Skin flap closure by dermal laser soldering: A wound healing model for sutureless hypospadias repair

• Published in: Urology (Ridgewood, N.J.) N.J.), 1997-08, Vol.50 (2), p.263-272
• Main Authors: Kirsch, Andrew J., Duckett, John W., Snyder, Howard M., Canning, Douglas A., Harshaw, David W., Howard, Pamela, Macarak, Edward J., Zderic, Stephen A.
• Format: Article
• Language: English
• Subjects: Animals; Biological and medical sciences; Disease Models, Animal; Hypospadias - surgery; Laser Therapy; Male; Medical sciences; Rats; Rats, Sprague-Dawley; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Surgical Flaps - methods; Surgical Flaps - pathology; Suture Techniques; Time Factors; Wound Healing
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/S0090-4295(97)00278-1

Laser tissue soldering (LTS) with the diode laser and human albumin-hyaluronate-indocyanine green solder is a safe and effective method of providing an immediate leak-free closure during hypospadias repair. In this report, we compare the physiology, histology, and immunohistochemistry of wound healing following LTS and suturing in a rat skin flap model. A 4 x 5-cm skin flap was raised and bisected (4 cm) on the dorsum of 48 Sprague-Dawley rats. The central wound was either closed from a dermal approach by suturing or LTS or left open, and studied at 0, 3, 5, 7, 10, 14, and 21 days postoperatively. An intraoperative comparison was made between suturing and LTS with respect to operative time. Postoperatively, flaps were excised for tensiometric analysis, and sections were stained with hematoxylin-eosin to define wound architecture. Resting skin temperature, laser exposed temperature without solder, and maximum temperature with solder (one drop) were measured at the level of the deep dermis, superficial striated muscle layer, and within the solder. Mean peak temperatures were recorded during a 1-minute laser activation time. Mean continuous suturing time (4.9 ±1.1 minutes) was significantly (P