Cutting and skin-ablative properties of pulsed mid-infrared laser surgery.
BACKGROUND
Pulsed mid-infrared lasers allow a precise removal of soft tissues with only minimal thermal damage.


OBJECTIVE
To study the potential dermatosurgical usefulness of currently available systems at different wavelengths (2010-nm Thulium:YAG laser, 2100-nm Holmium:YAG laser, 2790-nm Erbium:YSGG laser, and 2940-nm Erbium:YAG laser) in vivo on pig skin.


METHODS
Immediate effects and wound healing of superficial laser-abrasions and incisions were compared with those of identical control lesions produced by dermabrasion, scalpel incisions, or laser surgery performed by a 1060-nm Nd:YAG and a 1060-nm CO2 laser (continuous and superpulsed mode).


RESULTS
Best efficiency and least thermal injury was found for the pulsed Erbium:YAG laser, leading to ablative and incisional lesions comparable to those obtained by dermabrasion or superficial scalpel incisions, respectively.


CONCLUSIONS
In contrast to other mid-infrared lasers tested, the 2940-nm Erbium:YAG laser thus provides a potential instrument for future applications in skin surgery, especially when aiming at a careful ablative removal of delicate superficial lesions with maximum sparing of adjacent tissue structures. However, in the purely incisional application mode pulsed mid-infrared lasers, though of potential usefulness in microsurgical indications (eg, surgery of the cornea), do not offer a suggestive alternative to simple scalpel surgery of the skin.
Kaufmann
R
R
Department of Dermatology, University of Ulm, Germany.
Hartmann
A
A
Hibst
R
R
D000538:Aluminum Silicates; D000818:Animals; D002245:Carbon Dioxide; D003869:Dermabrasion / Q000295:instrumentation; D062109:Dermatologic Surgical Procedures; D004848:Epithelium / Q000473:pathology; D004871:Erbium; D004890:Erythema / Q000473:pathology; D006097:Granulation Tissue / Q000473:pathology; D006695:Holmium; D006358:Hot Temperature; D007249:Inflammation; D007259:Infrared Rays; D053685:Laser Therapy / Q000295:instrumentation / Q000379:methods*; D009354:Neodymium; D012867:Skin / Q000473:pathology; D013525:Surgical Instruments; D013552:Swine; D013932:Thulium; D014945:Wound Healing; D015019:Yttrium
D000538:Aluminum Silicates; D002245:Carbon Dioxide; D009354:Neodymium; D015019:Yttrium; D004871:Erbium; D013932:Thulium; D006695:Holmium