Effects of scalpel, electrocautery, and CO2 and KTP lasers on wound healing in rat tongues.
OBJECTIVE
Evaluate wound healing of incisions created by the scalpel, electrocautery, CO2 laser, and potassium titanyl phosphate (KTP) laser in the upper aerodigestive tract in an animal model.


METHODS
Prospective randomized study in an animal model.


METHODS
Postoperative oral intake, histologic depth of injury, and tensile mechanical strength were measured in rat tongues after creating incisions using a scalpel, electrocautery, CO2 laser, and KTP laser. An unpaired, two-tailed Student's t-test was used to compare results between the experimental groups.


RESULTS
Oral intake, indirectly assessed by postoperative weight loss, by the third postoperative day was significantly decreased in the electrocautery (P = 0.004), CO2 laser (P = 0.001), and KTP laser (P = 0.0001) groups as compared with the scalpel group. The depth of the wound healing, as assessed by histologic examination, was successively greater for the scalpel (75 +/- 13 microm), electrocautery (110 +/- 10 microm), CO2 laser (145 +/- 10 microm), and KTP laser (195 +/- 23 microm) groups. However, this difference was only statistically significant for the CO2 laser (P = 0.006) and KTP laser (P = 0.01) groups relative to the scalpel group. Wounds created by the KTP laser had the lowest strength (76.5 +/- 6.9 kPa) as compared with the CO2 laser (156 +/- 28.4 kPa), electrocautery (153 +/- 15.7 kPa), and scalpel groups (249 +/- 61.8 kPa). This difference was only statistically significant for the KTP laser group (P = 0.02) when compared with the scalpel group.


CONCLUSIONS
Wounds created in the upper aerodigestive tract of rats by scalpels result in the least postoperative weight loss, tissue destruction, and decrease in tensile strength, whereas wounds created by the KTP laser demonstrated a significantly greater postoperative weight loss, depth of wounding, and decrease in tensile strength.
Carew
J F
JF
Department of Otolaryngology-Head and Neck Surgery, Manhattan Eye, Ear and Throat Hospital, New York, New York 10021, USA.
Ward
R F
RF
LaBruna
A
A
Torzilli
P A
PA
Schley
W S
WS
D000818:Animals; D002245:Carbon Dioxide; D004564:Electrocoagulation; D053685:Laser Therapy / Q000295:instrumentation; D011183:Postoperative Complications; D011188:Potassium; D051381:Rats; D017208:Rats, Wistar; D013525:Surgical Instruments; D013718:Tensile Strength; D014059:Tongue / Q000601:surgery*; D015431:Weight Loss; D014945:Wound Healing / Q000502:physiology
D002245:Carbon Dioxide; D011188:Potassium