title: 1950-nm diode laser-assisted microanastomoses (LAMA): an innovative surgical tool for hand surgery emergencies.
abstract: Based on previous observations, the 1950-nm diode laser seems to be an ideal wavelength for laser microvascular anastomoses. The data presented here, part of a larger ongoing study, assess its use in emergency hand surgery. Between 2011 and 2014, 11 patients were operated on for hand trauma with laser-assisted microanastomoses (LAMA) and prospectively analysed. LAMA was performed with a 1950-nm diode laser after placement of equidistant stitches. For vessel size <1.5 mm, the following laser parameters were used: spot size 400 μm, five spots for each wall, power 125 mW, and arterial/venous fluence 100/90 J/cm(2) (spot duration 1/0.9 s). Mean operating time for arterial and venous microanastomoses was 7.3 ± 1.4 and 8.7 ± 1.0 min, respectively. Three anastomoses required a secondary laser application. Arterial and venous patency rates were 100 % at the time of surgery. The success rate for the 11 procedures assessed clinically and with the Doppler was 100 %. The technique is compared to the current literature. The 1950-nm LAMA is a reliable tool with excellent results in emergency hand surgery. The system is very compact and transportable for utilization in the emergency operating room.
authors.affiliation: Department of Plastic and Transsexual Surgery, Burn Surgery, Hand Surgery, CHU University of Bordeaux, Centre François-Xavier-Michelet, Groupe hospitalier Pellegrin, Place Amélie-Raba-Léon, 33076, Bordeaux, France, franckleclere@yahoo.fr.
authors.forename: Franck Marie
authors.initials: FM
authors.lastname: Leclère
authors.forename: Michel
authors.initials: M
authors.lastname: Schoofs
authors.forename: Peter
authors.initials: P
authors.lastname: Vogt
authors.forename: Vincent
authors.initials: V
authors.lastname: Casoli
authors.forename: Serge
authors.initials: S
authors.lastname: Mordon
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D004638:Emergency Treatment; D006225:Hand / Q000098:blood supply* / Q000601:surgery; D006801:Humans; D053685:Laser Therapy; D054023:Lasers, Semiconductor / Q000627:therapeutic use*; D008297:Male; D008866:Microsurgery / Q000379:methods; D055806:Microvessels / Q000601:surgery*; D008875:Middle Aged; D011446:Prospective Studies; D014654:Vascular Patency; D014656:Vascular Surgical Procedures / Q000379:methods; D055815:Young Adult