Comparison of the Effects of the CO₂ Surgical Laser and Conventional Surgical Techniques on Healing and Wound Tensile Strength of Skin Flaps in the Dog

Abstract

Skin flaps used to repair large skin defects in dogs can be created and elevated with a CO(2) laser. In areas of increased skin mobility or tension, skin flaps created with CO(2) laser may be more susceptible to complications such as dehiscence, and care should be taken to minimize these complications.

Comparison of lateral thermal injury and healing of porcine skin incisions performed by CO2‐laser, monopolar electrosurgery and radiosurgery: a preliminary study based on histological and immunohistochemical results

“…Re‐epithelialization during wound healing has been found to be faster in steel scalpel incisions when compared with MES and CO 2 ‐laser incisions, 3,35,36 whereas several other studies have not proved statistically significant differences regarding the progress of re‐epithelialization among these instruments 12,33 . Furthermore, despite the relatively slow epithelial cell proliferation observed during early stages of wound healing in MES and CO 2 ‐laser incisions, the overall time elapsed until complete re‐epithelialization does not seem to differ significantly between the above and steel scalpel incisions 6,23,37 …”

“…The literature abounds in clinical and experimental studies comparing the effects of various surgical and/or ablative instruments on different tissue types with those of steel scalpel. A multitude of studies compare MES with steel scalpels, 9 different laser types between them, 7,10–13 with steel scalpel 6,14–17 or MES 18,19 . Moreover, numerous studies compare MES and CO 2 ‐laser with steel scalpel and/or other ablative tools 2,20–23 .…”

“…Heat diffusion at the operative site also causes denaturation of intracellular proteins, evident as coagulative necrosis within a variable distance from the incision, described as “lateral thermal injury” (LTI). This has been associated with intraoperative (discomfort or pain) and/or postoperative (disturbed function of adjoining vital structures such as maxillary/mandibular bone or dental pulp, delayed and/or impaired wound healing, conspicuous scarring) morbidity and has substantially limited the use of these instruments for biopsy harvesting of skin or oral mucosa lesions 4–8 …”

“…This has been 979 associated with intraoperative (discomfort or pain) and/or postoperative (disturbed function of adjoining vital structures such as maxillary/mandibular bone or dental pulp, delayed and/or impaired wound healing, conspicuous scarring) morbidity and has substantially limited the use of these instruments for biopsy harvesting of skin or oral mucosa lesions. [4][5][6][7][8] This preliminary study aims to quantitate and compare the LTI produced during skin incisions performed by CO2-laser, MES (producing electrosurgical current of 1 MHz), and MRS (producing electrosurgical current of 3.8 MHz), used at settings and configurations similar to those applied in clinical practice. Furthermore, the effects of LTI on the initial stages of wound healing (re-epithelialization and inflammatory process) were evaluated histologically and immunohistochemically for each experimental group and compared with those activated after skin incision by steel scalpel (control group).…”

Electromagnetic Energy Sources in Surgery

“…CO 2 laser is not used in endoscopy because the beam is guided through hollow ceramic tubes instead of flexible optic fibers 65,71,72 . CO 2 lasers are used for open, laparoscopic and arthroscopic procedures in human general surgery, dermatology, gynecology, ENT (ear, nose, throat), thoracic, oncology, and arthroscopic soft tissue surgeries 45,68,73 . In canine and feline patients, CO 2 laser applies to elective procedures 65 (Table 4).…”