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Diamond laser scalpel vs. steel scalpel: a side by side comparison of cutaneous wound healing
Douglas M Keel1, Mitchel P Goldman, Richard E Fitzpatrick
1Department of Dermatology, Naval Medical Center San Diego, San Diego, CA, USA.
Background And Objectives:
To compare the cutaneous wound healing using the diamond laser scalpel with wound healing using a steel scalpel and electrocoagulation for hemostasis.
Study Design/Materials And Methods:
A prospective and randomized, comparative trial was conducted on eighteen patients. Fusiform excisions were performed using the diamond laser scalpel on one half of each excision and a steel scalpel with electrocoagulation for hemostasis on the other half. The Clinicon SureBlade diamond laser scalpel was used with the Luxar CO(2) attachment at the 6-8-W settings. Blinded assessment of adverse events and photographs were taken at 1 day, 7-10 days, 4 weeks, and 8-12 weeks. The final scar was evaluated at 8-12 weeks for cosmetic outcome and three physicians blinded to the method of excision evaluated photographs of the wounds. Histologic evaluation was performed on all excisions for collateral thermal damage.
Results:
Investigator assessment showed no statistically significant differences between the diamond laser scalpel side and the steel scalpel side with respect to bleeding, bruising, swelling, pain, dehiscence, or final scar appearance. The mean residual thermal damage was 350.3 microm (95% CI +/- 37 microm, P < 0.001). The diamond laser scalpel scored higher on intra-operative coagulation (P = 0.20) although these differences were not statistically significant.
Conclusions:
The cosmetic outcomes of cutaneous excisions performed with the diamond laser scalpel are equivalent to excisions performed with steel scalpels with electrocoagulation for hemostasis.
