[Is the CO2 laser surgery advantageous? A morphological and experimental study (author's transl)].

The great advantages of CO2 laser surgery are the contact-less cutting and the haemostatic effect. An obliteration of blood- and lymph-vessels thus preventing tumour-cell mobilisation and metastatic spread is considered as most advantageous for tumour surgery. Basing on own morphological and experimental investigations, some of these advantages are critically discussed. The morphology of human skin incisions made by a CO2 laser is described, using light microscopy, and the wound healing process of laser incisions in the dorsal skin of rats is compared with incisions made by thermocautery and conventional scalpel. After contamination of laser and scalpel incisions with india-ink, the migration of these particles to the regional lymph-nodes was also investigated. Compared to the scalpel-incisions, the laser- and even more the thermocauter-incisions showed the well known delay in healing, due to the extensive tissue necrosis at the wound margins. This coagulation necrosis, however, was not obliterate the lymphatic drainage. It is concluded from these experiments that the use of the CO2 laser will not guarantee the prevention of metastatic spread and should mainly be recommended where the haemostatic effect is essential.