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Litvinova K, Chernysheva M, Stegemann B, Leyva F. Autofluorescence guided welding of heart tissue by laser pulse bursts at 1550 nm. BIOMEDICAL OPTICS EXPRESS 2020; 11:6271-6280. [PMID: 33282489 PMCID: PMC7687929 DOI: 10.1364/boe.400504] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 09/30/2020] [Accepted: 10/06/2020] [Indexed: 06/12/2023]
Abstract
Wound healing and other surgical technologies traditionally solved by suturing and stapling have recently been enhanced by the application of laser tissue welding. The usage of high energy laser radiation to anastomose tissues eliminates a foreign body reaction, reduces scar formation, and allows for the creation of watertight closure. In the current work, we show that an ultrafast pulsed fibre laser beam with 183 µJ·cm-2 energy fluence at 1550 nm provides successful welding of dissected chicken heart walls with the tensile strength of 1.03±0.12 kg·cm-2 equal to that of native tissue. The welding process was monitored employing fluorescence spectroscopy that detects the biochemical composition of tissues. We believe that fluorescence spectroscopy guided laser tissue welding is a promising approach for decreasing wound healing times and the avoiding risks of postoperative complications.
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Affiliation(s)
- Karina Litvinova
- Aston Medical School, Aston University, Aston Triangle, B4 7ET, Birmingham, UK
| | - Maria Chernysheva
- Leibniz Institute of Photonic Technology, Albert Einstein str 9, 07745, Jena, Germany
| | - Berthold Stegemann
- Aston Medical School, Aston University, Aston Triangle, B4 7ET, Birmingham, UK
| | - Francisco Leyva
- Aston Medical School, Aston University, Aston Triangle, B4 7ET, Birmingham, UK
- Cardiology Department, Queen Elizabeth Hospital, Mindelsohn Way, B15 2TH, Birmingham, UK
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2
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Bittolo Bon S, Rapi M, Coletta R, Morabito A, Valentini L. Plasticised Regenerated Silk/Gold Nanorods Hybrids as Sealant and Bio-Piezoelectric Materials. NANOMATERIALS (BASEL, SWITZERLAND) 2020; 10:E179. [PMID: 31968575 PMCID: PMC7022986 DOI: 10.3390/nano10010179] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 12/30/2019] [Accepted: 01/13/2020] [Indexed: 02/07/2023]
Abstract
Manual and mechanical suturing are currently the gold standard for bowel anastomosis. If tissue approximation fails, anastomotic leaks occur. Anastomotic leaks may have catastrophic consequences. The development of a fully absorbable, biocompatible sealant material based on a bio-ink silk fibroin can reduce the chance of anastomotic leaks. We have produced a Ca-modified plasticised regenerated silk (RS) with gold nanorods sealant. This sealant was applied to anastomosed porcine intestine. Water absorption from wet tissue substrate applied compressive strains on hybrid RS films. This compression results in a sealant effect on anastomosis. The increased toughness of the hybrid plasticised RS resulted in the designing of a bio-film with superior elongation at break (i.e., ≈200%) and bursting pressure. We have also reported structure-dependent piezoelectricity of the RS film that shows a piezoelectric effect out of the plane. We hope that in the future, bowel anastomosis can be simplified by providing a multifunctional bio-film that makes feasible the mechanical tissue joint without the need for specific tools and could be used in piezoelectric sealant heads.
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Affiliation(s)
- Silvia Bittolo Bon
- Dipartimento di Ingegneria Civile e Ambientale, Università degli Studi di Perugia, UdR INSTM, Strada di Pentima 4, 05100 Terni, Italy;
| | - Michele Rapi
- Università degli Studi di Firenze Laurea Magistrale in Medicina e Chirurgia, Piazza San Marco 4, 50121 Firenze, Italy;
| | - Riccardo Coletta
- Department of Pediatric Surgery, Meyer Children’s Hospital, Viale Pieraccini 24, 50139 Firenze, Italy; (R.C.); (A.M.)
| | - Antonino Morabito
- Department of Pediatric Surgery, Meyer Children’s Hospital, Viale Pieraccini 24, 50139 Firenze, Italy; (R.C.); (A.M.)
- Dipartimento Neuroscienze, Psicologia, Area del Farmaco e della Salute del Bambino NEUROFARBA, Università degli Studi di Firenze, Viale Pieraccini 6, 50121 Firenze, Italy
| | - Luca Valentini
- Dipartimento di Ingegneria Civile e Ambientale, Università degli Studi di Perugia, UdR INSTM, Strada di Pentima 4, 05100 Terni, Italy;
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Urie R, Guo C, Ghosh D, Thelakkaden M, Wong V, Lee JK, Kilbourne J, Yarger J, Rege K. Rapid Soft Tissue Approximation and Repair using Laser-activated Silk Nanosealants. ADVANCED FUNCTIONAL MATERIALS 2018; 28:1802874. [PMID: 37138942 PMCID: PMC10153584 DOI: 10.1002/adfm.201802874] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Tissue approximation and repair have been conventionally performed with sutures and staples, but these means are inherently traumatic. Tissue approximation using laser-responsive nanomaterials can lead to rapid tissue sealing and repair, and is an attractive alternative to existing clinical methods. Here, we demonstrate the use of laser-activated nanosealants (LANS) with gold nanorods (GNRs) embedded in silk fibroin polypeptide matrices. The adaptability of LANS for sealing soft tissues is demonstrated using two different modalities: insoluble thin films for internal, intestinal tissue repair, and semi-soluble pastes for external repair, shown by skin repair in live mice. Laser repaired intestinal tissue held over seven times more fluid pressure than sutured intestine and also prevented bacterial leakage. Skin incisions in mice closed using LANS' showed indication of increased mechanical strength and faster repair compared to suturing. Laser-activated silk-GNR nanosealants rapidly seal soft-tissue tears and show high promise for tissue approximation and repair in trauma and routine surgery.
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Affiliation(s)
- Russell Urie
- Chemical Engineering, Arizona State University, Tempe, AZ 85287, USA
| | - Chengchen Guo
- School of Molecular Sciences, Arizona State University, Tempe, AZ 85287, USA
| | - Deepanjan Ghosh
- Biological Design, Arizona State University, Tempe, AZ 85287, USA
| | - Mitzi Thelakkaden
- Harrington Biomedical Engineering, Arizona State University, Tempe, AZ 85287, USA
| | - Valerie Wong
- College of Veterinary Medicine, Midwestern University, Glendale, AZ 85308, USA
| | - Jung Keun Lee
- College of Veterinary Medicine, Midwestern University, Glendale, AZ 85308, USA
| | - Jacquelyn Kilbourne
- Department of Animal Care Technologies, Arizona State University, Tempe, AZ 85287, USA
| | - Jeffery Yarger
- School of Molecular Sciences, Arizona State University, Tempe, AZ 85287, USA
| | - Kaushal Rege
- Chemical Engineering, Arizona State University, Tempe, AZ 85287, USA
- To whom all correspondence should be addressed Prof. Kaushal Rege, Chemical Engineering, 501 E. Tyler Mall, ECG 303, Arizona State University, Tempe, AZ 85287-6106 USA, , Phone: (480)-727-8616, Fax: 480-727-9321
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Mushaben M, Urie R, Flake T, Jaffe M, Rege K, Heys J. Spatiotemporal modeling of laser tissue soldering using photothermal nanocomposites. Lasers Surg Med 2018; 50:143-152. [PMID: 28990678 PMCID: PMC5820132 DOI: 10.1002/lsm.22746] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2017] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Laser tissue soldering using photothermal solders is a technology that facilitates rapid sealing using heat-induced changes in the tissue and the solder material. The solder material is made of gold nanorods embedded in a protein matrix patch that can be placed over the tissue rupture site and heated with a laser. Although laser tissue soldering is an attractive approach for surgical repair, potential photothermal damage can limit the success of this approach. Development of predictive mathematical models of photothermal effects including cell death, can lead to more efficient approaches in laser-based tissue repair. METHODS We describe an experimental and modeling investigation into photothermal solder patches for sealing porcine and mouse cadaver intestine sections using near-infrared laser irradiation. Spatiotemporal changes in temperature were determined at the surface as well as various depths below the patch. A mathematical model, based on the finite element method, predicts the spatiotemporal temperature distribution in the patch and surrounding tissue, as well as concomitant cell death in the tissue is described. RESULTS For both the porcine and mouse intestine systems, the model predicts temperatures that are quantitatively similar to the experimental measurements with the model predictions of temperature increase often being within a just a few degrees of experimental measurements. CONCLUSION This mathematical model can be employed to identify optimal conditions for minimizing healthy cell death while still achieving a strong seal of the ruptured tissue using laser soldering. Lasers Surg. Med. 50:143-152, 2018. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Madaline Mushaben
- Department of Chemical and Biological Engineering, Montana State University, Bozeman, Montana
| | - Russell Urie
- Department of Chemical Engineering, Arizona State University, Tempe, Arizona
| | - Tanner Flake
- Department of Chemical Engineering, Arizona State University, Tempe, Arizona
| | - Michael Jaffe
- College of Veterinary Medicine, Midwestern University, Glendale, 85308, Arizona
| | - Kaushal Rege
- Department of Chemical Engineering, Arizona State University, Tempe, Arizona
| | - Jeffrey Heys
- Department of Chemical and Biological Engineering, Montana State University, Bozeman, Montana
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Mueller SK, Scangas G, Amiji MM, Bleier BS. Prospective transfrontal sheep model of skull-base reconstruction using vascularized mucosa. Int Forum Allergy Rhinol 2017; 8:614-619. [PMID: 29227037 DOI: 10.1002/alr.22058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 10/24/2017] [Accepted: 11/10/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND No high-fidelity animal model exists to examine prospective wound healing following vascularized reconstruction of the skull base. Such a model would require the ability to study the prospective behavior of vascularized mucosal repairs of large dural and arachnoid defects within the intranasal environment. The objective of this study was to therefore develop and validate a novel, in vivo, transfrontal sheep model of cranial base repair using vascularized sinonasal mucosa. METHODS Twelve transfrontal craniotomy and 1.5-cm durotomy reconstructions were performed in 60-kg to 70-kg Dorset/Ovis Aries sheep using vascularized mucosa with or without an adjunctive Biodesign™ underlay graft (n = 6 per group). Histologic outcomes were graded (scale, 0 to 4) by a blinded veterinary histopathologist after 7, 14, and 28 days for a range of wound healing parameters. RESULTS All sheep tolerated the surgery, which required 148 ± 33 minutes. By day 7, the mucosa was fully adherent with complete partitioning of the sinus and intracranial compartments. Fibroblast infiltration and flap neovascularization scores significantly increased between day 7 (0.3 ± 0.5 and 0.0 ± 0.0) and day 28 (4.0 ± 0.0, p = 0.01 and 2.0 ± 0.8, p = 0.01; respectively), while hemorrhage scores significantly decreased from 2.5 ± 0.6 to 0.0 ± 0.0 (p = 0.01). The inflammatory scores were not significantly different between the heterologous graft and control sides. CONCLUSION The described sheep model accurately reflects prospective intranasal wound healing following vascularized mucosal reconstruction of dural defects. This model can be used in future studies to examine novel reconstructive materials, tissue glues, and transmucosal drug delivery to the central nervous system.
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Affiliation(s)
- Sarina K Mueller
- Department of Otolaryngology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA.,Department of Otolaryngology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - George Scangas
- Department of Otolaryngology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA
| | - Mansor M Amiji
- Department of Pharmaceutical Sciences, Northeastern University, Boston, MA
| | - Benjamin S Bleier
- Department of Otolaryngology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA
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Urie R, Quraishi S, Jaffe M, Rege K. Gold Nanorod-Collagen Nanocomposites as Photothermal Nanosolders for Laser Welding of Ruptured Porcine Intestines. ACS Biomater Sci Eng 2015; 1:805-815. [DOI: 10.1021/acsbiomaterials.5b00174] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Russell Urie
- Chemical
Engineering, Arizona State University, Tempe, Arizona 85287, United States
| | - Sana Quraishi
- Chemical
Engineering, Arizona State University, Tempe, Arizona 85287, United States
| | - Michael Jaffe
- College
of Veterinary Medicine, Midwestern University, Glendale, Arizona 85308, United States
| | - Kaushal Rege
- Chemical
Engineering, Arizona State University, Tempe, Arizona 85287, United States
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Schiavon M, Marulli G, Zuin A, Lunardi F, Villoresi P, Bonora S, Calabrese F, Rea F. Experimental evaluation of a new system for laser tissue welding applied on damaged lungs. Interact Cardiovasc Thorac Surg 2013; 16:577-82. [PMID: 23396621 DOI: 10.1093/icvts/ivt029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Alveolar air leaks represent a challenging problem in thoracic surgery, leading to increased patient morbidity and prolonged hospitalization. Several methods have been used, but no ideal technique exists yet. We investigated the lung-sealing capacity of an experimental kit for laser tissue welding. METHODS The kit is composed of a semiconductor laser system applied on a protein substrate associated with a chromophore that increases absorption. In vitro tests on porcine lung tissue were done to define ideal laser parameters (power 100 Å, frequency 50 Hz, pulse duration 400 µs) and protein substrate dilution (50%). For in vivo tests, through a left thoracotomy, 14 pigs received two different lung damages: a linear incision and a circular incision. Protein substrate applied on damaged areas was treated with laser to obtain a layer that reconstituted the integrity of the visceral pleura. Air leaks were intraoperatively evaluated by water submersion test with an airway pressure of 20 cmH2O. Animals were sacrificed at postoperative days 0 and 7 to study early and late pathological features. RESULTS After applying laser treatment, no air leaks were seen in all proofs except in 2 cases in which a second application was required. At time 0, pathological damage mostly consisted of superficial alveolar necrotic tissue covered by protein membrane. At time 7, a complete recovery of lung lesions by fibrous scar with slight inflammatory reaction of adjacent lung tissue was seen. CONCLUSIONS This experimental study demonstrated the effectiveness of laser tissue welding applied to seal air leaks after lung surgery. Further studies are needed to verify acceptability for human application.
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Affiliation(s)
- Marco Schiavon
- Department of Cardio-Thoracic and Vascular Sciences, University of Padua, Padua, Italy.
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