R. James Rockwell

Carbon dioxide laser excision of acute burns with immediate autografting

Abstract 1. 1. A series of 13 patients underwent 15 operations for primary burn excision with the CO2 laser. No mortality was experienced. 2. 2. Burn wounds excised with a knife lost on an average 3.8 cc of blood for every 1 cc lost with a laser. 3. 3. The laser required 1.6 min of operating time for every 1 min required to excise a similar area of eschar with a cold knife. 4. 4. Skin grafts take and survive as well on laser excised sites as on cold knife prepared sites. 5. 5. Early results from excision with the laser are most encouraging and efforts with this modality of treatment are being expanded.

Laser wound healing compared with other surgical modalities

Abstract In this study the measured rate of healing of identical excisional wounds produced by the carbon dioxide laser and three other surgical modalities, viz.: conventional scalpel blade, electrosurgical (Bovie) unit, and plasma torch are compared. Differences in the gross and microscopic findings are discussed and partially explained. These studies would indicate that portable and easily controllable lasers have the potentiality of becoming a new type of practical surgical-knife and haemostatic instrument.

The laser in pediatric surgery

Abstract The clinical uses of the laser in children are discussed with particular reference to the angiomas. The possible future uses and hazards encountered are described. The need for extensive research in the use of the laser has been stressed. The laser remains a tool for research and, as yet, not for general use as a form of therapy. Its role, if any, in the field of surgery remains to be determined.

Designs and functions of laser systems for biomedical applications.

INTRODUCTION Since the first published reports in 1963 describing the early medical laser investigations, there has been considerable interest about the use of the laser in many clinical and research applications. As with chemical and electrical energy which are now used in chemotherapy and electrosurgery, laser energy is recognized as having considerable potential as a tool in medicine and biology. The question of its true value depends on the critical evaluation of further studies. The early investigations were not without some disappointments. The first laser systems were cumbersome units, usually with poor performance characteristics. Consequently, output levels were not only incorrectly chosen, but also the lasers were usually used under less than ideal conditions (often with only some a priori knowledge of the actual levels of laser energy delivered). These circumstances provided a poor introduction to medical researchers of the true capabilities of laser energy while at the same time filling the literature with erroneous data about its biological effects. At this time, however, reliable lasers are available which offer a wide range of operational characteristics.l As shown in TABLES 1 and 2, both pulsed and continuous wave (CW) lasers are now available which produce a wide range of frequencies and power levels. An important aspect of medical laser research today is the correct selection of the laser that will provide the output parameters most ideally suited to the type of reaction desired. For example, the reaction of laser energy in tissues varies widely with the wavelength and exposure time, as well as the beam intensity. Thus, it is necessary that all laser parameters be specified and their reactions known, when considering system designs for a particular biomedical application. In the past several years, lasers have made the transition from laboratory curiosities to clinical and research instruments.2 This discussion will outline the important criteria necessary in the system designs and the operational parameters of the lasers used for some of the biomedical applications now under study.