EFFECTS OF SCALPEL, ELECTROCAUTERY, AND CO2 AND KTP LASERS ON WOUND-HEALING IN RAT TONGUES

Objective: Evaluate wound healing of incisions created by the scalpel, electrocautery, CO2 laser, and potassium titanyl phosphate (KTP) lase r in the upper aerodigestive tract in an animal model. Study Design: P rospective randomized study in an animal model. Methods: Postoperative oral intake, histologic depth of injury, and tensile mechanical stren gth were measured in rat tongues after creating incisions using a scal pel, electrocautery, CO2 laser, and KTP laser. An unpaired, two-tailed Student's t-test was used to compare results between the experimental groups. Results: Oral intake, indirectly assessed by postoperative we ight loss, by the third postoperative day was significantly decreased in the electrocautery (P = 0.004), CO2 laser (P = 0.001), and KTP lase r (P = 0.0001) groups as compared with the scalpel group. The depth of the wound healing, as assessed by histologic examination, was success ively greater for the scalpel (75 +/- 13 mu m), electrocautery (110 +/ - 10 mu m), CO2 laser (145 +/- 10 mu m), and KTP laser (195 +/- 23 mu m) groups. However, this difference was only statistically significant for the CO2 laser (P = 0.006) and KTP laser (P = 0.01) groups relativ e to the scalpel group. Wounds created by the KTP laser had the lowest strength (76.5 +/- 6.9 kPa) as compared with the CO2 laser (156 +/- 2 8.4 kPa), electrocautery (153 +/- 15.7 kPa), and scalpel groups (249 /- 61.8 kPa). This difference was only statistically significant for t he KTP laser group (P = 0.02) when compared with the scalpel group. Co nclusions: Wounds created in the upper aerodigestive tract of rats by scalpels result in the least postoperative weight loss, tissue destruc tion, and decrease in tensile strength, whereas wounds created by the KTP laser demonstrated a significantly greater postoperative weight lo ss, depth of wounding, and decrease in tensile strength.