Use of surgical lasers in veterinary dermatology has increased. Carbon dioxide (CO2<\/sub>) laser is ideal for either ablation or excision of lesions caused by a variety of conditions. Achieving optimal results requires knowing how to manipulate the settings. Although CO2<\/sub> lasers may at first seem intimidating, they are very user friendly.<\/p>\n Take-Home Points<\/strong><\/p>\n <\/div><\/div><\/p>\n The term \u201claser\u201d originated as an anacronym for light amplification by stimulated emission of radiation<\/i>. In veterinary medicine, lasers are typically classified as therapeutic<\/a> or surgical. Therapeutic lasers consist of cold or red lasers used for wound healing and anti-inflammatory effects. Surgical lasers used in veterinary medicine are diode lasers and carbon dioxide (CO2<\/sub>) lasers. Diode lasers have a solid crystal as the lasing medium and deliver infrared light at significantly lower wavelengths than the CO2<\/sub> laser, for which gas is the lasing medium.1<\/sup> Some clinicians have replaced the scalpel blade with the surgical laser for many applications. Benefits of using surgical lasers rather than scalpel blades include the ability to seal blood vessels, nerve endings, and lymphatics; to sterilize the tissue; and to make precise incisions.2<\/sup> <\/span><\/p>\n Diode lasers have a crystal that is placed in contact with the skin to incise through the tissue. Unlike CO2<\/sub> lasers, diode lasers work in a liquid interface, which enables their use in saline, blood, or urine. Diode lasers are flexible and can be passed through channels and ports, making them easily used in conjunction with endoscopy equipment. The major downside of diode lasers is that they produce about 10 to 20 times more collateral tissue damage at the incision than CO2<\/sub> lasers, thereby increasing the risk for wound dehiscence.1<\/sup> Thus, use of diode lasers in veterinary dermatology is limited.<\/span><\/p>\n The infrared light from the CO2<\/sub> laser is absorbed by water in the skin and, when used optimally, vaporizes the intended tissue only. A variety of tips can be used with the CO2<\/sub> laser (<\/span>FIGURE 1<\/b><\/span>). The smaller tips (e.g., 0.25 mm) are ideal for incising into skin; the larger tips (e.g., 0.8 to 1.4 mm) are ideal for dissecting or ablating the tissue. Clinicians should be familiar with how to use adjustable settings such as power (in watts) and mode (i.e., single pulse, repeat pulse, continuous wave, superpulse) (<\/span>FIGURE 2<\/b><\/span>). The surrounding peripheral tissue damage is significantly less with the use of a CO2<\/sub> laser than a diode laser. For these reasons, the CO2<\/sub> laser is the preferred surgical laser for veterinary dermatology. This article focuses on the use of the CO2<\/sub> laser.<\/span><\/p>\n\n
Types of Surgical Laser Used in Veterinary Medicine<\/h2>\n
Diode Lasers<\/h3>\n
CO2<\/sub> Lasers<\/h3>\n
![\"\"](\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2024\/08\/Pieper_TVPSepOct24_DermLaserTherapy_Fig1.png\")
FIGURE 1. The varying sizes of removable tips used with a CO2 laser.<\/span><\/a><\/div><\/div>![\"\"](\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2024\/08\/Pieper_TVPSepOct24_DermLaserTherapy_Fig2A.png\")
FIGURE 2. CO2 laser modes. (A) Single-pulse mode delivers a single pulse as shown by the individual peak.<\/span><\/a><\/div><\/div>
![\"\"](\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2024\/08\/Pieper_TVPSepOct24_DermLaserTherapy_Fig2B.png\")
![\"\"](\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2024\/08\/Pieper_TVPSepOct24_DermLaserTherapy_Fig2C.png\")
![\"\"](\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2024\/08\/Pieper_TVPSepOct24_DermLaserTherapy_Fig2D.png\")