Abstract
Background and Objectives
Closing lacerations in thin eyelid and periorbital skin is time consuming and requires high skill for optimal results. In this study we evaluate the outcomes after single layer closure of wounds in thin skin with a sutureless, lightโactivated photochemical technique called PTB.
Study Design/Materials and Methods
Dorsal skin of the SKHโ1 hairless mouse was used as a model for eyelid skin. Incisions (1.2โcm) were treated with 0.1% Rose Bengal dye followed by exposure to 532โnm radiation (25, 50, or 100โJ/cm^2^; 0.25โW/cm^2^) for PTB. Other incisions were sutured (five 10โ0 monofilament), exposed only to 532โnm (100โJ/cm^2^), or not treated. Outcomes were immediate seal strength (pressure causing leakage through incision of saline infused under wound), skin strength at 1, 3, and 7 days (measured by tensiometry), inflammatory infiltrate at 1, 3, and 7 days (histological assessment), and procedure time.
Results
The immediate seal strength, as measured by leak pressure, was equivalent for all PTB fluences and for sutures (27โ32โmmHg); these pressures were significantly greater than for the controls (untreated incisions or laser only treatment; Pโ<โ0.001). The ultimate strength of PTBโsealed incisions was greater than the controls at day 1 (Pโ<โ0.05) and day 3 (Pโ<โ0.025) and all groups were equivalent at day 7. Sutures produced greater inflammatory infiltrate at day 1 than observed in other groups (Pโ=โ0.019). The average procedure time for sutured closure (311โseconds) was longer than for the PTB group treated with 25โJ/cm^2^ (160โseconds) but shorter than the group treated with 100โJ/cm^2^ (460โseconds).
Conclusion
PTB produces an immediate seal of incisions in thin, delicate skin that heals well, is more rapid than suturing, does not require painful suture removal and is easy to apply. Lasers Surg. Med. 44:163โ167, 2012. ยฉ 2012 Wiley Periodicals, Inc.