The Dysplastic Nevus, the True Myth

Abstract

Background: Several factors influence the development of the surgical wound healing process. Conventional incisions with a scalpel are always associated with greater haemorrhaging, resulting in increased surgical time and inflammatory reaction, in contrast to CO2-laser incisions. Objective: The study aimed to evaluate the influence of CO2-laser and scalpel skin incisions on the surgical wound healing process Animals: We used a sample of 70 dogs (N = 70) of both genders submitted to elective spay surgeries. Methods: The sample was divided in two groups according to the surgical method performed: group S (scalpel) and group L (CO2 laser). Assessment was made over three time points: T0 (before surgery), T1 (48 hours after surgery) and T2 (8 days after surgery). Blood samples were collected to quantify the variations in white blood cells (WBC), plasmatic protein total (PPT) and serum albumin (ALB). To rate a patient's pain level, we used the Melbourne Pain Scale (MPS). We followed up with the patients to evaluate the wound for closure time, dehiscence and scar appearance. Results: Skin incisions made with the CO2 laser are associated with lower WBC counts and minor tissue trauma because the endothelial wall does not incur as much injury as with scalpel incisions, thus decreasing the PPT and ALB extravasation levels and promoting the healing process. At T1, the individuals in group L had lower pain levels and consequently exhibited greater post-operative patient comfort. The cosmetic results were different between the methods, with 100% of the group L patients showing very good scar appearances eight days after surgery. Conclusion: These findings show that the method selected to perform skin incisions influences the healing process of the affected tissues.

Comparison of the Hemodynamic Response in General Anesthesia between Patients Submitted to Skin Incision with Scalpel and CO2 Laser Using Dogs as an Animal Model. A Preliminary Study Miguel Carreira L 1, 2, 3, *, Ramalho R3 , Nielsen

“…In contrast, the CO2 laser by sealing blood vessels, lymphatics, and nerve endings, reduces to a minimum the local inflammatory response, which is related to lower levels of glucocorticoids, epinephrine and norepinephrine, and therefore to lower pain level. [5,8,9,21,22,27] Considering that skin is one of the tissues where the nociceptive system is most figurative, it is to be expected that the CO2 laser's ability to reduce stimulation of the skin nociceptive system may also be associated with a lower autonomic nervous system stimulation of the remaining tissues and organs to be operated upon, resulting therefore in discrete hemodynamic variations as registered in our study.…”

Evaluation of the Relationship of Serum Lactate Concentration and Blood pH on Surgical Wound Healing in Cats Submitted to Total Mastectomy as an Animal Model

“…[5] Generally, four overlapping phases are considered, as follows: 1) the haemostasis and coagulation phase; 2) the inflammatory phase; the 3) proliferative phase; and 4) the remodelling and maturation phase. [6][7][8][9][10][11][12][13][14] Recognition of these phases, based on macroscopic characteristics, allows the clinician to make an association between the microscopic and biochemical events, thereby directing procedures to the appropriate management of the lesion. [5][6][7][8] Several local and systemic (endogenous or exogenous) factors can lead to impaired healing processes.…”

“…[6][7][8][9][10][11][12][13][14] Recognition of these phases, based on macroscopic characteristics, allows the clinician to make an association between the microscopic and biochemical events, thereby directing procedures to the appropriate management of the lesion. [5][6][7][8] Several local and systemic (endogenous or exogenous) factors can lead to impaired healing processes. [3,7,[13][14][15][16] Oxygen (O 2 ) and lactate are essential elements in all stages in the development of the tissues healing.…”

“…[5][6][7][8] Several local and systemic (endogenous or exogenous) factors can lead to impaired healing processes. [3,7,[13][14][15][16] Oxygen (O 2 ) and lactate are essential elements in all stages in the development of the tissues healing. [13,15] In combination with growth factors, lactate stimulates fibroblast proliferation and angiogenesis.…”