CUTTING AND SKIN-ABLATIVE PROPERTIES OF PULSED MIDINFRARED LASER-SURGERY

BACKGROUND. Pulsed mid-infrared lasers allow a precise removal of soft tissues with only minimal thermal damage. OBJECTIVE. To study the potential dermatosurgical usefulness of currently available systems at different wavelengths (2010-nm Thulium:YAG laser, 2100-nm Holmium:YAG laser, 2790-nm Erbium:YSGG laser, and 2940-nm Erbium: YAG laser) in vivo on pig skin. METHODS. Immediate effects and wound healing of superficial laser-abrasions and incisions were compared with those of identical control lesions produced by dermabrasion, scalpel incisions, or laser surgery performed by a 1060-nm Nd:YAG and a 1060-nm CO2 laser (continuous and super-pulsed mode). RESULTS. Best efficiency and least thermal injury was found for the pulsed Erbium: YAG laser, leading to ablative and incisional lesions comparable to those obtained by dermabrasion or superficial scalpel incisions, respectively. CONCLUSION. In contrast to other mid-infrared lasers tested, the 2940-nm Erbium: YAG laser thus provides a potential instrument for future applications in skin surgery, especially when aiming at a careful ablative removal of delicate superficial lesions with maximum sparing of adjacent tissue structures. However, in the purely incisional application mode pulsed mid-infrared lasers, though of potential usefulness in microsurgical indications (eg, surgery of the cornea), do not offer a suggestive alternative to simple scalpel surgery of the skin.