Optimizing free electron laser incisions at 6.45 microm with computer-assisted surgical techniques and the utilization of a heat-conducting template.

BACKGROUND AND OBJECTIVE

We sought to optimize laser incisions by evaluating the effects of varying the slit width of a heat-conducting template and the step size with the Computer-Assisted Surgical Techniques (CAST) system on free electron laser (FEL) incisions at 6.45 microm.

STUDY DESIGN/MATERIALS AND METHODS: Stainless steel calipers were used as a heat-conducting template on human skin in vitro. The CAST system made the incisions as a series of spot ablations with set step sizes of 50 microm or 1,250 microm. At each step size, incisions were made with or without the calipers, by using varying slit widths. Histologic specimens were analyzed for lateral thermal damage over the entire depth of the incision and over the superficial 150 microm of dermis.

RESULTS

Lateral thermal damage over the superficial 150 microm of dermis was most significantly reduced with the calipers at a slit width approximating the FEL's beam diameter (636 microm +/- 100 microm). Also, incisions made with the larger step size (1,250 microm) had significantly less lateral thermal damage over the entire depth of the incision.

CONCLUSIONS

The use of a heat-conducting template with an aperture approximating the FEL's beam diameter and larger step size improved FEL incisions at 6.45 microm.