Romanos G, Ng K
Dental School (Carolinum), Department of Oral Surgery, University of Frankfurt, Germany.
Lasers Surg Med. 1999;24(5):368-74. doi: 10.1002/(sici)1096-9101(1999)24:5<368::aid-lsm7>3.0.co;2-6.
Prior studies of laser wound healing using different animal models have shown a delayed tissue response after carbon dioxide (CO2) laser application. This article reports on the preliminary findings of healing of superpulsed CO2 laser and scalpel incisions in the hard palate of monkeys.
STUDY DESIGN/MATERIALS AND METHODS: Twelve parallel incisions using a superpulsed, continuous wave CO2 laser and a scalpel were performed in the hard palate of each of two adult monkeys at 3, 7, and 14 days time schedules. Power levels of 2.0, 4.0, and 6.0 Watts were used for the laser incisions. Wounds were harvested, fixed in 10% formalsaline for at least 48 hours and processed routinely. Each specimen was embedded in paraffin wax at 90 degrees to the surface epithelium and 5 microm thick sections prepared for staining with haematoxylin and eosin, Periodic acid Schiff and Masson-trichrome at a step-serial interval of 100 microm. Sections were evaluated independently.
According to the clinical findings we showed a wound closure in all of the wounds (laser and scalpel incisions) at 3, 7, and 14 days of healing. Histologically, we showed that laser incisions at three and seven days demonstrated an increased, power setting-dependent tissue necrosis and marked inflammatory response with minimal organization compared to scalpel incisions. At 14 days both types of incisions exhibited complete wound healing of the epithelium and connective tissue.
According to these preliminary results, superpulsed CO2 laser tends to produce more pronounced changes (due to tissue thermal damage) with corresponding greater inflammatory reaction and delay in tissue organization only initially.
先前使用不同动物模型对激光伤口愈合的研究表明,应用二氧化碳(CO2)激光后组织反应延迟。本文报告了超脉冲CO2激光和手术刀在猴硬腭切口愈合的初步研究结果。
研究设计/材料与方法:对两只成年猴的硬腭分别在3天、7天和14天的时间点,使用超脉冲、连续波CO2激光和手术刀进行12个平行切口。激光切口使用2.0瓦、4.0瓦和6.0瓦的功率水平。收集伤口组织,用10%甲醛固定至少48小时并常规处理。每个标本以与表面上皮成90度角包埋在石蜡中,制备5微米厚的切片,用于苏木精和伊红染色、过碘酸希夫染色和Masson三色染色,切片间隔为100微米。切片由独立人员进行评估。
根据临床观察,我们发现所有伤口(激光和手术刀切口)在愈合3天、7天和14天时均实现了伤口闭合。组织学检查显示,与手术刀切口相比,激光切口在3天和7天时表现出组织坏死增加,且与功率设置有关,并有明显的炎症反应,组织形成极少。在14天时,两种类型的切口上皮和结缔组织均实现了完全愈合。
根据这些初步结果,超脉冲CO2激光最初往往会产生更明显的变化(由于组织热损伤),伴有相应更强的炎症反应和组织形成延迟。