Plantar warts – CO2 Laser and Surgical Excision

Plantar warts – CO2 Laser and Surgical Excision
Once you’ve attempted conservative management of any condition, there comes a time when your attempts are not managing the condition and surgery comes into view. Depending on the condition, this moment can come sooner than others. For warts, once you’ve given home remedies and topical medications a try, likely a three-month battle at a minimum, surgery becomes the next step. In the offices/surgery centers that have access to a CO2 laser, this can be used in conjunction with surgical treatment.

CO2 Laser

CO2 Laser

What is the CO2 Laser
This laser is used in dermatology to ablate or surgically remove tissue. The CO¬2 laser emits an invisible beam of light at 10,600 nanometers. The light energy targets the water both inside and outside of the cell and when absorbed the skin is vaporized.

What You Should Know About Using The CO2 Laser
The goal of the combined laser and surgical treatment of warts is to rid the body of the wart tissue and return the skin to “normal skin lines.” Whether this is performed in an operating room, or a clinic treatment room it doesn’t necessarily matter, but since the process can be painful, many prefer to use light sedation, which is medicine administered through an IV by an anesthesiologist. Once the tissue is “vaporized” with the laser, the surgeon will use an instrument to remove the wart tissue. This process can be repeated until the wart like tissue is completely removed and normal skin lines are visible.

In order to ensure that all of the bad tissue is removed, the surgeon will need to remove 3mm of tissue beyond the visual border of the wart.

The surgeon will often send a sample of the removed tissue to the pathologies for further analysis to ensure that the tissue removed was indeed a wart.

Surgical Instruments

Surgical Instruments

Will this procedure cause scarring?
The short answer is, usually no. If the surgeon doesn’t penetrate the ‘basement membrane’ or lower level of the epidermis, scarring will not occur.

How long will it take to heal?
This approach involves burning the tissue and therefore a dressing involving silver sulfadiazine cream is used. Post-operative care includes covering the area with this cream, a non-stick dressing, and a sterile bandage to prevent infection as it heals. This dressing is changed daily and will take about one month to fully heal.

References:
1. Shankar DS, Chakravarthi M. Carbon Dioxide Laser Guidelines. Accessed 10/31/2016 at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2918344
2. http://www.podiatrytoday.com/key-insights-wart-treatment

Images:
1. http://www.jointlaser.com/ProductShow.asp?ID=197
2. http://www.progress.com.sg/product/curette/
3. http://www.podiatrytoday.com/key-insights-wart-treatment

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