Prof. Abraham Katzir: “Plastic surgeons will love this invention.”Suturing wounds and cuts has always been problematic. Even using today’s microsurgery techniques, the treated wounds are open to infection, and the patient is inevitably left with permanent and unsightly scars.

When carbon dioxide lasers were invented, many thought they would be the ideal remedy, sealing wounds more effectively and minimizing scarring. Attempts to use these lasers for bonding cuts in the operating room or in clinics failed dismally, however, because surgeons were unable to control the heat emitted by the laser. The lasers either “undercooked” or “overcooked” the patient’s delicate tissues, causing long-term thermal damage.

Now a team of Israeli researchers could have the solution. The scientists, from Tel Aviv University (TAU), have developed a new technique that maintains the heat of the laser at exactly the right temperature for optimal wound healing, allowing surgeons to seal cuts both on our skin and inside our bodies with less scarring, and less exposure to infection.

The new technique, developed by Prof. Abraham Katzir and a team from TAU’s Applied Physics Group, is called laser-welding. When the laser begins to overheat and risks burning the tissue, the device reduces laser power, and if the temperature is too low to complete a closure, laser power in increased appropriately.

Keeping the heat right

Katzir is the first researcher to apply the carbon dioxide laser, coupled to optical fibers, for wound closure under a tight temperature control. His innovation is in the use of unique optical fibers made from silver halide developed at the university. The fibers deliver the laser’s energy to heat the bonded cut and are used for controlling the temperature. They also make it possible to bond tissues inside the body.

“Sutures or stitches are not water tight, and blood or urine can pass through cuts, causing severe infection,” he says. “Also, in many cases, a surgeon needs great skill to perform internal stitching, or in bonding tiny blood vessels, or in mending cuts on the skin so there will be no trace left on the body.”

The device has already been tested successfully in clinical trials on people undergoing gall bladder surgery. At the close of the surgery, four cuts were left on the skin of the abdomen, two of which were sutured and two laser-bonded. The results of the trials suggest that the laser-bonded tissues heal faster, with less scarring.

Faster healing, less trauma

Successful preliminary experiments also showed that the new technique can be used to bond cuts on the cornea, bladder, intestines, blood vessels or trachea. It may also be used for bonding tissues inside the body on organs such as the kidney, and even in brain surgery. Perfect for healing soft tissues, the laser may prevent an enormous amount of trauma when used for closing internal wounds.

“We think plastic surgeons will especially love this invention. Bonding tissues that heal well without scarring is a true art that few people possess,” says Katzir. He believes the method will be much easier to master than suturing, and will generate a watertight bond, preventing infections and accelerating healing.

The researchers plan to apply to the FDA in the US for large scale trials, and with permission from Israel’s Ministry of Health, they will soon begin testing the device on longer cuts, such as hernia operations. If these trials prove successful, the basic research could be developed into a commercial product within a few years.

Katzir is looking ahead. “It could also become a device for the battlefield, allowing soldiers to heal each other on contact with a laser wand,” he suggests.