Assessment of circular wound healing in rats after exposure to 808-nm laser pulses during specific healing phases.

BACKGROUND AND OBJECTIVES: Low-level laser therapy (LLLT), is an important application modality for the advancement of wound healing processes. In this study, histological and morphometric analyses have been made to understand and compare effects of high-power 808-nm pulses on circular skin wounds among groups irradiated immediately after wounding and groups irradiated at specific stages of the healing period. STUDY DESIGN: Experimental groups were as follows: Laser Therapy (LT) was received as three sessions of laser irradiation (6.38 J/cm2, 1.276 W/cm2, 808 nm) immediately after wounding (Inflammatory group, n = 12), 24 hours post-wounding (Proliferative group, n = 12), and 72 hours post-wounding (Remodeling group, n = 12); the Control group (n = 12) received no irradiation. Histological analyses were performed on the 3rd, 7th, and 14th days post-wounding. RESULTS: Mean wound diameters were 5 mm for all groups. On Day 7, wound diameters were measured as 2.99 ± 0.17, 2.95 ± 0.3, 2.52 ± 0.11, and 2.41 ± 0.34 mm for the Control, Inflammatory, Proliferative, and Remodeling groups, respectively. At 2 weeks post-wounding, dermal tissue in the Inflammatory and Proliferative groups closed superficially, while 1.30 ± 0.1 mm and 1.30 ± 0.06 mm openings remained in the Control and Remodeling groups, respectively. Mean wound healing rates (WHR) for all treatment groups were found to differ significantly from the control group (P < 0.05). Upon comparing the Proliferative group with the other treatment groups, a significant difference was found. However, no significant difference was found between the Inflammatory and Remodeling groups, with the former having a slightly higher mean value. CONCLUSION: Histological and morphometric results showed that high-power, low-energy application has the best effect when first applied 24 hours post-wounding (late inflammatory, early proliferative stage) as demonstrated by increases in granulation tissue, fibroblasts and collagen deposition, which lead to faster rates of wound contraction and thus accelerated healing.

The effect of irradiance level in 980-nm diode laser skin welding.

OBJECTIVE: Current research aimed to investigate the role of irradiance in skin laser welding. BACKGROUND DATA: Optical and thermal responses of tissue to infrared irradiation are highly dependent on both wavelength and tissue type. The desired effect on tissue is created by proper selection of laser power, application time, and spot size. METHODS: Full-thickness skin incisions on Wistar rat dorsum were welded with 980-nm diode laser application. Two irradiance levels (200 and 16.6 W/cm(2)) were applied with high (6 W, 400 ms) and low (0.5 W, 5 s) powers of laser with the same spot size (0.03 cm(2)). Subjects were monitored throughout a 21-day recovery period; incisions were sampled for histology and mechanical tests on particular control days (1, 4, 7, 14, and 21). Closure index, thermally altered areas, epidermal thickness, and granulation areas of H&E (eosin) stained samples were calculated. The breaking point during a mechanical tensile test that ran at 5-mm/min crosshead speed was recorded. RESULTS: In the suture group, there was no closure 24 h postoperation. For laser groups, immediate closure at the surface layers of the incisions was observed: Almost half-thickness (from surface to deep dermis) welding was achieved. Granulation tissue level and epidermal thickness level for all groups were similar on postoperative day 21. CONCLUSION: The laser welding technique was found reliable in terms of immediate and mechanically strong closure compared with suture. Low irradiance of a 980-nm laser (16.6 W/cm(2)) yielded noticeably stronger bonds at the end of 21 days of recovery, as well as minimal thermal damage.

Successful treatment of multidrug-resistant Acinetobacter baumannii ventriculitis with intravenous and intraventricular colistin.

Management of multidrug-resistant Acinetobacter baumannii (MDRAB) meningitis/ventriculitis is a difficult therapeutic problem owing to the limited penetration of antibiotics into cerebrospinal fluid (CSF). A 2-month-old girl with ventriculitis caused by MDRAB is reported. Despite therapy with intravenous (IV) colistin ventricular fluid, cultures remained positive for MDRAB. Institution of combination therapy with IV and intraventricular colistin resulted in a successful clinical and microbiological outcome. Intraventricular/intrathecal and IV colistin might be the best therapeutic option in the treatment of central nervous system infection caused by MDRAB. Further studies are required to evaluate pharmacokinetic and pharmacodynamic parameters of combined IV and intraventricular/intrathecal colistin administration, especially in children.

Closure of skin incisions by 980-nm diode laser welding.

A 980-nm diode laser is proposed to be an alternative welding laser in dermatology due to its optimal penetration in tissue. An in vivo predosimetry study was done to estimate the optimal laser energy delivery conditions (6 W, 400 ms). Next, in vivo experiments were comparatively performed to examine healing of wounds closed either with suture or laser welding. One-centimeter-long, full-thickness incisions were done on the dorsal side of Wistar rats. Wounds were surgically removed at 1, 4, 7, 14, and 21 days postoperatively. Macroscopic examinations showed that welding had minimal scarring and a fine quality healing. According to histological (hematoxylin and eosin staining) results, change of epidermal thickness and granulation tissue formation through 21 days of healing period showed similarities in both methods. Epidermal thickness of welded wounds decreased from 62.46+/-6.87 microm (first day) to 36.49+/-0.92 microm (21st day) and that of sutured wounds decreased from 62.94+/-13.53 microm (first day) to 37.88+/-7.41 microm (21st day). At day 14, epidermal thickness of sutured wounds (61.20+/-6.60 microm) were higher than welded wounds (49.69+/-6.31 microm) (p<0.05). Besides, granulation values were greater for the sutured wounds but the difference was statistically significant (p<0.05) only for the seventh day (197,190.29+/-.89,554.96 microm(2) for sutured wounds, 138,433.1+/-51,077.17 microm(2) for welded wounds). Those differences indicate a faster recovery with laser welding. It is concluded that tissue welding with a 980-nm diode laser can be a good candidate for tissue welding applications with accelerated and improved healing, but further investigations are in progress for clinical use.