Deepithelialization Prior to Onlay Grafting Using the UltraPulse Carbon Dioxide Laser

Abstract

When used in a defoeused mode, the UltraPulse carbon dioxide laser causes skin vaporization at a subepidermal level with minimal surrounding thermal destruction, allowing early reepithelialization from retained skin appendages. This attribute is of paramount importance if only skin resurfacing is desired. However, because the effect essentially is total removal of the epidermis, such a sequela can also be used advantageously to prepare a vascularized dermal bed prior to onlay of composite grafts or secondary overgrafting. This skin deepithelialization can be achieved in a bloodless field, permitting constant visualization of the depth of penetration, and an integrated computerized pattern generator scanner allows rapid, precise, and consistent desurfacing to the desired level. This preliminary investigation demonstrates that successful overgrafting is possible on a viable dermal plane exposed by the UltraPulse carbon dioxide laser, as another example of its role in skin deepithelialization.