The evaluation of rhytidectomy flap healing after CO2 laser resurfacing in a pig model.

[OBJECTIVE] This study was conducted to determine when it becomes safe to perform laser resurfacing after rhytidectomy flap elevation.

[STUDY DESIGN] Eighty-four sites on 12 domestic Yorkshire pigs were selected; 4 x 10-cm skin flaps were elevated in 72 of the 84 sites and shortened 10%. The 12 remaining sites (controls) were treated with laser resurfacing alone. Laser resurfacing was also performed at days 0, 7, 14, 21, and 28 after closing the skin flaps. The healing time for the laser-resurfaced sites without flap elevation were compared to that of the skin flaps treated with the laser at days 0, 7, 14, 21, and 28. Twelve "skin flap" controls were elevated, shortened 10%, and closed without laser treatment. Resurfacing was performed using 2 passes with the Sharplan Silk Touch CO(2) laser.

[RESULTS] The average healing time for the skin flaps treated with the laser at day 0 was 23.9 days. All of these flaps showed skin slough with delayed healing followed by scar formation. The areas treated with the laser alone (controls), and the subsequent skin flaps treated with the laser postoperatively at days 7, 14, 21, and 28 days completely re-epithelialized in an average of 7.8, 8.1, 7.3, 7.4, and 7.3 days, respectively. There were no statistically significant differences in healing time between the controls and flaps treated with the laser on or after 7 days (P > 0.05). However, there were statistically significant differences in healing time between the laser-treated skin flaps at day 0 and the controls, between the laser-treated flaps on day 0 and day 7, and between the laser-treated flaps on day 0 and day 14 (P < 0.001). Because there was little difference in healing time after 14 days, only the healing times for laser-treated skin flaps up to 14 days were compared using paired t tests.

[CONCLUSIONS] From our observations using a pig model, we conclude that skin flaps may be safely laser resurfaced about 1 week postoperatively. On the other hand, simultaneous flap elevation and laser resurfacing results in delayed healing with subsequent scar formation.