Comparison of surgical lasers and conventional methods in skin incisions

Laser blepharoplasty: diamond laser scalpel compared to the free beam CO2 laser

BACKGROUND

Blepharoplasty has long been employed for functional and cosmetic purposes. Different modalities have been utilized to incise and remove excess eyelid tissue in an attempt to improve surgical technique.

OBJECTIVE

This study compares a free beam CO2 laser to a diamond surgical scalpel combined with a CO2 laser for performance of blepharoplasty.

METHODS

Ten patients underwent bilateral upper lid blepharoplasty. One side was randomly assigned to the free beam CO2 laser technique, while the other side was performed with the diamond laser scalpel. Intraoperative surgical times and hemostasis were measured. Masked observers assessed postoperative parameters at day 1, week 1, week 2, week 4, and month 4. These assessments were analyzed clinically and statistically.

RESULTS

The two modalities produced similar results for the intraoperative and postoperative parameters studied.

CONCLUSION

The diamond laser scalpel has the advantage of tactile feedback and the option of use without coagulation.

Clinical comparison between conventional suture and vaporization with carbon dioxide laser in rat's skin

OBJECTIVE

This study compares wound healing efficiency on a rat's skin when the incision was closed with a conventional suture versus vaporized with a CO2 laser.

MATERIALS AND METHODS

In this study, 24 rats were used, and two longitudinal incisions were made with a conventional scalpel in the dorsum of each rat. The left incision was sutured with nylon thread, and the right incision was closed by vaporization with a defocused CO2 laser in continuous mode with an 8-watt power density. Clinical photographs were taken immediately after the procedure, 24 h later, and after 3, 7, 14, and 21 days, documenting the healing of the incision.

RESULTS

The results showed that there was an initial delay in wound repair in the vaporized incision as compared to the scalpel incision, but after 21 days, both incisions showed the same clinical characteristics. However, the vaporized incision showed no trauma of the tissue, as opposed to the sutured incision, and no hemorrhagic complications.

CONCLUSION

These results suggest that the CO2 laser can eventually replace the use of sutures.

Selection of incisions for gynecologic procedures

Progress is being made in the employment of abdominal incisions. The use of mass closure has greatly decreased the incidence of disruption. The avoidance of subcutaneous sutures has likewise decreased the rate of wound infections, and modern aggressive management has lessened the time that patients must contend with incisional abscesses when they do occur. There will always be considerable discussion and debate on the choice of an abdominal incision. However, the primary consideration remains always to choose and construct a surgical incision large enough to operate through comfortably and effectively.