title: Cold plasma welding system for surgical skin closure: in vivo porcine feasibility assessment.
abstract: BACKGROUND
  Cold plasma skin welding is a novel technology that bonds skin edges through soldering without the use of synthetic materials or conventional wound approximation methods such as sutures, staples, or skin adhesives. The cold plasma welding system uses a biological solder applied to the edges of a skin incision, followed by the application of cold plasma energy. The objectives of this study were to assess the feasibility of a cold plasma welding system in approximating and fixating skin incisions compared with conventional methods and to evaluate and define optimal plasma welding parameters and histopathological tissue response in a porcine model.
  
  
  METHODS
  The cold plasma welding system (BioWeld1 System, IonMed Ltd, Yokneam, Israel) was used on porcine skin incisions using variable energy parameters. Wound healing was compared macroscopically and histologically to incisions approximated with sutures.
  
  
  RESULTS
  When compared to sutured skin closure, cold plasma welding in specific system parameters demonstrated comparable and favorable wound healing results histopathologically as well as macroscopically. No evidence of epidermal damage, thermal or otherwise, was encountered in the specified parameters. Notably, bleeding, infection, and wound dehiscence were not detected at incision sites. Skin incisions welded at extreme energy parameters presented second-degree burns.
  
  
  CONCLUSIONS
  Implementation of cold plasma welding has been shown to be feasible for skin closure. Initial in vivo results suggest cold plasma welding might provide equal, if not better, healing results than traditional methods of closure.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Sheba Medical Center, Tel Hashomer, Israel; and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel, IonMed Ltd, Yokneam, Israel.
authors.forename: Moti
authors.initials: M
authors.lastname: Harats
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel, IonMed Ltd, Yokneam, Israel.
authors.forename: Amnon
authors.initials: A
authors.lastname: Lam
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel, IonMed Ltd, Yokneam, Israel.
authors.forename: Michael
authors.initials: M
authors.lastname: Maller
authors.affiliation: School of Health Sciences, Faculty of Health, University of Tasmania, Rozelle Campus, Sydney, Australia.
authors.forename: Rachel
authors.initials: R
authors.lastname: Kornhaber
authors.affiliation: Department of Plastic and Reconstructive Surgery, Sheba Medical Center, Tel Hashomer, Israel; and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel, IonMed Ltd, Yokneam, Israel.
authors.forename: Josef
authors.initials: J
authors.lastname: Haik