CO2 laser produces infrared light absorbed by intra- and extracellular water molecules. Radiowave radiosurgical (RWRS) instruments use electron waves to cause ionic agitation in cells at the tip of the electrode, where it contacts tissue. Both vaporize intracellular water to cut and coagulate tissue. The thermal energy produced also dissipates into surrounding tissues as heat, potentially delaying healing and increasing risk for dehiscence.

A study was conducted to evaluate first-intention healing of CO2 laser (4.0-MHz RWRS) and scalpel incisions in ball pythons. Wound healing in reptiles is slower than in mammals or birds and is affected by wound orientation, nutrition, health and immune status, and provision of species-specific environmental conditions. A skin biopsy sample was collected and 2-cm skin incisions (4 per modality) were made in each of 6 snakes, then closed with surgical staples. One skin biopsy sample per incision type per snake was obtained on days 2, 7, 14, and 30. Samples were assessed and scored for total inflammation, histologic response, and other variables. Based on histologic response scores, use of a scalpel was preferable, followed by RWRS, then laser. Greater wound edge separation was noted for laser incisions than for RWRS and scalpel incisions. Less necrotic tissue was noted in incisions made with a scalpel compared with CO2 laser and RWRS incisions. Results suggested no substantial benefit to using CO2 laser and RWRS over using a scalpel when making incisions.

Comparison of first-intention healing of carbon dioxide laser, 4.0-MHz radiosurgery, and scalpel incisions in ball pythons (Python regius). Hodshon RT, Sura PA, Schumacher JP, et al. AM J VET RES 74:499-508, 2013.