Value in microsurgery of the ultrapulse carbon dioxide laser for rapid skin deepithelialization

Abstract

Although laser technology continues to evolve, its role in microsurgery is limited to minor adjunctive applications including skin deepithelialization. In the past, continuous-wave carbon dioxide (CO(2)) lasers were the best for performing skin deepithelialization. The newer ultrapulse CO(2) lasers also show promise in this regard. They have become readily available and are very popular for aesthetic skin resurfacing. Their use for skin deepithelialization is an essential part of microsurgical procedures for free flap contouring, flap onlay at the recipient site, and revision of skin grafted free flap donor sites. Complications are essentially nonexistent and competency in using this modality is straightforward for any microsurgeon.

Treatment of Vitiligo with Suction Epidermal Grafting by the Use of an Ultrapulse CO2 Laser with a Computerized Pattern Generator

“…Recently it has been widely used for the deepithelialization of various flaps in plastic reconstruction. 8,[15][16][17][18] Although epidermal grafting after pulsed Er:YAG laser ablation has been reported recently, 12-14 CO 2 laser has advantages over pulsed Er:YAG laser including the fact that hemostasis is achieved, and the first pass causes an epidermal/dermal split that allows easy and complete removal of the epidermis with a single pass. 19 The Ultrapulse CO 2 laser was developed to operate with a CPG.…”

Treatment of Vitiligo with Suction Epidermal Grafting by the Use of an Ultrapulse CO2Laser with a Computerized Pattern Generator

“…It has proved successful in eliminating wrinkles, improving facial discolorations, smoothing scars, and rejuvenating sun‐damaged skin. Recently it has been widely used for the deepithelialization of various flaps in plastic reconstruction 8,15–18 . Although epidermal grafting after pulsed Er:YAG laser ablation has been reported recently, 12–14 CO 2 laser has advantages over pulsed Er:YAG laser including the fact that hemostasis is achieved, and the first pass causes an epidermal/dermal split that allows easy and complete removal of the epidermis with a single pass 19…”