Value in microsurgery of the ultrapulse carbon dioxide laser for rapid skin deepithelialization

Although laser technology continues to evolve, its role in microsurgery is limited to minor adjunctive applications including skin deepithelialization. In the past, continuous-wave carbon dioxide (CO(2)) lasers were the best for performing skin deepithelialization. The newer ultrapulse CO(2) lasers also show promise in this regard. They have become readily available and are very popular for aesthetic skin resurfacing. Their use for skin deepithelialization is an essential part of microsurgical procedures for free flap contouring, flap onlay at the recipient site, and revision of skin grafted free flap donor sites. Complications are essentially nonexistent and competency in using this modality is straightforward for any microsurgeon.