Preoperative and Postoperative Considerations for Carbon Dioxide


In the past few years, there have been many reports demonstrating the effectiveness of carbon dioxide (C02) laser resurfacing of facial rhytides and acne scarring.!" The procedure has become a widely utilized technique, surpassing other currently available cosmetic treatments because of its increased availability and high degree of clinical effectiveness.'? The advantages of pulsed laser resurfacing are the precise control of tissue vaporization, minimization of residual thermal damage, and intraoperative hemostasis. The CO2 laser emits light at a wavelength of 10,600 nm. In this far infrared spectrum, most of the laser energy is absorbed by the superficial layers of skin (down to a depth of 30 urn)." The thermal relaxation time of skin to this level is 200 to 600 ~S.12 To minimize thermal damage, lasers have been developed with pulse durations shorter than 1 ms (1 ms = 1000 us). The amount of energy needed to vaporize this thickness of tissue has been determined to be approximately 5 J/cm• By rapidly heating the skin's intracellular water, tissue is vaporized. Current CO2 lasers vaporize tissue to a specific depth, with a single pass ablating 20 to 50 urn of skin. I)While different laser systems have been found to produce slightly varying degrees of residual thermal damage in the dermis, clinical effects have been similar. 14-16 In general, increasing the number of laser passes correlates with increased depth of tissue penetration. Most of the early complications of CO2 lasers were related to the inability of the systems to provide sufficiently high fluences to effect tissue vaporization. Instead, skin was charred, producing deeper tissue destruction than desired. The development of computerized scanning devices that deliver rapid, non-overlapping, uniform impacts has made the pulsed laser resurfacing procedure more efficient and effective. It is

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@inproceedings{ResurfacingPreoperativeAP, title={Preoperative and Postoperative Considerations for Carbon Dioxide}, author={Laser Resurfacing and Sharon Horton and Tina S. Alster} }