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Histologic analysis of the thermal effect on epidermal and dermal structures following treatment with the superpulsed CO 2 laser and the Erbium:YAG laser: An in vivo study
Author(s) -
Utley David S.,
Koch R. James,
Egbert Barbara M.
Publication year - 1999
Publication title -
lasers in surgery and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 112
eISSN - 1096-9101
pISSN - 0196-8092
DOI - 10.1002/(sici)1096-9101(1999)24:2<93::aid-lsm4>3.0.co;2-x
Subject(s) - er:yag laser , rhytidectomy , erbium , dermis , laser , medicine , in vivo , epidermis (zoology) , necrosis , hyperplasia , surgery , pathology , anatomy , optics , physics , microbiology and biotechnology , biology
Background and Objective To compare the in vivo histologic effects of the carbon dioxide (CO 2 ) and erbium:yttrium aluminum garnet (Er:YAG) lasers. To ascertain the effects of combining CO 2 and Er:YAG laser modalities during a single treatment session. Study Design/Materials and Methods Ten patients underwent laser treatment to four left preauricular sites 7 days prior to rhytidectomy as follows: CO 2 alone, CO 2 /Er:YAG, Er:YAG alone, and Er:YAG/CO 2 . The right preauricular area was identically treated 1 hour prior to rhytidectomy. Laser treated skin was excised during rhytidectomy and was evaluated histopathologically in a blinded manner. Results After 7 days, all groups were reepithelialized and showed equal neo‐collagen formation. After 7 days, CO 2 /Er:YAG and Er:YAG alone had the least collagen injury and thickest epidermis and papillary dermis of all groups. Specimens lased 1 hour prior to excision showed the least collagen injury and thermal necrosis when treated with CO 2 /Er:YAG and Er:YAG alone. Four passes with CO 2 removed 250 μm of tissue, while eight passes with the Er:YAG removed 160 μm of tissue. Conclusions Limiting CO 2 laser passes and ending with Er:YAG produces less collagen injury, less thermal necrosis, and more robust epithelial and dermal fibrous tissue regeneration. CO 2 followed by Er:YAG has similar thermal necrosis and collagen injury as Er:YAG alone, presumably due to Er:YAG removal of CO 2 induced thermal injury. Lasers Surg. Med. 24:93–102, 1999. © 1999 Wiley‐Liss, Inc.