Fire hazards and CO2 laser resurfacing

The purpose of this study was to investigate the fire risk of laser resurfacing in the presence of supplemental oxygen. This study aims at defining safety parameters of variables such as laser energy level, oxygen flow rate, and "oxygen to laser target distance" when oxygen is delivered through a nasal cannula or nasopharyngeal tube. The typical operating room environment was simulated in the laboratory using the Yucatan minipig animal model. The energy source was a Coherent Ultrapulse CO2 laser. It was found that combustion did not occur at laser settings of 500 mJ, 50 W, 100 kHz, and a density of 5, used in conjunction with an oxygen flow rate of 6 liter/minute with the target area as close as 0.5 cm to the oxygen delivery. A total of 400 computer pattern generator treatments were delivered using this energy setting without observation of any combustion (p < 0.001). This provides evidence that while using even somewhat high laser settings and oxygen flow rate, laser induced fires can be avoided. We conclude that use of the laser in the presence of oxygen is safe, provided the target area is free of combustible fuels. Despite this assurance, laser mishaps are serious because they lead to both morbidity and mortality. It is our recommendation that close attention be constantly paid to all details, thus reducing the hazard potential of laser energy on local factors in an oxygen-rich environment.