SURGICAL CLEANSING OF VARICOSE ULCERS OF THE LEG USING A CO2-LASER WITH ROTATING MIRROR SCANNER

Objective: Our purpose was to evaluate the effectiveness of cleansing by CO2 laser with a rotating mirror scanner in accelerating ulcer gran ulation and reducing sensitization, bleeding, and the need for painful medications. Summary Background Data: Cleansing, the first step in tr eating phlebostatic ulcers, may be performed with a defocussed CO2 las er, but laser-to-target distance, technique, and duration of the proce dure may vary. Methods: We studied 20 patients, ages 38-85, with ''com mon'' phlebostatic ulcers showing a tendency not to granulate. The pat ients were divided into two groups by sex (7 females and 3 males) and by size of ulcer. The first group was treated using the CO2 laser and rotating mirror scanner; the second was treated surgically with scisso rs and tweezers. In both groups debridement was followed by mobile and fixed elastocompressing bandage, mobilization, and phlebotonics. Six patients in the first group and four in the second subsequently underw ent short stripping to correct the incompetent saphenous circulation. Results: Ulcer cleansing was achieved in all 20 cases. In the laser gr oup, the treatment was well tolerated by 9 patients and granulation wa s achieved in 10 days on average; in the second group, cleansing was v ery painful in 5 cases and granulation was achieved in 25 days on aver age. Both groups had good cicatrization at 3 months after elastocompre ssion, zinc dioxide medication, mobilization, and phlebotonics. The 6- month follow-up revealed only one recurrence-a small ulcer at a differ ent location-in the first group and no cases of recurrence in the seco nd. Conclusions: Cleansing by CO2 laser and rotating mirror scanner al lows the acceleration of ulcer granulation and reduces sensitization, bleeding, and the need for painful and costly medications.