Potential application of biomedical photonics technologies in purulent surgery

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Abstract

This review systematises current data on the physical principles of laser radiation interaction with biological tissue. The features of the "laser wound" are analysed, the advantages and the potential complications of laser surgery are considered. The mechanisms of photothermal action underlying the proposed technique of passive drainage are analysed in detail. Particular attention is paid to the unique property of laser radiation to induce controlled, reversible thermal changes at the edges of the surgical wound, which temporarily slows down their healing process. This effect provides the creation of conditions for prolonged and adequate drainage of purulent exudate through a wound channel significantly smaller than that of a traditional incision, without the use of drainage materials that traumatise the wound surface.

This review proposes a fundamentally new approach to using the photothermal effect not for destruction, but for the controlled management of biological processes at the wound edges to provide optimal conditions for drainage. A comprehensive analysis of the literature conducted in this article suggests that the proposed approach has no direct analogues and offers significant medical, social, and economic potential by reducing healing time, frequency of dressing changes, and the risk of wound-related complications and low patient compliance. The review's uniqueness lies in its systematic presentation of the theoretical prerequisites and practical perspectives for developing a new, pathogenetically substantiated technology for treating purulent wounds in outpatient practice.

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About the authors

Runar R. Shaimardanov

Russian University of Medicine

Author for correspondence.
Email: shaimardanovrunar@yandex.ru

Junior Researcher, Laboratory of Minimally Invasive Surgery, Technobiomed Research Institute; Surgeon, Medsi Group of Companies

Russian Federation, Moscow

Dmitry N. Panchenkov

Russian University of Medicine

Email: dnpanchenkov@mail.ru

M.D., Professor, Head of the Department of Surgery and Surgical Technologies, Head of the Laboratory of Minimally Invasive Surgery

Russian Federation, Moscow

References

  1. Markolf HN. Laser–tissue interactions: fundamentals and applications. 4th ed. Mannheim: Springer Nature Switzerland AG. 2019; 322.
  2. Boulnois JL. Photophysical processes in recent medical laser developments: a review. Lasers in Medical Science. 1986;1:47–66.
  3. Parsa P, Jacques SL, Nishioka NS. Optical properties of rat liver between 350 and 2200 nm. Applied Optics. 1989;28:2325–30.
  4. Cilesiz IF, Welch AJ. Light dosimetry: effects of dehydration and thermal damage on the optical properties of the human aorta. Applied Optics. 1993;32:477–87.
  5. Madi M, Mahmoud M. The evaluation of healing effect of low-level laser treatment following gingivectomy. Beni-Suef University Journal of Basic and Applied Sciences. 2020;9:34.
  6. Chung H, Dai T, Sharma SK, Huang YY, Carroll JD, Hamblin MR. The nuts and bolts of low-level laser (light) therapy. Annals of Biomedical Engineering. 2012;40:516–33.
  7. Williams JA, Pearson GJ, Colles MJ. Antibacterial action of photoactivated disinfection used on endodontic bacteria in planktonic suspension and in root canals. Journal of Dentistry. 2006;34:363–71.
  8. Moan J, Christensen T. Photodynamic effects on human cells exposed to light in the presence of hematoporphyrin. Cancer Letters. 1981;11:209–14.
  9. Koizumi N, Harada Y, Minamikawa T, Tanaka H, Otsuji E, Takamatsu T. Advances in photodynamic diagnosis of gastric cancer using 5-aminolevulinic acid. World Journal of Gastroenterology. 2016;22:1289–96.
  10. Niemz MH, Loesel FH, Fischer M, Lappe C, Bille JF. Surface ablation of corneal tissue using UV, green and IR picosecond laser pulses. Proceedings of SPIE. 1994;2079:131–9.
  11. Garrison BJ, Srinivasan R. Laser ablation of organic polymers: microscopic models for photochemical and thermal processes. Journal of Applied Physics. 1985;57:2909–14.
  12. Rasmussen RE, Hammer-Wilson M, Berns MW. Mutation and sister chromatid exchange induction in CHO cells by excimer and UV radiation. Photochemistry and Photobiology. 1989;49:413–8.
  13. Niemz MH, Klancnik EG, Bille JF. Plasma-mediated ablation of corneal tissue at 1053 nm. Lasers in Surgery and Medicine. 1991;11:426–31.
  14. Vogel A, Busch S, Jungnickel K, Birngruber R. Mechanisms of intraocular photodisruption. Lasers in Surgery and Medicine. 1994;15:32–43.
  15. Vogel A, Schweiger P, Frieser A, Asiyo MN, Birngruber R. Nd:YAG laser surgery: tissue interaction and collateral effects. IEEE Journal of Quantum Electronics. 1990;26:2240–60.
  16. Kucera A, Blake JR. Computational modelling of cavitation bubbles near boundaries. Computational techniques and applications. Amsterdam: North-Holland. 1988.
  17. Skobelkin OK, Kozlov VI, Geinits AV, Danilin NA, Derbenev VA. Primenenie lazernykh khirurgicheskikh apparatov. Lantset. Moskva. 2002; 91. (in Russ.)
  18. Hobiny A, Abbas I. Eigenvalue approach for investigating thermal and mechanical responses on living tissues during laser irradiation with experimental verification. Physics of Fluids. 2024;36(3):031902.
  19. Ji Y, Wang G, Chen Z, Chen H. Step response model and real-time prediction of temperature fields in laser irradiated biological tissues. International Journal of Thermal Sciences. 2023;189:108309.
  20. Hayes JR, Wolbarsht ML. Thermal model for retinal damage induced by pulsed lasers. Aerospace Medicine. 1968;39:474–80.
  21. Pelz B, Schott MK, Niemz MH. Electro-optic mode locking of an erbium:YAG laser. Applied Optics. 1994;33:364–7.
  22. Lepock JR, Frey HE, Ritchie KP. Protein denaturation during heat shock. Journal of Cell Biology. 1993;126:1267–76.
  23. Nevorotin AI. Vvedenie v lazernuyu khirurgiyu. Sankt-Peterburg: SpetsLit. 2000; 175. (in Russ.)
  24. Colin P, Nevoux P, Marqa M. Laser interstitial thermotherapy at 980 nm for prostate cancer. BJU International. 2011;109:452–8.
  25. Dai X, Zheng W, Wang Z, et al. Investigation of bio-heat transfer with variable physical parameters during cutaneous laser therapy combined with cryogen spray cooling. International Journal of Heat and Mass Transfer. 2024;222:124987.
  26. Eichler J, Seiler T. Lasertechnik in der Medizin. Berlin: Springer. 1991.
  27. Kuzin MI, Kostyuchenok BM, Karlov VA. Wound infection. Khirurgiya. 1980;(12):83–4. (in Russ.)
  28. Gostishchev VK. Infektsii v khirurgii. Moskva: GEOTAR-Media; 2007; 763. (in Russ.)
  29. Nazarov EA, Fokin IA. Ozono- i lazeroterapiya gnoinykh ran. Sovremennye problemy terapii khirurgicheskikh infektsii. Moskva. 2005; 64. (in Russ.)
  30. Abaev YuK. Rany i ranevaya infektsiya. Rostov-na-Donu: Feniks. 2006; 427. (in Russ.)
  31. Pantsyreva YuM. Klinicheskaya khirurgiya. Moskva: Meditsina. 1988; 640. (in Russ.)
  32. Yu W, Naim JO, Lanzafame RJ. Growth factor expression in early wound healing. Surgery and Medicine. 1994;15:281–9.
  33. Nevorotin AI, Kull' MM. Electron-histochemical characteristics of laser necrosis. Arkhiv patologii. 1989;(7):63–70. (in Russ.)
  34. Hotta S, Kashimura H, Hirai S. Subcellular changes after photodynamic therapy. Lasers in Surgery and Medicine. 1995;16:262–71.
  35. Bianconi F, Leoni M, Petras A, Schena E, Gerardo-Giorda L, Gizzi A. Higher-order thermal modeling and computational analysis of laser ablation in anisotropic cardiac tissue. Biomechanics and Modeling in Mechanobiology. 2025;24(2):559–577.
  36. Yukina GYu, Zhloba AA, Zel'tser GL. Lazernaya rana: kompleksnyi analiz. V: Lazernaya biologiya i meditsina. Tartu. 1992;176–83. (in Russ.)
  37. Machulaitis RR. Subablyatsionnyi rezhim lazernogo oblucheniya. Avtoref. dis. kand. med. nauk. 1994. (in Russ.)
  38. Zhloba AA, Machulaitis RR, Kull' MM, Zel'tser GL. Rezorbtsiya koagulirovannykh tkanei. Tartu. 1991; 13–18. (in Russ.)
  39. Romanos GE, Pelekanos S, Strub JR. Effects of Nd:YAG laser on wound healing. Lasers in Surgery and Medicine. 1995;16:368–78.
  40. Jaffe BH, Walsh JT. Water flux from partial-thickness skin wounds. Lasers in Surgery and Medicine. 1996;18:1–9.
  41. Khirurgicheskie infektsii kozhi i myagkikh tkanei. Natsional'nye rekomendatsii. Moskva. 2015; 109. (in Russ.)
  42. Shimko VV, Simonova OP, Novolodskii VI, Kirillov AB, Reshetnikova LK. Laser treatment in purulent diseases. Bulletin VSNTs SO RAMN. 2005;3:271. (in Russ.)
  43. Sabel'nikov ON. Outpatient treatment of purulent wounds. Astrakhanskii meditsinskii zhurnal. 2009;4:182–183. (in Russ.)
  44. Nabiev AF. Outpatient treatment of purulent wounds. Vestnik khirurgii Kazakhstana. 2014;(3):59–60. (in Russ.)
  45. Hu S, Xiao J, Nie X, Wang C. Vacuum sealing drainage combined with continuous irrigation for the treatment of oral and maxillofacial abscesses—a retrospective study. BMC Oral Health. 2025;25:76.
  46. Tan T, Lee HY, Huang MS, Chan AK, Pendharkar AV, Ho AL, O’Connor CMP, Sussman ES, Desai A, Cheung SH, Berger GK, Li G. Prophylactic Postoperative Measures to Minimize Surgical Site Infections in Spine Surgery: Systematic Review and Evidence Summary. The Spine Journal. 2020;20(3):435–447.
  47. Kazaryan NS. Aspiratsionno-protochno-promyvnoe drenirovanie. Dis. kand. med. nauk. Omsk. 2014; 117.
  48. Kulikov KG. Matematicheskoe modelirovanie mediko-biologicheskikh sistem. SPb. 2011; 240.

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2. Fig. 1. Spectral absorption coefficients of the main chromophores of biological tissues. The dependence of the optical absorption coefficient of water, melanin, and oxy- and deoxyhemoglobin on the laser wavelength, determining the selectivity of the effect, is demonstrated.

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3. Fig. 2. Diagram of the mechanisms of laser radiation interaction with biological tissues [2]. The dependent dominant effects on the power density and exposure time of laser radiation is demonstrated; non-ionising (photochemical, photothermal) and ionising (photoablative and plasma-induced) effects are conditionally distinguished.

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4. Fig. 3. Schematic diagram of the photothermal interaction of laser radiation with tissue. The diagram demonstrates the sequence of processes: absorption of laser radiation and heat generation, heat transfer to tissue, and the formation of a thermal effect that determines the nature and extent of thermal damage depending on laser parameters and tissue properties.

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5. Fig. 4. Schematic distribution of photothermal effects in biological tissue under laser irradiation. The forming zones with varying degrees of thermal damage depending on local temperature are demonstrated: a central zone of evaporation (vapourisation) surrounded by a zone of carbonisation and coagulative necrosis, and then a zone of hyperthermia.

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6. Fig. 5. Zones of morphofunctional changes in a laser wound. The diagram demonstrates the formation of concentric zones after laser exposure: a central zone of complete inactivation (thermal tissue necrosis); a surrounding zone of partial inactivation with reduced cellular activity and delayed resorption of necrosis; and a peripheral zone of normal activity, morphologically comparable to undamaged tissue.

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