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Healing after carbon dioxide laser incisions has been assessed in three animal experiments. Nine incisions in pig skin were found to be significantly weaker after 7 days than similar incisions made with a scalpel, but stronger than those made with a cutting diathermy. Laser excision of skin discs in pigs provided a satisfactory base to take split-skin grafts, but graft take around the edges was less complete than after scalpel excisions. Division and anasto mosis of the colon of 75 rats showed that the laser produced anastomoses that were as strong after 7 days as those produced by scalpel or diathermy division, but the laser did not produce the narrowing of the lumen that occurred with diathermy. It is concluded that if epithelial surfaces are particularly thick and slow to cut with the laser than thermal damage will impair healing, but that in general epithelial surfaces need not be avoided in laser surgery.

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A prospective randomized trial was conducted on 301 adult males undergoing inguinal herniorrhaphy to assess the value of postoperative suction drainage. Hernias were classified into 'complicated' and 'simple'. In the 'complicated' group suction drainage for 24 h significantly reduced the incidence of wound haematoma, seroma or infection from 48.7 per cent to 17.6 per cent (P < 0.01); there was also a noticeable effect on the postoperative morbidity in the 'simple' hernias, although this just failed to achieve significance (4.5 per cent in the suction group compared with 9.8 per cent in the controls). It is concluded that suction drainage should be employed postoperatively following repair of hernias where dissection may be difficult or where other complicating factors are present.

No abstract