title: Nonsurgical delay of dorsal rat cutaneous flap using a long-pulsed 1064-nm Nd:YAG laser with a contact cooling device.
abstract: BACKGROUND
  This study evaluated the efficiency of a long-pulsed neodymium:yttrium-aluminum-garnet laser, operating at 1064 nm and equipped with a contact cooling device, in the delay of a caudally based dorsal rat skin flap (10 x 3 cm). This laser has deeper tissue penetration and has not been used for this purpose before.
  
  
  METHODS
  Twelve male Sprague-Dawley rats were used in each of six groups. The delay effects of three different laser treatment patterns (only longitudinal borders, cephalic and longitudinal borders, and entire surface of the 10 x 3-cm flap) were compared with an acute untreated control flap as well as two surgical delay methods (incision of longitudinal borders and incision of longitudinal borders plus flap undermining). The laser effects on the cutaneous vasculature and perfusion were assessed by intravenous fluorescein injection, histologic study, microangiography, and in vivo real-time video monitoring.
  
  
  RESULTS
  Selective thermocoagulation of subdermal vessels was achieved using a 6-mm spot, 140-J/cm fluence, and 40-msec pulse width. In the cephalic and longitudinal borders laser-treated group, a delay effect was achieved. The maximum delay effect was achieved by the surgical delay group that used the method of incision of the longitudinal borders plus flap undermining. Laser treatment of only the longitudinal borders did not improve flap survival, whereas treatment of the entire flap surface significantly reduced flap survival.
  
  
  CONCLUSIONS
  Nonsurgical delay of a dorsal rat cutaneous flap is possible by selective occlusion of the subdermal plexus at the longitudinal and cephalic borders of the planned flap using a long-pulsed 1064-nm neodymium:yttrium-aluminum-garnet laser equipped with a contact cooling device.
authors.affiliation: Department of Plastic Surgery, Clinical Center for Cosmetic Laser Surgery, Dallas, Texas, USA. cengizacikel@superonline.com
authors.forename: Cengiz
authors.initials: C
authors.lastname: Acikel
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Kenkel
authors.forename: Serdar
authors.initials: S
authors.lastname: Ozturk
authors.forename: Kimihiro
authors.initials: K
authors.lastname: Nojima
authors.forename: John E
authors.initials: JE
authors.lastname: Hoopman
authors.forename: S Tunc
authors.initials: ST
authors.lastname: Gokaslan
authors.forename: Spencer A
authors.initials: SA
authors.lastname: Brown
mesh_terms: D000818:Animals; D006085:Graft Survival; D017075:Laser Coagulation; D008297:Male; D008833:Microcirculation; D051381:Rats; D017207:Rats, Sprague-Dawley; D013524:Surgical Flaps / Q000098:blood supply; D013997:Time Factors