Mistry Yusuf Abbas, Natarajan Srivalli S, Ahuja Suraj A
Department of Oral and Maxillofacial Surgery, MGM Dental College and Hospital, Mumbai, Maharashtra, India.
Ann Maxillofac Surg. 2018 Jan-Jun;8(1):35-41. doi: 10.4103/ams.ams_147_17.
Laser tissue bonding (LTB) is believed to have certain advantages over conventional sutures such as fluid-tight closure and minimal scarring and fibrosis.
The aim of the present study was to evaluate the bond strength of laser tissue welding and laser tissue soldering in mucosal and vascular repair.
A total of 85 samples of bovine oral mucosa and 85 bovine aortas were bonded using a CO laser and different laser powers. Human serum albumin was used as solder. The breaking load for mucosal samples and the bursting pressure for aorta samples were evaluated. Few specimens were evaluated histologically for thermal damage and other microscopic changes.
Two-way ANOVA was performed as the data were normally distributed and analyzed for significant differences between the groups. This was followed by Simple Main effects (Tuckey's test) to determine the individual variation between groups and also the significant differences within the groups.
Significantly higher values of breaking load (44.2 ± 3.03 g) and bursting pressure (70.8 ± 12.33 mmHg) were noted when 50% albumin was used. When reinforcing sutures were given the bond strength was further increased (68.0 ± 4.0 g for breaking load) (108.0 ± 12.56 mmHg for bursting pressure). Microscopically, a bridge of solder coagulum formed across the wound. Thermal damage was restricted to the top layers only although it did extend much more laterally adjacent to the wound edges. Few areas of vacuolization and carbonization were seen.
LTB seems to be a promising new method of wound closure and warrants further evaluation in the form of and clinical studies.
与传统缝合相比,激光组织焊接(LTB)被认为具有某些优势,如密闭缝合、最小化疤痕和纤维化。
本研究的目的是评估激光组织焊接和激光组织钎焊在黏膜和血管修复中的结合强度。
使用CO激光和不同激光功率对总共85个牛口腔黏膜样本和85个牛主动脉进行焊接。用人血清白蛋白作为焊料。评估黏膜样本的断裂负荷和主动脉样本的破裂压力。对少数标本进行组织学评估,以观察热损伤和其他微观变化。
由于数据呈正态分布,进行双向方差分析,分析组间的显著差异。随后进行简单主效应分析(Tukey检验),以确定组间的个体差异以及组内的显著差异。
当使用50%白蛋白时,观察到断裂负荷(44.2±3.03克)和破裂压力(70.8±12.33毫米汞柱)的值显著更高。当使用加强缝合时,结合强度进一步提高(断裂负荷为68.0±4.0克)(破裂压力为108.0±12.56毫米汞柱)。在显微镜下,伤口上形成了一层焊料凝固物桥。热损伤仅局限于顶层,尽管它在伤口边缘附近的横向延伸范围更大。可见少量空泡化和碳化区域。
激光组织焊接似乎是一种有前景的伤口闭合新方法,值得以和临床研究的形式进行进一步评估。