CO<sub>2</sub> Laser Blepharoplasty: A Comparison to Cold Steel and Electrocautery

David, Laurence M.; Sanders, George B.

doi:10.1111/j.1524-4725.1987.tb00507.x

Cited by 80 publications

(9 citation statements)

References 4 publications

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“…The longer operating times and intraoperative hemorrhage lead to bruising, swelling, and tissue distortion. 16 Although some authors report that the CO 2 laser offers little advantage over the scalpel, 17 a recent survey comparison of scalpel versus CO 2 laser blepharoplasty indicated laser benefits, including quicker recovery time to usual activities (6.3 vs. 9.1 days) and shorter operating times (four eyelid blepharoplasty times of 58 vs. 94 minutes). 18 In another study, Biesman et al performed upper blepharoplasty on 35 patients using laser on one side and traditional instruments on the other.…”

Section: Co 2 Laser To Other Incisional Methodsmentioning

confidence: 99%

Incisional Laser Surgery

Prevel¹,

Biesman²

2001

Perspectives in Plastic Surgery

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Soft tissue laser incisional surgery is a relatively recent discipline within the field of surgical instrumentation. Although lasers were first used to create soft tissue incisions in humans some 40 years ago, the greatest advances in the development of a practical instrument have been made in the last decade. The goal of the ideal Incisional device is to minimize local tissue trauma and promote rapid and uneventful wound healing while simultaneously providing for superb hemostasis in the surgical field. Currently, no laser meets these lofty goals, but recent developments have brought us closer to an efficacious surgical instrument. This article explores the use of lasers in soft tissue Incisional surgery from an historical perspective and discusses current applications and limitations of available technology. A discussion of developing technologies is also provided.The ideal device for surgical incision and dissection would provide superb intraoperative hemostasis, cause minimal tissue trauma, and produce a wound with tensile strength and a final appearance equal to or better than wounds produced with standard instrumentation. To date, such a device has not been identified. As a result, interest has turned to both the CO 2 and the erbium-YAG (Er:YAG) lasers as a means of achieving this elusive goal.

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Section: Co 2 Laser To Other Incisional Methodsmentioning

confidence: 99%

Incisional Laser Surgery

Prevel¹,

Biesman²

2001

Perspectives in Plastic Surgery

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“…Laurence et al 17 conducted an RCT to compare the efficacy of CO 2 laser blepharoplasty with that of cold steel and electrocautery. Thirteen cases were included, and the results showed less bleeding on the laser side and a good correlation between decreased operative time and decreased bleeding when compared with the cold steel surgery side.…”

Section: Part I Systematic Reviewmentioning

confidence: 99%

“…We observed that in later operations, surgeons could incise with electrocautery quicker than during prior operations and sometimes quicker than when using the scalpel. In a systematic review, the authors found five previous studies [17][18][19][20][21] on Colorado needle electrocautery for upper eyelid skin incision; however, among these articles, they did not have an RCT study to compare Colorado needle electrocautery and a scalpel in upper blepharoplasty incision with respect to bleeding during skin incision and scarring using standard evaluation. Moreover, there were no previous studies on Asian people with poor scar outcomes compared with White people.…”

Section: Prs Global Open • 2023mentioning

confidence: 99%

Comparison of Colorado Needle Electrocautery and Traditional Scalpel for Upper Eyelid Blepharoplasty Incision: A Randomized Controlled Trial and Systematic Review

Pruksapong,

Jankajorn,

Burusapat

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Background: Upper eyelid blepharoplasty is a popular aesthetic surgery. Electrocautery provides a hemostatic benefit for skin incision; however, its effect on scar cosmesis remains unclear, especially in Asian skin types. We aimed to compare the Colorado needle electrocautery pure cutting mode and the traditional scalpel to determine their efficacy, complications, and cosmetic outcomes. Methods: A systematic review was performed to review the outcome with the conventional method (scalpel) and other methods in upper blepharoplasty procedures. Further, a prospective intraindividual randomized controlled trial was conducted to compare the efficacy of Colorado needle electrocautery and the scalpel in upper blepharoplasty. Study outcomes included scar quality at different times until 1-year postoperation, bleeding during incision, and postoperative ecchymosis. Results: Five articles met the inclusion criteria for this systematic review. The prospective randomized controlled trial study included 30 patients; the average incisional time on the electrocautery side was significantly longer than that on the scalpel side, and the electrocautery side had less blood loss during incision than the scalpel side (2.4 versus 3.27 using average cotton bud sticks, respectively) (P < 0.001). Hypopigmented scarring occurred more frequently on the scalpel side; however, the difference was not statistically significant. Conclusions: Colorado needle electrocautery pure cutting mode can be an alternative to traditional scalpel for upper eyelid blepharoplasty skin incision because of long-term scar quality. Electrocautery use has hemostatic benefits, leading to a decrease in bleeding that can obscure the incision site. However, the incision time on the electrocautery side was significantly longer than the scalpel side, which may be owing to an adaptation of surgical technique.

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“…1,2 Studies have evaluated the various modalities of removing excess eyelid skin based on time to perform the surgical procedure, amount of intraoperative bleeding, scar cosmesis, postoperative healing outcomes, and cost. [3][4][5][6][7][8][9] Historically, electrocautery has been avoided in aesthetic blepharoplasty because of concerns for surrounding tissue injury leading to increased scarring, damage to surrounding skin appendages, immediate postoperative ecchymosis, tissue edema, and possible nidus for infection. 3,8,10 The newer Colorado needle tip (Stryker, Inc., Kalamazoo, MI) allows for a more precise delivery of energy as compared to the broader electrodes used in traditional electrocautery.…”

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confidence: 99%

Histologic Comparison of Upper Blepharoplasty Skin Excision Using Scalpel Incision Versus Microdissection Electrocautery Needle Tip Versus Continuous Wave CO2 Laser

Carqueville

Chesnut²

2021

Dermatol Surg

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BACKGROUND The various techniques of upper blepharoplasty have been compared based on surgical time to perform the procedure, postoperative healing, scar cosmesis, and cost. Few studies have evaluated the histology of the excised tissue, and no study has compared the tissue histology of 3 blepharoplasty methods using scalpel, microdissection needle with electrocautery, and CO2 laser excision in the same patient. OBJECTIVE To evaluate the histologic changes of tissue after removal of upper eyelid skin using scalpel incision, microdissection electrocautery needle, and CO2 laser. METHODS Upper blepharoplasty skin excisions were examined from specimens obtained using scalpel incision, microdissection needle tip with electrocautery, and CO2 continuous wave beam. The specimens were sent for permanent sections for histologic evaluation. RESULTS The skin that was removed using cold steel scalpel incision showed no cellular necrosis or heat artifact. The tissue treated with the CO2 laser demonstrated significant thermal injury, including loss of cellular polarity, keratinocyte necrosis, and separation of the epidermis from the basement membrane. The skin excised using the electrocautery microdissection needle demonstrated fulguration artifact, including spindling of the epidermal nuclei with palisading of the keratinocytes. Necrosis was not prominent in the electrocautery microdissection needle specimens. CONCLUSION The amount of histologic tissue injury was greatest in the skin treated with continuous wave CO2 laser, followed by the microdissection needle with electrocautery. The cold steel scalpel incision showed no cellular necrosis.

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CO₂ Laser Blepharoplasty: A Comparison to Cold Steel and Electrocautery

Cited by 80 publications

References 4 publications

Incisional Laser Surgery

Incisional Laser Surgery

Comparison of Colorado Needle Electrocautery and Traditional Scalpel for Upper Eyelid Blepharoplasty Incision: A Randomized Controlled Trial and Systematic Review

Histologic Comparison of Upper Blepharoplasty Skin Excision Using Scalpel Incision Versus Microdissection Electrocautery Needle Tip Versus Continuous Wave CO2 Laser

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CO2 Laser Blepharoplasty: A Comparison to Cold Steel and Electrocautery

Cited by 80 publications

References 4 publications

Incisional Laser Surgery

Incisional Laser Surgery

Comparison of Colorado Needle Electrocautery and Traditional Scalpel for Upper Eyelid Blepharoplasty Incision: A Randomized Controlled Trial and Systematic Review

Histologic Comparison of Upper Blepharoplasty Skin Excision Using Scalpel Incision Versus Microdissection Electrocautery Needle Tip Versus Continuous Wave CO2 Laser

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CO₂ Laser Blepharoplasty: A Comparison to Cold Steel and Electrocautery