title: Reduction in lateral thermal damage using heat-conducting templates: a comparison of continuous wave and pulsed CO2 lasers.
abstract: OBJECTIVE
  The advantages of the continuous wave (c.w.) CO(2) laser are offset by the delay in laser wound healing secondary to thermal damage. We have developed novel heat-conducting templates to reduce laser thermal damage. Because shortened pulse durations also decrease thermal damage, we tested the effectiveness of heat-conducting templates with a c.w. CO(2) clinical laser and a short-pulsed CO(2) laser to determine the best method and mechanism to minimize thermal damage.
  
  
  METHODS
  Comparison of 0.2-second shuttered c.w. and 5-microsecond pulsed CO(2) lasers were made by doing incisions on 150 tissue samples from reduction mammoplasties and abdominoplasties. Copper, aluminum, glass, and Plexiglass heat-conducting templates were tested against no template (air) with both lasers. Histological samples were evaluated using computerized morphometrics analysis.
  
  
  RESULTS
  Statistically significant reductions in lateral thermal damage were seen with the copper (50%) and aluminum (39%) templates used with the c.w. CO(2) laser. Only the copper template (39%) significantly reduced thermal damage when used with the pulsed CO(2) laser. Less thermal damage was seen using the pulsed CO(2) laser compared to the c.w. CO(2) laser with each template.
  
  
  CONCLUSIONS
  Heat-conducting templates significantly reduced the amount of lateral thermal damage when used with the c.w. CO(2) laser (copper and aluminum) and short-pulsed CO(2) laser (copper). The c.w. CO(2) laser with the copper template compared favorably to the short-pulsed CO(2) laser without a template. Therefore, both heat conductive templates and short-pulse structure provide successful methods for reducing lateral thermal damage, and a combination of the two appears to provide optimal results.
authors.affiliation: Department of Medicine, Division of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee 37232-5227, USA.
authors.forename: Nicole
authors.initials: N
authors.lastname: Spector
authors.forename: Jared
authors.initials: J
authors.lastname: Spector
authors.forename: Darrel L
authors.initials: DL
authors.lastname: Ellis
authors.forename: Lou
authors.initials: L
authors.lastname: Reinisch
mesh_terms: D000535:Aluminum; D002056:Burns / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D002245:Carbon Dioxide; D003300:Copper; D003627:Data Interpretation, Statistical; D006358:Hot Temperature / Q000009:adverse effects*; D006801:Humans; D066298:In Vitro Techniques; D053685:Laser Therapy / Q000009:adverse effects / Q000379:methods*; D012867:Skin / Q000293:injuries* / Q000528:radiation effects*; D012881:Skin Temperature / Q000528:radiation effects; D014945:Wound Healing / Q000502:physiology
chemical_list: D002245:Carbon Dioxide; D003300:Copper; D000535:Aluminum