Lippert B M, Teymoortash A, Folz B J, Werner J A
Department of Otolaryngology, Head and Neck Surgery, Philipps University, Deutschhausstr. 3, 35037 Marburg, Germany.
Lasers Med Sci. 2003;18(1):36-42. doi: 10.1007/s10103-002-0244-4.
The wound healing after laser surgery is delayed in contrast to conventional scalpel surgery. There are some animal studies, which investigated the effects of laser surgery upon wound healing, whereas clinical investigations on wound healing of human mucous membrane after laser surgery is missing. A histological study on the laryngeal mucosa of 11 patients after laser incisions who underwent emergent laser debulking surgery for acute airway obstruction and a clinical study of 24 patients with oral or oropharynx cancer who were treated by laser surgery were performed to investigate the course of wound healing. The histological findings showed that the beginning of wound healing was delayed after laser surgery. The duration of wound healing after laser surgical tumour resection revealed a clear dependence on the size of the initial defect. The average duration of wound healing after CO(2) laser surgery (32.8 +/- 9.2 days) was significantly shorter than after Nd:YAG laser surgery (40.4 +/- 9.2). Due to the more pronounced zone of necrosis at the base of the wound ground this effect is more evident using the Nd:YAG laser. However, the different course of wound healing with both laser systems does not seem to have a negative influence on functional results.
与传统手术刀手术相比，激光手术后的伤口愈合会延迟。有一些动物研究调查了激光手术对伤口愈合的影响，然而缺少对人类黏膜激光手术后伤口愈合的临床研究。对11例因急性气道阻塞接受紧急激光减容手术的患者进行激光切口后的喉黏膜组织学研究，并对24例接受激光手术治疗的口腔或口咽癌患者进行临床研究，以调查伤口愈合过程。组织学研究结果显示，激光手术后伤口愈合开始延迟。激光手术切除肿瘤后伤口愈合的持续时间明显取决于初始缺损的大小。二氧化碳激光手术后伤口愈合的平均持续时间（32.8±9.2天）明显短于钕：钇铝石榴石激光手术（40.4±9.2天）。由于伤口底部坏死区域更明显，使用钕：钇铝石榴石激光时这种效果更明显。然而，两种激光系统不同的伤口愈合过程似乎对功能结果没有负面影响。
