Laser welding and collagen crosslinks

Abstract

The strength and stability of laser-welded tissue may be influenced, in part, by the effects of laser exposure on collagen crosslinking. We therefore studied the effects of diode laser exposure (805 nm, 1 - 8 watts, 30 seconds) plus indocyanine green dye (ICG) on calf tail tendon collagen crosslinks. The effect of ICG dye alone on crosslink content prior to laser exposure was investigated; unexpectedly, we found that ICG-treated tissue had significantly increased DHLNL and OHP, but not HLNL. Laser exposure after ICG application reduced elevated DHLNL and OHP crosslink content down to their native levels. The monohydroxylated crosslink HLNL was inversely correlated with laser output (p less than 0.01 by linear regression analysis). DHLNL content was highly correlated with content of its maturational product, OHP, suggesting that precursor-product relationships are maintained. We conclude that: (1) ICG alone induces DHLNL and OHP crosslink formation; (2) subsequent laser exposure reduces the ICG-induced crosslinks down to native levels; (3) excessive diode laser exposure destroys normally occurring HLNL crosslinks.