Laser resurfacing of skin flaps: an experimental comparison of three different lasers

Abstract

Objective. The influence of Coherent Ultrapulse, TruPulse and Erbium:YAG laser skin resurfacing on survival of the skin flaps whenperformed simultaneously was evaluated. Material and methods. Weused twelve female Yucatan minipigs in the study. Skin flaps includingpaniculus carnosus were raised on the animals’ back. The flaps weresutured into the defect under tension. We designed 4 experimentalgroups: Control-Flaps only, Group 2-Flaps + 4 immediate TruPulselaser passes, Group 3-Flaps + 2 immediate Coherent UltraPulse laserpasses, Group 4-Flaps – immediate 50J/cm2 total fluence with Erbium:YAG laser. Results. Flap survival in Control group was 98.8%. Therewas no flap in Group 2 with complete survival. Survival of the flaps inGroup 2 (Tru-Pulse) ranged from 75-90%, with average flap survivalarea of 85.2%. In Group 3 (UltraPulse) all 24 flaps had some area of necrosis.Flap survival in Group 3 ranged from 75-95%, with an averageof 85.6%. In Group 4 (Erbium: YAG) flap survival area ranged from70-95%, with all 24 flaps with some area of necrosis, with average flapsurvival area of 87.3%. There is a significant statistical difference inflap survival area between groups 2, 3 and 4 versus Control (p<0.001).Conclusion. The results of our study suggest that laser resurfacing ofskin flaps sutured under tension in the same operative session is detrimentalfor skin flap survival. We also found no significant differencein flap survival area between TruPulse, Coherent UltraPulse and Erbium:YAG laser treated flaps.