CO2 laser oral soft tissue welding: an in vitro study

Abstract

Background and aim: Although there are some studies reporting the benefits of using laser to improve wound closure, there were a few studies in a model of oral mucosa. The aim of this in vitro study was to compare immediate tensile strength of the wound closure between suture alone and suture combined with CO2 laser welding.

Materials and methods: The study was conducted in 40 samples of the tissue blocks from ventral sides of pig tongues. A 20 mm-length and 5 mm-depth incision was made in each sample. The samples were randomly allocated into 2 groups namely: the control group and the experimental group. The samples of the control group were sutured with 3- stitch of 4-0 black silk. The samples of the experimental group were irradiated with CO2 laser (ultrapulse mode, 800 Watt peak power, 10 Hz, 0.2 ms pulse duration and 2,262.62 J/cm(2) energy density) before sutured. The immediate tensile strength of the wound was measured by using customized tensiometer under stereomicroscope.

Results: The median of tensile strength of the control group and the experimental group were 30.40 g/cm(2) and 40.50 g/cm(2), respectively. There was no statistically significant difference between the groups (P value = 0.58). The proportions of the samples without wound dehiscence at the maximum limit of the tensiometer (120 g/cm(2)) were 0.15 (3/20) in the control group and 0.35 (7/20) in the experimental group.

Conclusion: The CO2 laser welding used in this study failed to show a greater immediate tensile strength but had a higher proportion of the wound without dehiscence at the 120 g/cm(2) tensile strength by comparison with the suture alone.

Keywords: Oral mucosa; Oral surgery; Suture; Tensile strength; Tensiometer; Wound closure.

Fig. 1A

Tissue block prepared from the ventral side of the tongue

Fig. 1B

Making an incision on the surface of tissue block

Fig. 1C

A scalpel with a 5 mm depth-stopper and a rule with a 20 mm incision-slot

Fig. 2A

The tissue block with incision wound

Fig. 2B

CO₂ laser irradiating to the margins and surfaces of the wound

Fig. 2C

The specimens of both groups were sutured with 4-0 black silk.

Fig. 3

The customized tensiometer The specimen was placed on a platform and gripped by the mounts. The movable mount (M) with the connector (C) of which ending rod pressing on an electronic meter (E) used for providing tension to the specimen and recoding the tensile strength.

Fig. 4a

Fig. 4b