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Original Investigation
June 22, 2017

Association of Electrochemical Therapy With Optical, Mechanical, and Acoustic Impedance Properties of Porcine Skin

Author Affiliations
  • 1Beckman Laser Institute and Medical Clinic, University of California, Irvine
  • 2Department of Biomedical Engineering, University of California, Irvine
  • 3Department of Otolaryngology–Head and Neck Surgery, School of Medicine, University of California, Irvine
JAMA Facial Plast Surg. Published online June 22, 2017. doi:10.1001/jamafacial.2017.0341
Key Points

Questions  What are the effects of electrochemical therapy, and how is skin changed?

Findings  In the 24 ex vivo porcine skin samples studied, tissue softening was observed at the anode and cathode electrode sites as a result of electrochemical modification. Volumetric changes were noted using each optical technique, and acoustic impedance properties additionally verified this observation.

Meaning  Electrochemical therapy appears to be a paradigm-shifting, easily deployable technique that can have a large effect on scar treatments and other cosmetic applications.

Abstract

Importance  The classic management of burn scars and other injuries to the skin has largely relied on soft-tissue transfer to resurface damaged tissue with local tissue transfer or skin graft placement. In situ generation of electrochemical reactions using needle electrodes and an application of current may be a new approach to treat scars and skin.

Objective  To examine the changes in optical, mechanical, and acoustic impedance properties in porcine skin after electrochemical therapy.

Design, Setting, and Participants  This preclinical pilot study, performed from August 1, 2015, to November 1, 2016, investigated the effects of localized pH-driven electrochemical therapy of ex vivo porcine skin using 24 skin samples. Platinum-plated needle electrodes were inserted into fresh porcine skin samples. A DC power supply provided a voltage of 4 to 5 V with a 3-minute application time. Specimens were analyzed using optical coherence tomography, optical coherence elastography, and ultrasonography. Ultrasonography was performed under 3 conditions (n = 2 per condition), optical coherence tomography was performed under 2 conditions (n = 2 per condition), and optical coherence elastography was performed under 2 conditions (n = 2 per condition). The remaining samples were used for the positive and negative control groups (n = 10).

Exposures  Platinum-plated needle electrodes were inserted into fresh porcine skin samples. A DC power supply provided a voltage of 4 to 5 V with a 3-minute application.

Main Outcomes and Measures  Tissue softening was observed at the anode and cathode sites as a result of electrochemical modification. Volumetric changes were noted using each optical and acoustic technique.

Results  A total of 24 ex vivo porcine skin samples were used for this pilot study. Optical coherence tomography measured spatial distribution of superficial tissue changes around each electrode site. At 4 V for 3 minutes, a total volumetric effect of 0.47 mm3 was found at the anode site and 0.51 mm3 at the cathode site. For 5 V for 3 minutes, a total volumetric effect of 0.85 mm3 was found at the anode site and 1.05 mm3 at the cathode site.

Conclusions and Relevance  Electrochemical therapy is a low-cost technique that is on par with the costs of suture and scalpel. The use of electrochemical therapy to create mechanical and physiologic changes in tissue has the potential to locally remodel the soft-tissue matrix, which ultimately may lead to an inexpensive scar treatment or skin rejuvenation therapy.

Level of Evidence  NA.

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