Optimizing free electron laser incisions at 6.45 microm with computer-assisted surgical techniques and the utilization of a heat-conducting template.
OBJECTIVE
We sought to optimize laser incisions by evaluating the effects of varying the slit width of a heat-conducting template and the step size with the Computer-Assisted Surgical Techniques (CAST) system on free electron laser (FEL) incisions at 6.45 microm.


METHODS
Stainless steel calipers were used as a heat-conducting template on human skin in vitro. The CAST system made the incisions as a series of spot ablations with set step sizes of 50 microm or 1,250 microm. At each step size, incisions were made with or without the calipers, by using varying slit widths. Histologic specimens were analyzed for lateral thermal damage over the entire depth of the incision and over the superficial 150 microm of dermis.


RESULTS
Lateral thermal damage over the superficial 150 microm of dermis was most significantly reduced with the calipers at a slit width approximating the FEL's beam diameter (636 microm +/- 100 microm). Also, incisions made with the larger step size (1,250 microm) had significantly less lateral thermal damage over the entire depth of the incision.


CONCLUSIONS
The use of a heat-conducting template with an aperture approximating the FEL's beam diameter and larger step size improved FEL incisions at 6.45 microm.
Department of Medicine (Division of Dermatology), Vanderbilt University and Nashville Veterans Affairs Medical Centers, Nashville, Tennessee 37232-5227, USA.
J B
JB
Robbins
L
L
Reinisch
D L
DL
Ellis
D046508:Culture Techniques; D062109:Dermatologic Surgical Procedures; D004583:Electrons; D006358:Hot Temperature / Q000009:adverse effects*; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D011829:Radiation Dosage; D012680:Sensitivity and Specificity; D012867:Skin / Q000473:pathology* / Q000528:radiation effects*; D012881:Skin Temperature / Q000528:radiation effects; D013813:Therapy, Computer-Assisted / Q000379:methods*