Reid R, Elfont E A, Zirkin R M, Fuller T A
Am J Obstet Gynecol. 1985 Jun 1;152(3):261-71. doi: 10.1016/s0002-9378(85)80206-4.
The rationale for using the carbon dioxide laser to treat either vulvar intraepithelial neoplasia or extensive papillomaviral infections is to destroy the entire area of abnormal epithelium to a shallow depth, so that rapid healing will occur from normal keratinocytes in the underlying pilosebaceous glands. After the first laser impact, anatomic landmarks in the crater base are disguised by a layer of charred proteins, and any structure that is visible will already have suffered thermal necrosis. Accurate control of depth depends upon special surgical strategies that correlate the level of the underlying zone of thermal necrosis with specific visual appearances within the zone of vaporization. Maneuvers that limit depth of penetration to one of three desirable surgical planes (basement membrane, papillary dermis, midreticular dermis) are described.
使用二氧化碳激光治疗外阴上皮内瘤变或广泛的乳头瘤病毒感染的基本原理是将异常上皮的整个区域浅深度破坏，以便位于下方的皮脂腺中的正常角质形成细胞能快速愈合。首次激光照射后，火山口底部的解剖标志被一层烧焦的蛋白质掩盖，任何可见的结构都已遭受热坏死。深度的精确控制取决于特殊的手术策略，即将热坏死下方区域的水平与汽化区内的特定视觉表现相关联。文中描述了将穿透深度限制在三个理想手术平面（基底膜、乳头真皮、网状真皮中层）之一的操作方法。
