Investigating the Range of Surgical Effects on Soft Tissue Produced by a Carbon Dioxide Laser

Abstract

The authors investigated the surgical and collateral effects on soft tissue of a carbon dioxide laser emitting at 9.3 micrometers. Specifically, incision widths and depths as well as effectiveness were studied. Three different laser modes were investigated: gated continuous wave, or Cw, Superpulse and OptiPulse (Medical Optics). Incision depths correlated positively with average power; higher powers produced deeper incisions. The gated Cw mode quickly produced wide, deep incisions; Superpulse achieved narrower, deep incisions; OptiPulse caused very narrow, shallow incisions. Collateral damage to adjacent tissues was reduced by a factor of about 2 using Superpulse, and by a factor of 10 using OptiPulse. A wide range of effects is achieved in soft tissue, depending on the laser parameter combination used.

Does a Pulsed Mode Offer Advantages Over a Continuous Wave Mode for Excisional Biopsies Performed Using a Carbon Dioxide Laser?

“…23,24 When a CO 2 laser is used for soft tissue surgeries, the conversion of energy into heat produces a lateral thermal damage zone, where no evaluation of the cell morphology is possible because of the denatured tissue. 4,[16][17][18] The simulation of cytologic atypias in the deeper tissue layers also has been described. [25][26][27] The thermally denatured tissue also represents a barrier to healing of the wound site.…”

“…3,4,[12][13][14] The CO 2 laser can be used in different modes, ranging from continuous wave to pulsed modes in the range of microseconds emitted with a defined frequency. 15,16 Histopathologically, different thermal damage zones have been described with different laser modes. [16][17][18] It has been speculated that delayed wound healing may be due to the extent of the lateral thermal damage zone.…”

“…15,16 Histopathologically, different thermal damage zones have been described with different laser modes. [16][17][18] It has been speculated that delayed wound healing may be due to the extent of the lateral thermal damage zone. 12,17,19 In animal models, a shorter pulse duration has resulted in a less extensive damage zone and earlier wound healing.…”

Ablation of temporomandibular joint structures of a pig with a fibre-guided 308nm excimer laser light—an in vitro investigation

“…Laser transmitted through optical fibres needs only a very small space (200-600 mm) and can remove diseased tissue with great precision compared with conventional treatment. In the past, mainly CO 2 -, Ho:YAGand Nd:YAG lasers have been investigated for medical applications (Whipple et al, 1987;Romanos, 1994;Wilder-Smith et al, 1997;Sherk et al, 2002). However, thermal damage to the irradiated tissue and the surroundings remains a great concern (White et al, 1991, Absten, 2002.…”

CO2 Laser: Evidence Based Applications in Dentistry

“…Lasers parameters such as power, repetition rate, average power and highest peak power play a role in surgical and collateral effects. Studies have concluded that high repetition rate, high peak power and lower average power yield favourable clinical results (Wilder-Smith, Dang, & Kurosaki, 1997 Due to the lack of tactile sensation, their use in hard-tissue applications is not favorable.…”