The morphological consequences of thermosurgery.

Immediately after electric coagulation or laser surgery, black-brown carbonizations were observed on the surface of different human tissue biopsies and in the experimental studies of rat organs. In specimens of liver, urinary bladder, and prostate coagulation necrosis developed, followed by a cell-rich granulation tissue with giant cells of the foreign body type. More than 3 months after the thermoinjury the granulomas could still be demonstrated in the tissue. After 6-8 weeks postoperatively (p.o.) a fibrous scar tissue began to develop. The number of lymphocytes in the central T-dependent peripheral lymphatic sheaths (PALS) of the spleen and their labeling index decreased within the first 2 days after thermoinjury followed by a slight hyperplasia after day 5. This initial T-cell alteration may reflect the clinico-serologic finding which shows that after skin burn a temporary reduction of the cell-mediated immune defense mechanism of the organism is observed. Compared with wound healing after scalpel or cryosurgical injuries, the delayed wound healing after thermosurgery may be caused by the alteration of the lymphoid system due to a disturbed co-operation of T- and B-lymphocytes with macrophages.