Answer:
There is a recent article from Jan 1999 in Surgery, in which the authors report the results of an initial clinical trial on the use of laser ablation of burn eschar. They report that scanning, high-powered carbon dioxide laser ablation of eschar may facilitate blood conservation in patients with burns. They treated 21 children with full thickness burns who required serial excision with ablation of the full thickness wound with a rapid scan continuous wave carbon dioxide laser system. A control wound was sharply excised and both wounds were immediately autografted. Endpoints were engraftment at 7 days and Vancouver scar scores. The initial engraftment averages 94.6% for both control and study sites, and there was no significant difference in Vancouver scar scores. There was no bleeding from 19 successfully ablated wounds. This pilot study follows a successful trial of this concept in a porcine model, and demonstrates the technical feasibility of laser vaporization of burn eschar in humans with immediate autografting.