Abstract
For the post-surgical treatment of oral wounds and mucosal defects beyond a certain size, the gold standard is still an autologous skin or mucosal graft in combination with complex suturing techniques. A variety of techniques and biomaterials has been developed for sutureless wound closure including different tissue glues or collagen patches. However, no wound covering that enables for sutureless fixation has yet been introduced. Thus, a new system was developed that allows for sutureless wound covering including a transparent collagen membrane, which can be attached to the mucosa using a specially modified 2λ laser beam with integrated temperature sensors and serum albumin as bio-adhesive. The sutureless wound closure system was tested for its applicability and its cytocompatibility by an established in vitro model in the present study. The feasibility of the laser system was tested ex vivo on a porcine palate. The in vitro cytocompatibility tests excluded the potential release of toxic substances from the laser-irradiated collagen membrane and the bio-adhesive. The results of the ex vivo feasibility study using a porcine palate revealed satisfactory mean tensile strength of 1.2–1.5 N for the bonding of the membrane to the tissue fixed with laser of 980 nm. The results suggest that our newly developed laser-assisted wound closure system is a feasible approach and could be a first step on the way towards a laser based sutureless clinical application in tissue repair and oral surgery.
Highlights
Larger mucosal defects, which can occur due to a variety of pathologies such as resections of different tumors or infections require for specialized techniques for wound closure
It has been shown that collagen as a biomaterial supports the wound healing process due to its non-inflammatory properties and excellent biocompatibility and collagen materials can promote epithelial regeneration [5,7,8,9]
It has been demonstrated that the tensile strength measured directly after laser soldering can be as high as the strength obtained by suturing [22]
Summary
Larger mucosal defects, which can occur due to a variety of pathologies such as resections of different tumors or infections require for specialized techniques for wound closure. Another application for LTS is the wound closure of skin or mucosa incisions, which has already successfully been investigated in vitro and in vivo [18,19,20,21] For such indications, it has been demonstrated that the tensile strength measured directly after laser soldering can be as high as the strength obtained by suturing [22]. The initial feasibility study included the fixation of the collagen membrane to the surface of a porcine palate using bovine serum as the bio-adhesive and measurements of the tensile strength to test the fixation-stability between the membrane and the tissue. AS1ddtoitidoenmaloinmsatrgaetseotfhtawt othsepceeclilms eanres oatfttahcehleadsearn-wdealldiveed imnedmiffberraennet aforecaslhpolwaneisnoSfutphpelmememenbtararyneF.igure S1 to demonstrate that the cells are attached and alive in different focal planes of the membrane
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