title: Light-activated sutureless closure of wounds in thin skin.
abstract: OBJECTIVE
  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, light-activated photochemical technique called PTB.
  
  
  METHODS
  Dorsal skin of the SKH-1 hairless mouse was used as a model for eyelid skin. Incisions (1.2 cm) were treated with 0.1% Rose Bengal dye followed by exposure to 532 nm radiation (25, 50, or 100 J/cm(2); 0.25 W/cm(2)) for PTB. Other incisions were sutured (five 10-0 monofilament), exposed only to 532 nm (100 J/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 (27-32 mmHg); these pressures were significantly greater than for the controls (untreated incisions or laser only treatment; P < 0.001). The ultimate strength of PTB-sealed incisions was greater than the controls at day 1 (P < 0.05) and day 3 (P < 0.025) and all groups were equivalent at day 7. Sutures produced greater inflammatory infiltrate at day 1 than observed in other groups (P = 0.019). The average procedure time for sutured closure (311 seconds) was longer than for the PTB group treated with 25 J/cm(2) (160 seconds) but shorter than the group treated with 100 J/cm(2) (460 seconds).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.
authors.forename: Penggao
authors.initials: P
authors.lastname: Yang
authors.forename: Min
authors.initials: M
authors.lastname: Yao
authors.forename: Sheri L
authors.initials: SL
authors.lastname: DeMartelaere
authors.forename: Robert W
authors.initials: RW
authors.lastname: Redmond
authors.forename: Irene E
authors.initials: IE
authors.lastname: Kochevar
mesh_terms: D000818:Animals; D005143:Eyelids / Q000293:injuries; D005260:Female; D022125:Lacerations / Q000188:drug therapy*; D051379:Mice; D008812:Mice, Hairless; D055668:Photochemical Processes; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000494:pharmacology / Q000627:therapeutic use*; D011897:Random Allocation; D012395:Rose Bengal / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome; D058106:Wound Closure Techniques; D014945:Wound Healing / Q000187:drug effects
chemical_list: D017319:Photosensitizing Agents; D012395:Rose Bengal