压力测量的即时封闭强度，在所有PTB辐照剂量组和缝合组中相当（27 - 32毫米汞柱）；这些压力显著高于对照组（未处理切口或仅激光处理组；P < 0.001）。PTB封闭切口的最终强度在第1天（P < 0.05）和第3天（P < 0.025）大于对照组，且所有组在第7天相当。缝线在第1天产生的炎症浸润比其他组更明显（P = 0.019）。缝合闭合的平均操作时间（311秒）长于接受25焦/平方厘米PTB处理的组（160秒），但短于接受100焦/平方厘米处理的组（460秒）。
PTB能对薄而脆弱的皮肤切口产生即时封闭效果，愈合良好，比缝合更快，无需痛苦地拆线且易于应用。
