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Safety of laser-generated shockwave treatment for bacterial biofilms in a cutaneous rodent model

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Abstract

Bacterial biofilms are often found in chronically infected wounds. Biofilms protect bacteria from antibiotics and impair wound healing. Surgical debridement is often needed to remove the biofilm from an infected wound. Laser-generated shockwave (LGS) treatment is a novel tissue-sparing treatment for biofilm disruption. Previous studies have demonstrated that LGS is effective in disrupting biofilms in vitro. In this study, we aim to determine the safety threshold of the LGS technology in an in vivo rodent model. To understand the in vivo effects of LGS on healthy cutaneous tissue, the de-haired dorsal skin of Sprague-Dawley rats were treated with LGS at three different peak pressures (118, 296, 227 MPa). These pressures were generated using a 1064 nm Nd/YAG laser (pulse duration 5 ns and laser fluence of 777.9 mJ) with laser spot size diameters of 2.2, 3.0, and 4.2 mm, respectively. Following treatment, the animals were observed for 72 h, and a small subset was euthanized at 1-h, 24-h, and 72-h post-treatment and assessed for tissue injury or inflammation under histology. Each treatment group consisted of 9 rats (n = 3/time point for 1-h, 24-h, 72-h post-treatment). An additional 4 control (untreated) rats were included in the analysis, for a total of 31 animals. Gross injuries occurred in 21 (77%) animals and consisted of minor erythema, with prevalence positively correlated with peak pressure (p < 0.05). Of injuries under gross observation, 94% resolved within 24 h. Under histological analysis, the injuries and tissue inflammation were found to be localized to the epidermis and superficial dermis. LGS appears to be well tolerated by cutaneous tissue for the laser energy settings shown to be effective against bacterial biofilm in vitro. All injuries incurred, at even the highest peak pressures, were clinically mild and resolved within 1 day. This lends further support to the overall safety of LGS and serves to translate LGS towards in vivo efficacy studies.

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Acknowledgment

The authors would like to thank Michael C. Fishbein, MD, for his guidance and assistance in the analysis of the histological data.

Funding

This research was generously supported by the American Society for Laser Medicine & Surgery (ASLMS) student research grant and ASLMS travel grant.

Author information

Authors and Affiliations

  1. Department of Bioengineering, University of California, Los Angeles (UCLA) Henry Samueli School of Engineering and Applied Science, Los Angeles, CA, USA

    William Yao & Warren S. Grundfest

  2. Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Orange, CA, 92868, USA

    Edward C. Kuan

  3. Department of Head and Neck Surgery, UCLA Medical Center, Los Angeles, CA, USA

    Maie A. St. John

  4. UCLA Head and Neck Cancer Program, Los Angeles, CA, USA

    Maie A. St. John

Authors
  1. William Yao
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  2. Edward C. Kuan
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  4. Maie A. St. John
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Corresponding author

Correspondence to Edward C. Kuan.

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Ethical approval

This study was performed with the approval of University of California Los Angeles Institutional Animal Care and Use Committee (protocol #2013-018-01).

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Not applicable for animal trial.

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Yao, W., Kuan, E.C., Grundfest, W.S. et al. Safety of laser-generated shockwave treatment for bacterial biofilms in a cutaneous rodent model. Lasers Med Sci 36, 1403–1410 (2021). https://doi.org/10.1007/s10103-020-03171-3

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  • DOI: https://doi.org/10.1007/s10103-020-03171-3

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