Skin grafts without scarring

November 27, 2002

SURGEONS could use laser-activated glue to attach skin grafts without the scarring and swelling that existing methods can cause. Skin grafts are commonplace in cosmetic surgery, and for burns victims a successful graft can be a matter of life or death. For the new skin to survive, it is essential to quickly establish a strong bond with tissue at the wound site. Surgeons use stitches, staples or tissue glues to secure the graft. But the surgical threads and staples sometimes cause extensive scarring, and chemical glues can trigger inflammation.

Robert Redmond and his team of dermatologists at Harvard Medical School in Boston believe they have now found an unlikely alternative that uses a medical dye called rose bengal. The biocompatible dye has been used for decades to stain patients' eyes during ophthalmic examinations. But Redmond's team knew that when the dye is illuminated with green light, it forms strong bonds with surrounding tissue.

To test the idea they took thin sections of pig skin that included the outer layer of skin, the epidermis, as well as the dermis layer beneath. They then placed two sections of skin together, dermis to dermis, with a thin layer of the dye in between. To bond the two layers, Redmond illuminated the skin with green light from a laser for 15 minutes.

He found that the bond between the layers of skin became 15 times as strong after being exposed to light. And the bond was twice as strong as that provided by standard glues. Crucially, the laser only heated the skin slightly above body temperature and did not kill or damage the surrounding tissue (Journal of Surgical Research, vol 108, p 77).

"If it ultimately works, it could have many uses beyond treatment of wounds- you could seal blood vessels or join tissues with sutureless bonds," says David Young, a plastic surgeon who runs the burns unit at San Francisco General Hospital. He points out though that Redmond's technique is currently far too slow to be practical. Redmond's next task is to use a more powerful laser to drive much faster bonding.
Author: Philip Cohen

New Scientist issue: 30th November 2002


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