COMPARISON OF CO2-LASER, ELECTROCAUTERY, AND SCALPEL INCISIONS ON ACUTE-PHASE REACTANTS IN RAT SKIN

Lasers and electrocautery devices have been applied as an alternative to the scalpel because of better hemostasis and lymphatic sealing. How ever, previous studies have demonstrated conflicting data regarding th e effects of these modalities on the inflammatory response, the first reaction by tissue during wound healing. The purpose of this study is to quantitate inflammatory responses in rat skin following laser, elec trocautery, and scalpel injury by measuring T-kininogen (T-KGN), a maj or acute-phase protein in the rat and its endogenous substrate, cathep sin B, an important inflammatory mediator. Full-thickness wounds (6 cm ) were created on the dorsum of Sprague Dawley rats by using a laser, electrocautery, or scalpel. Tissue samples were harvested at 1 hour to 21 days after injury. T-KGN levels were radioimmunoassayed; cathepsin B activity was assayed by using a synthetic substrate Z-Arg-Arg-MCA. Data were analyzed by analysis of variance. T-KGN levels peaked at 3 d ays for all modalities, although the laser group was statistically (P less than or equal to 0.01) higher at 1, 3, and 7 days after injury. I n contrast, cathepsin B activity was significantly (P less than or equ al to 0.01) lower at 3 days in the laser group. CO2 laser ablation inc ites a greater inflammatory response than electrocautery or scalpel in juries. High levels of T-KGN may provide protection from proteolytic d amage associated with cathepsins.