Clinical evaluation of the carbon dioxide laser for burn wound excisions: a comparison of the laser, scalpel, and electrocautery.

The use of a 100 watt carbon dioxide laser for surgical excisions of burn eschar was evaluated in 13 patients with symmetrical burns. In each patient, laser excision was compared with either scalpel or electrocautery excision of a comparable area. Graft "take," blood loss, and operative speed were measured. Graft "take" following laser excisions was comparable to that obtained when either scalpel or electrocautery was used. Regression analysis indicates that laser excisions involved 29% of the blood loss encountered with scalpel excisions and that laser speed was 1.49 times scalpel speed. Although laser blood loss was 60% of electrocautery blood loss, laser speed was significantly slower: 73% of electrocautery speed. These differences, however, were of small clinical consequence. It is felt that the surgical arm of this laser is at present quite awkward and is in need of technological refinement if the full potential of the laser is to be realized.