TY - JOUR
T1 - Middermal Wound Healing
T2 - A Comparison Between Dermatomal Excision and Pulsed Carbon Dioxide Laser Ablation
AU - Green, Howard A.
AU - Burd, Elizabeth
AU - Nishioka, Norman S.
AU - Brüggemann, Ulrich
AU - Compton, Carolyn C.
PY - 1992/5
Y1 - 1992/5
N2 - Background.— Continuous-wave carbon dioxide lasers are not widely used for the surgical removal of most skin lesions because it is difficult to control laser ablation and the extensive laser-induced thermal damage slows healing. Pulsed lasers provide means to reduce thermal damage produced during laser ablation and permit precise control of tissue removed during ablation. Using a swine model, we compared on a gross and microscopic level the healing of middermal wounds of similar depth and area created by a dermatome and a focused pulsed CO2 laser. Results.— Pulsed CO2 laser ablation removed skin precisely and bloodlessly with 85 ±15 μm (mean ±SD)of residual thermal damage covering the surface of the wound. Compared with the dermatome, tissue reepithelialization was delayed in the laser wounds at day 3. By day 7, epithelial coverage of the laser-created wounds was not significantly different from the dermatome-created wounds. No significant difference in the appearance of the two wounds was noted at 42 days. Conclusions.— We conclude that the focused pulsed CO2 laser is capable of precisely and bloodlessly ablating skin with conservation of residual subjacent adnexal elements, minimal early interference with epibolic epithelial outgrowth, and no pathologic effects on the wound healing process. Pulsed CO2 lasers may be a valuable instrument for the conservative ablation of skin and skin lesions.
AB - Background.— Continuous-wave carbon dioxide lasers are not widely used for the surgical removal of most skin lesions because it is difficult to control laser ablation and the extensive laser-induced thermal damage slows healing. Pulsed lasers provide means to reduce thermal damage produced during laser ablation and permit precise control of tissue removed during ablation. Using a swine model, we compared on a gross and microscopic level the healing of middermal wounds of similar depth and area created by a dermatome and a focused pulsed CO2 laser. Results.— Pulsed CO2 laser ablation removed skin precisely and bloodlessly with 85 ±15 μm (mean ±SD)of residual thermal damage covering the surface of the wound. Compared with the dermatome, tissue reepithelialization was delayed in the laser wounds at day 3. By day 7, epithelial coverage of the laser-created wounds was not significantly different from the dermatome-created wounds. No significant difference in the appearance of the two wounds was noted at 42 days. Conclusions.— We conclude that the focused pulsed CO2 laser is capable of precisely and bloodlessly ablating skin with conservation of residual subjacent adnexal elements, minimal early interference with epibolic epithelial outgrowth, and no pathologic effects on the wound healing process. Pulsed CO2 lasers may be a valuable instrument for the conservative ablation of skin and skin lesions.
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U2 - 10.1001/archderm.1992.01680150069008
DO - 10.1001/archderm.1992.01680150069008
M3 - Article
C2 - 1575527
AN - SCOPUS:0026647780
SN - 0003-987X
VL - 128
SP - 639
EP - 645
JO - Archives of Dermatology
JF - Archives of Dermatology
IS - 5
ER -