[The use of the carbon dioxide laser in acute surgical infection of the soft tissues]

Abstract

Clinico-laboratory studies were conducted in 46 patients with wound infection for the treatment of which carbon-dioxide laser was used, and in 78 patients who were operated on with a metal scalpel (control). It is shown that "excision" and "evaporation" of tissues took 15-45 minutes. Repeated interventions were performed in 15% of cases due to bleeding from vessels measuring 1.0-1.5 mm in diameter. After surgical debridement with a scalpel the number of microbes reduced from 10(7)-10(9) to 10(3)-10(4) per g. After exposure to the laser beam this value was 10(1) but on day 3-4 it was 10(5)-10(6). The extent of the zone of coagulation necrosis in the zone exposed to the laser beams measured up to 500 microns, and began diminishing only on day 7-9 of postoperation. Suppuration of the wounds in 56% of patients of the main group treated by operation was in conformity with the results of bacteriological and morphological studies. In the control group this index was 15.4%. It is concluded that the use of carbon-dioxide laser as a "light scalpel" with subsequent primary closure of the wound is inexpedient. Its use in preparing a wound for closure with secondary sutures has no advantages over radical surgical debridement.