By Patricia Daukantas
OSA Fellow Jim Wynne could be resting on his laurels for his role in developing laser ophthalmic surgery. Instead, he’s working on a new idea: using lasers to excise dead tissue from the wounds of burn victims.
Wynne, who works at IBM Corp.’s Thomas J. Watson Research Center, attended yesterday’s laser exhibit and demonstration on Capitol Hill in Washington, D.C. He and a Maryland ophthalmologist, Sonny Goel, were there to discuss laser eye surgery techniques such as laser-assisted in situ keratomileusis, or LASIK. As I recounted on this blog a few months ago, Wynne discovered the excimer laser’s ability to remove tissue cleanly without damage to the surrounding tissues, and that realization led to the wonders of ophthalmic refractive surgery.
For years, Wynne and his tennis buddy, dermatologist Jerome Felsenstein, have been batting around the idea of using a laser to debride the charred, dead layers of skin from the wounds of severely burned people. Currently, surgeons need to do this with a scalpel. Wynne and the dermatologist were trying to figure out how to get the advantages of extremely clean tissue removal without making the procedure take way too much time.
The answer, according to IBM’s recently filed patent application, is to use two ultraviolet lasers in a sterile, self-terminating procedure. One laser, operating at 308 nm, would act like rough sandpaper and remove a lot of the dead tissue quickly. The second, with a wavelength of 192 nm, would carefully clean off the last little bit of dead tissue and stop “when it hits salt water” or living tissue, Wynne said. (As he explained, the 192-nm light is close to a strong absorption line of chlorine ions, so when the light encounters the slightly salty liquid of living tissue, the energy goes into changing the Cl– ions into neutral Cl atoms instead of heating the proteins in the skin.)
Wynne stressed that there’s one major caveat: This technique has not yet been tried on living animals (including people). But he showed me photos of an experiment performed on pigskin from a butcher shop. Wynne and his colleagues burned sections of the pigskin to a crisp with a blowtorch, and then they used the two lasers to remove the blackened surface of epidermal tissue and reveal the non-charred layers underneath. According to Wynne, the animal studies cannot be done at IBM, so he’s working out a partnership with one of the trauma surgeons at Brigham and Women’s Hospital in Boston (Mass., U.S.A.). They’re still seeking funding and equipment.
Wynne hopes that this technique – if it turns out to work on living patients, which is still not a given – could improve treatment of wounded soldiers in the field. The mobile medical unit could take off the necrotic outer layers of tissue before infections and fungi take hold, and then the patients could be airlifted to a burn center for skin grafts and treatment of their other injuries.
Finally, Wynne pointed out with pride this article from Ocular Surgery News, which provides compelling evidence that the benefits from LASIK and photorefractive keratectomy (PRK) are not just cosmetic: for members of the U.S. armed forces, who can’t wear contact lenses on the battlefield, the procedures mean a chance at a career track closed to the nearsighted – and can be life-saving for soldiers captured or caught on the battlefield without their eyeglasses.
It was great to meet Jim Wynne in person and pick up on his enthusiasm for doing science and inspiring others to pursue science. Since 1990, Wynne has been IBM’s program manager for local education outreach, and for most of that period he’s been getting IBM employees and high school students to volunteer at family science programs aimed at third- through fifth-graders. We wish him all the best with these educational efforts and look forward to hearing more about the laser-debridement experiments in the future.
2010-04 April, Biomedical optics, Lasers, Ophthalmology