Urie Russell, Quraishi Sana, Jaffe Michael, Rege Kaushal
Chemical Engineering, Arizona State University, Tempe, Arizona 85287, United States.
College of Veterinary Medicine, Midwestern University, Glendale, Arizona 85308, United States.
ACS Biomater Sci Eng. 2015 Sep 14;1(9):805-815. doi: 10.1021/acsbiomaterials.5b00174. Epub 2015 Aug 24.
Surgical site infection and postoperative leakage are complications that may develop following colorectal surgery and result in fatal consequences. Rapid, fluid-tight wound closure through laser tissue welding (LTW) can reduce postoperative leakage and thus decrease infection. Laser tissue welding involves generation of localized heat by exposing an exogenous chromophore to near-infrared (NIR) irradiation in order to seal wounds. In this study, we generated gold nanorod (GNR)-collagen nanocomposites (NCs) for laser-facilitated welding of ruptured intestinal tissue. The fluid content, stiffness, elasticity, and laser-induced temperature response of these nanocomposites were modulated to optimize laser-induced tissue fusion and minimize tissue damage. In addition, the effect of laser operating parameters including power density, femtosecond pulsed wave (PW) or continuous wave (CW) laser, and exposure duration were all studied. Laser power density and treatment duration significantly affected the temperatures reached during welding, as well as tissue weld strength and burst pressure. CW laser was found to induce significantly higher temperatures of the nanocomposites during treatment than PW laser, but the differences in weld strength and burst pressure for the two laser types were insignificant. This suggests that PW lasers can result in robust welds while minimizing potential thermal damage compared to CW lasers. The ultimate tensile strength of welded ruptured tissue was returned to as high as 68% of the native tissue strength through laser treatment, and laser treatment with these nanocomposites restored up to 64% of native tissue leak pressure and 42% of burst pressure. To the best of our knowledge, the laser power densities used (≤2.50 W/cm) are among the lowest reported for laser tissue welding, and the laser configuration and use require very little surgical skill. Our results indicate that GNR-collagen nanocomposites are promising photothermal biomaterials in laser tissue welding applications.
手术部位感染和术后渗漏是结直肠手术后可能出现的并发症，并可能导致致命后果。通过激光组织焊接（LTW）实现快速、液密性伤口闭合可减少术后渗漏，从而降低感染风险。激光组织焊接是通过将外源性发色团暴露于近红外（NIR）辐射来产生局部热量，从而封闭伤口。在本研究中，我们制备了金纳米棒（GNR）-胶原蛋白纳米复合材料（NCs），用于促进破裂肠组织的激光焊接。对这些纳米复合材料的流体含量、硬度、弹性和激光诱导温度响应进行了调节，以优化激光诱导的组织融合并最小化组织损伤。此外，还研究了激光操作参数的影响，包括功率密度、飞秒脉冲波（PW）或连续波（CW）激光以及照射持续时间。激光功率密度和治疗持续时间显著影响焊接过程中达到的温度，以及组织焊接强度和爆破压力。结果发现，CW激光在治疗过程中诱导纳米复合材料的温度明显高于PW激光，但两种激光类型在焊接强度和爆破压力方面的差异不显著。这表明，与CW激光相比，PW激光可以在使潜在热损伤最小化的同时实现牢固的焊接。通过激光治疗，焊接破裂组织的极限拉伸强度恢复到原生组织强度的68%，使用这些纳米复合材料进行激光治疗可恢复高达64%的原生组织渗漏压力和42%的爆破压力。据我们所知，所使用的激光功率密度（≤2.50 W/cm）是激光组织焊接报道中最低的之一，并且激光配置和使用所需的手术技能非常少。我们的结果表明，GNR-胶原蛋白纳米复合材料在激光组织焊接应用中是有前景的光热生物材料。
