Laser tissue welding of dura mater and peripheral nerves: a scanning electron microscopy study.
OBJECTIVE
In order to elucidate the mechanism of tissue welding, scanning electron microscopy (SEM) was used to investigate the ultrastructural changes on the surface of dura mater and peripheral nerves after CO2 laser welding.


METHODS
The dura mater and the epineurium of the nerves was welded with a CO2 laser at 100 mW with pulses of 1.0 s (spot size 320 microns), both with and without additional use of a protein solder (egg white). The specimens were immediately examined using SEM.


RESULTS
The laser tissue bonding mechanism is collagen-to-collagen attachment. After laser irradiation, the collagen fibrils are swollen, densely packed, and fused together. When a protein solder is used, the coagulated solder forms a solid bridge between the tissue edges, which is melted on and between the collagen fibrils.


CONCLUSIONS
Laser welds in dura mater and peripheral nerves are the result of collagen-to-collagen bonding. In solder-assisted laser welds, the tissue connection is made by an internal and an external matrix of coagulated solder.
Menovsky
T
T
Laser Center, Academic Medical Center, Amsterdam, The Netherlands.
Beek
J F
JF
van Gemert
M J
MJ
D000818:Animals; D003094:Collagen; D004388:Dura Mater / Q000601:surgery* / Q000648:ultrastructure; D005260:Female; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D017348:Microscopy, Electron, Scanning Transmission; D010525:Peripheral Nerves / Q000601:surgery* / Q000648:ultrastructure; D011817:Rabbits
D003094:Collagen