Controlling thermal damage of incisions using diamond, copper, and sapphire heat-conducting templates with and without cooling.

Introduction: We investigated the reduction of thermal damage to the surrounding tissue when laser incisions were made with and without using thermal conducting templates at room temperature and cooled to 5 degrees C.

Study Design/materials And Methods: We used the Vanderbilt free-electron laser (FEL) at 5.4, 6.1, 6.45, and 7.7 microns. We also used a conventional continuous wave (CW) carbon dioxide laser at 10.6 microns. Incisions were made on 5x10 mm pieces of human breast skin (in vitro) and analyzed with histology. Computer morphometrics were used to measure the amount of thermal damage.

Results: All templates produced a statistically significant reduction in the thermal damage. Additionally, we showed that cooling the templates made a statistically significant greater reduction in the thermal damage. The cooled diamond template reduced the thermal damage from the FEL to 28% of the damage observed without a template. The same cooled template reduced the thermal damage from the CO(2) laser to 56% of the damage observed without a template. Lesser reductions were observed with the copper template and even less with the sapphire template. The sapphire template reduced the thermal damage to 39 and 67% of the damage observed without a template for the FEL and the CO(2) laser, respectively.

Conclusion: These results indicate that unwanted lateral thermal damage from laser incisions can be reduced with cooled thermally conductive templates with the best results obtained with the diamond template, which is also the best thermal conductor.