Advancing Wound Closure Techniques: Safe and Successful Wound Closure with Novel Pulsed 980 nm Laser Welding

INTRODUCTION: Laser-tissue welding is an important technique for achieving tight wound closure by simultaneously coagulating and cauterizing the tissue. It has several advantages over traditional suture-based wound closure methods, including fast wound closure and no foreign body reaction risk. Additionally, its ease of use makes it a potential option for wound closure in disaster scenarios or conflict areas, where trained personnel may not be available to perform complex surgical procedures. The unique properties of laser-based closure systems make them a promising frontier in wound care. However, the main challenge is to develop a laser-based method that can achieve potent wound closure without causing significant thermal injury. In this study, we aimed to investigate the use of different laser wavelengths to achieve better closure with minimal injury. METHODS: Three vertical one cm full-thickness skin incisions were created along the paravertebral tract on both sides of the dorsolateral skin. Contralateral wounds were matched and closed with either a 980 nm or a 1064 nm laser-welding technique, using 1 watt for 10 seconds and 5 joules per wound. On postoperative day 4 or 7, skin samples were collected and stained with hematoxylin and eosin to measure superficial and deep wound closure, thermal damage area, coagulation area, and granulation area. RESULTS: On days 4 and 7, the 980 nm tissue samples showed significantly less thermal damage than the 1064 nm samples. Histological evaluation showed that the shorter wavelength pulsation achieved greater closure on the superficial wound edge, resulting in tighter wound closure. The deep dermal wound edges were comparable between the two laser cohorts. However, the wounds treated with the 980 nm laser showed a significant reduction over time, bringing the profundal part closer together. There was no statistical difference between the two groups in terms of coagulation area. CONCLUSIONS: Our study demonstrated that the use of pulsed 980 nm laser welding resulted in a reduction in wound size and less formation of granulation tissue. Additionally, there were significantly fewer thermal side effects observed compared to the use of 1064 nm laser welding. These findings suggest that pulsed 980 nm laser welding may be a more effective and safer technique for wound closure. To our knowledge, there is no technique that can achieve good closure without excessive thermal side effects, and our method is novel in terms of achieving this. However, more research is necessary to fully understand the potential long- term effects of pulsed laser mode on various types of wounds and animal models. If future studies confirm the efficacy and safety of this technique, it could become a valuable method for surgical skin closure in both clinical and emergency settings.