Light-Activated Nanosutures: Wound Healing for the 21st Century

The use of suture material for wound closure dates back to at least 3000 BC. Although there have been refinements, little progress has been made in developing entirely new procedures. These investigators employed a novel process, photoactivated tissue bonding (PTB), for the closure of cutaneous wounds from surgical excisions. The procedure is as follows: The dye rose bengal is applied to both surfaces of a wound. Alone, this compound is biologically inactive, but exposure to green light (532 nm; in this study, from a KTP laser) initiates a photochemical reaction that rapidly produces covalent cross-links between collagen molecules. Unlike typical sutures, light-activated tissue bonding produces little inflammation.

In this first human study, 31 wounds from surgical excision of skin lesions on the abdomen, back, forearm, shoulder, upper arm, and thigh were evaluated. Half of each wound was closed with 4-0 nylon nonabsorbable sutures, and the other half with PTB. Trained observers assessed healing directly and by photographs at 2 weeks and 6 months. At 2 weeks, the PTB side showed less erythema, crusting, and oozing than the sutured side, and the observers rated the PTB side superior in appearance (P<0.001). Wound dehiscence was not observed with either closure technique. At 6 months, appearance was rated superior in 77% of the PTB-closed sides (P>0.001), and sutures were associated with wider scars. Patient satisfaction in scar appearance was also greater in the PTB treated area, both at 2 weeks and at 6 months.