Whipple T L, Caspari R B, Meyers J F
Lasers Surg Med. 1984;3(4):291-5. doi: 10.1002/lsm.1900030405.
Most surgical applications of CO2 laser energy permit carbonized and devitalized tissue to slough and become exteriorized through some natural orifice. The use of laser energy in joints with no external communication, however, must rely on synovial response to clear the carbon ash residue. Sixteen New Zealand white rabbits underwent arthrotomy and subtotal laser meniscectomy with no effort to cleanse the carbon residue. The animals were sacrificed at regular intervals up to 8 weeks, and the menisci and synovium were harvested for microscopic inspection. The initial synovial response was characterized by hypertrophic changes with a moderate increase in cell population and subsynovial interstitial fluid. Particulate matter was invested by the synovium, and provoked an influx of acute inflammatory cells. By 6 weeks, only rare particles of carbonaceous material were found in the synovium and no particulate matter could be located by 8 weeks. Laser induced carbon ash residue appears relatively innocuous to the joint in vivo and is readily cleared by an adequate and short-lived synovial response.
二氧化碳激光能量的大多数外科应用允许碳化和失活的组织脱落，并通过一些自然孔道排出体外。然而，在没有外部连通的关节中使用激光能量时，必须依靠滑膜反应来清除碳灰残渣。16只新西兰白兔接受了关节切开术和部分激光半月板切除术，未对碳残渣进行清理。在长达8周的时间内定期处死动物，并采集半月板和滑膜进行显微镜检查。最初的滑膜反应表现为肥大性改变，细胞数量和滑膜下间质液适度增加。滑膜包裹颗粒物质，并引发急性炎症细胞的流入。到6周时，滑膜中仅发现罕见的碳质物质颗粒，到8周时则找不到颗粒物质。激光诱导的碳灰残渣在体内对关节似乎相对无害，并且可以通过充分且短暂的滑膜反应轻易清除。
