Yuan Mingzhou, He Xu, Huang Guangtao, Yin Meifang, Pra Ilaria Dal', He Jinqing, Xiao Jie, He Dehua, Li Jun, Liu Xiaofang, Zhong Rong, Ma Yuncan, Wu Jun
Department of Burn and Plastic Surgery, Medical Innovation Technology Transformation Center, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, 3002 Sungang West Road, Futian District, Shenzhen 518035, China.
Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, School of Biomedical Engineering; 1066 Xueyuan Road, Nanshan District, Shenzhen University Medical School, Shenzhen 518060, China.
Burns Trauma. 2025 Jun 24;13:tkaf042. doi: 10.1093/burnst/tkaf042. eCollection 2025.
From the perspective of aesthetic surgery and regenerative medicine, the precision of surgical instruments is critical for preventing aesthetic complications during procedures such as skin debridement and the removal of unwanted tissues, as well as for better regeneration. Femtosecond lasers (fs-lasers) can achieve micrometer-level tissue removal. However, an uneven skin texture can cause the laser to defocus, leading to iatrogenic injury and hindering clinical application. Overcoming the defocusing tendency of fs-lasers is therefore crucial for their clinical use.
Our self-developed fs-laser microfabrication platform was used to implement a focus-corrected method based on 2D interpolation for uneven skin surfaces, using different laser powers and velocities for linear, planar, and 3D scanning of porcine skin. Leveraging the identified dose-response relationship, the optimized device and parameters were used for precise tissue ablation in an rat experiment. The structural integrity and viability of the remaining skin were evaluated histologically.
Our study revealed that focus-corrected fs-laser ablation enabled controllable micrometer-level removal of target skin tissues. The depth of tissue removal was correlated with the fs-laser single-pulse energy. Unlike other laser devices, the scanning velocity did not affect the ablation depth, as the focusing mechanism of the focus-corrected fs-laser restricts ablation beyond the focal point. Appropriate fs-laser parameters for parallel linear scanning enabled tissue removal in various 3D shapes. Increased depth of field, increased single-pulse energy, and faster scanning velocity enabled precise, rapid, and safe ablation of skin tissue in the rat model. Histological and biochemical analyses demonstrated that focus-corrected fs-laser debridement did not damage the surrounding collagen structure or cell viability of the wound.
We demonstrated that focus-corrected fs-laser ablation enables micron-scale skin removal with minimal collateral damage. By selectively adjusting single-pulse energy for depth-specific ablation and operation at the maximum permissible scanning velocity, this technique enables precise skin removal in the desired shape, offering an innovative and ultrahigh-precision surgical approach for skin as well as other tissues or organ surgery.
从美容外科和再生医学的角度来看，手术器械的精度对于预防皮肤清创和去除多余组织等手术过程中的美学并发症以及更好的再生至关重要。飞秒激光（fs-激光）可以实现微米级的组织去除。然而，皮肤质地不均匀会导致激光散焦，从而导致医源性损伤并阻碍临床应用。因此，克服fs-激光的散焦倾向对于其临床应用至关重要。
我们使用自行开发的fs-激光微加工平台，对不均匀的皮肤表面实施基于二维插值的聚焦校正方法，对猪皮进行线性、平面和三维扫描时使用不同的激光功率和速度。利用确定的剂量反应关系，将优化后的设备和参数用于大鼠实验中的精确组织消融。通过组织学评估剩余皮肤的结构完整性和活力。
我们的研究表明，聚焦校正的fs-激光消融能够可控地实现目标皮肤组织的微米级去除。组织去除深度与fs-激光单脉冲能量相关。与其他激光设备不同，扫描速度不影响消融深度，因为聚焦校正的fs-激光的聚焦机制限制了焦点以外的消融。适用于平行线性扫描的fs-激光参数能够实现各种三维形状的组织去除。增加景深、增加单脉冲能量和更快的扫描速度能够在大鼠模型中精确、快速且安全地消融皮肤组织。组织学和生化分析表明，聚焦校正的fs-激光清创不会损害伤口周围的胶原结构或细胞活力。
我们证明聚焦校正的fs-激光消融能够以最小的附带损伤实现微米级的皮肤去除。通过选择性地调整单脉冲能量以进行特定深度的消融，并以最大允许扫描速度进行操作，该技术能够精确去除所需形状的皮肤，为皮肤以及其他组织或器官手术提供了一种创新的超高精度手术方法。
