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03-11-2011 | Surgery | Article

Photochemical tissue bonding shows promise for wound closure

Abstract

Free abstract

MedWire News: A novel technique using Rose Bengal dye and green light is an effective alternative to suturing for closure of wounds, show study results.

Photoactivated tissue bonding (PTB) acts by creating protein-to-protein crosslinks or "nanosutures" between tissue surfaces using a combination of photosensitizing dye and lasers, explain Irene Kochevar (Harvard Medical School, Boston, Massachusetts, USA) and colleagues.

Previous research showed that the technique was able to effectively close wounds in animals.

To investigate the efficacy of PTB in humans, Kochevar and team carried out a split lesion paired comparison study of 31 people with wounds created by excision of skin lesions.

Following deep closure of the wounds with absorbable sutures, one half of each excision was closed using non-absorbable nylon sutures, whilst the other half was closed using PTB (Rose Bengal dye application and green laser exposure).

Appearance and scar characteristics were measured at 2 weeks and 6 months after wound closure by three dermatologists (blinded manner) and by the patients themselves.

As reported in the British Journal of Dermatology, neither form of wound closure had resulted in dehiscence.

However, the PTB halves of the wounds were less red and judged to be of better appearance than the sutured sections of the wounds.

At 6 months, scars produced by PTB were deemed to be of significantly better appearance and width than those created using sutures, and healing in general was also significantly better with PTB than with suturing.

The patients were also significantly more satisfied with the appearance of the PTB sealed section of the wounds at both time points.

The authors note that the study blinding may not have been very effective, as the sutured sections of the wounds were fairly visually obvious. They suggest that PTB should be tested against more sophisticated suturing methods.

"As such, future studies will include in the design alternative suture materials and techniques, as well as sutureless approaches, eg, cyanoacrylate glues and skin tapes," say Kochevar et al.

"This is the first study in humans for a novel light-based technology that utilizes molecular protein-protein crosslinks, ie, nanosutures, for effective wound sealing," write the authors.

"Early healing after PTB showed little inflammation and no adverse reactions, and PTB produced better scar appearance at 6 months compared with traditional superficial suture closure," they conclude.

By Helen Albert

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