The use of the carbon dioxide laser permits primary closure of contaminated and purulent lesions and wounds.

Excision of contaminated and purulent wounds with the carbon dioxide laser makes it safe to close the wounds primarily when certain steps are observed during the operation. The contaminated surface is sterilized with the defocused beam. The surgeons' and assistants' hands should not touch the contaminated areas, and both should wear two pairs of rubber gloves to protect against accidental contamination. All infected tissue is excised completely, and the wound cleansed by copious irrigation and the defocused laser. The wound may then be safely closed by simple sutures, skin graft, or by the rotation of a vascularized musculocutaneous flap. A series of cases are presented in order to illustrate these points.