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Traditional surgery to reshape a nose or an ear involves cutting and suturing, sometimes followed by long periods of recovery and scarring. But now researchers have developed a method of "molecular surgery" that uses tiny needles, electric current, and 3D-printed molds to quickly reshape living tissue without incisions, scars, or recovery time. The technique even looks promising as a means of repairing motionless joints or as a non-invasive alternative to laser eye surgery.
The researchers will present their findings today at the 2019 Spring National Meeting and Exposition of the American Chemical Society (ACS).
"We are considering this new technique as a low-cost office procedure performed under local anesthesia," said Michael Hill, Ph.D., one of the project's lead researchers, who will discuss the work at the meeting. "The whole process takes about five minutes."
Hill, who works at Occidental College, is involved in this project when Brian Wong, MD, Ph.D., of the University of California at Irvine, asked for help in developing a non-invasive technique of cartilage remodeling. Such a method would be useful for cosmetic surgery procedures, like making the nose more attractive. But the method could also help to solve problems, such as a deviated septum, or conditions for which there is no good treatment, such as joint contractures caused by a cerebrovascular accident or cerebral palsy . Having himself had a painful septum operation, Hill understands what patients are experiencing and is enthusiastic about participating in a project to develop a better strategy.
Wong was already an expert in an alternative technique using an infrared laser to heat the cartilage, making it flexible enough to reshape it. "The problem is that this technique is expensive and that it is difficult to sufficiently heat the cartilage so that it is malleable without killing the tissues," Hill says. To find a more practical approach, Wong's team began experimenting with warming the current passing through the cartilage. The method allowed them to reshape the fabric, but curiously, not warming it. Wong turned to Hill to determine how the new method works and to refine it to prevent tissue damage.
Cartilage is tiny, stiff collagen fibers loosely woven with biopolymers. Its structure resembles spaghetti that was thrown at random on a counter, the individual strands being tied by a thread. "If you get it, the strands would not fall apart, but it would be a floppy disk," says Hill. The cartilage also contains negatively charged proteins and positively charged sodium ions. Cartilage with a higher density of these charged particles is stiffer than cartilage with a lower charge density.
The Hill & # 39; s group discovered that current flowing through the cartilage electrolyses water into the tissues, converting it into oxygen and hydrogen ions, or protons. The positive charge of the protons negates the negative charge on the proteins, reducing the charge density and making the cartilage more malleable. "Once the fabric is soft," he says, "you can shape it in any shape."
The team tested the method on a rabbit whose ears are normally erect. They used a mold to hold a leaning ear in the desired new shape. If they had then removed the mold without applying current, the rabbit's ear would have regained its original vertical position, just as a human ear would. But by inserting microneedle electrodes into the ear at the bend and by pulsing the current through them with the mold in place, they briefly softened the cartilage at the site of the curvature without letting it. to damage. Cutting the current then allowed the cartilage to harden in its new form, after which the mold was removed.
To achieve this result with traditional methods, a surgeon should cut through the skin and cartilage and then glue the pieces together. This can lead to the formation of scar tissue at the joint. This scar tissue sometimes has to be removed during subsequent operations, says Hill. By avoiding this mechanical damage to the cartilage, the molecular surgery technique does not cause scars or pain.
Researchers are exploring licensing options for cartilage technology with medical device manufacturers. They are also studying the applications of other types of collagen tissue, such as tendons and corneas. In one eye, the shape of the cornea affects the vision. Excessive curvature, for example, causes myopia. Many obstacles must be overcome before this method can be used to correct a person's vision, but preliminary experiments on animals have yielded promising results. The researchers used a 3D printer to make a contact lens. After painting electrodes on it, they put the contact lens on the eye. The current application allowed them to temporarily soften the cornea and change its curvature.
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