Laser-assisted wound closure allows safer, cheaper oral surgery

18 Feb 2016

European project aims to deliver protection against germs and faster recovery through biophotonic technique.

Surgery to areas around the head, face and neck can present challenges to clinicians even after the initial procedure is completed.

In current oral and maxillofacial surgery, protecting the area post-surgery in order to keep germs out has involved either the use of compresses, or complicated grafts of skin or mucous membrane, with associated suturing requirements. This can be particularly significant when the wound is beyond a certain size.

A simpler way to cover the wound would have distinct advantages, and a European project to develop just such a solution has recently started.

Partners from Germany, Israel, Latvia and Italy have come together in the BI-TRE (Biophotonic technologies for tissue repair) consortium, supported by the European Commission's FP7 research framework and under the transnational BiophotonicsPlus initiative.

The group's goal is to develop a novel technique for wound closure, in which a covering of collagen membranes is applied to the wound and attached to the mucosa with a laser-assisted technique.

As well as providing protection against germs and infection, this method could potentially reduce both patient discomfort and treatment time, making the overall procedure more cost-effective.

Silk implant
The project takes its cue from established techniques in vascular laser welding and treatments of the cornea, and involves the photothermal activation of biocompatible materials applied to the site of the wound. Integrated sensors and real-time controllers will be developed to monitor the process and ensure its effectiveness.

According to the project proposals, BI-TRE foresees two distinct types of surgical application for such a laser system.

One is the repair of arterial wounds and the rejoining of blood vessels that had previously branched out separately, procedures known as anastomoses. In this context, a laser-based joining could replace the use of stitches, reducing both the occlusion involved and the subsequent healing time.

The other attractive application is the fixing in position of wound dressings used to treat oral wounds. BI-TRE suggests that around 41 percent of the population suffer from lesions or other abnormal oral mucosa - the mucous membrane lining the inside of the mouth - making a safer and quicker treatment regime a potentially substantial market.

The group envisages a technique in which a silk implant incorporating both a three-dimensional non-woven structure to support tissue growth and a covering membrane to protect against bacteria is put in place. Irradiation with a suitable laser source would then fix the implant in position, covering the mucosal defect and promoting healing.

Project members include DILAS, which is supplying an optimized laser beam source and LifePhotonic for handpiece and system integration. Fraunhofer ILT handles project coordination and process development.

Other contributors include Tuscany-based laser-developer El.En; the Nello Carrara Institute of Applied Physics, part of Italy's CNR National Research Council; and the Biophotonics Laboratory of the University of Latvia.

Also on board is Isreali biotech company Opticul Diagnostics, which will develop a thermal imager and single-channel temperature sensor for real time recording and analysis of temperature during the wound-covering procedure.