Intraoperative CO₂ (Carbon Dioxide)

Intraoperative Fractionated CO₂ Laser Treatment of Wound Edges During Mohs Micrographic Surgery

To evaluate whether intraoperative fractionated CO₂ laser treatment of surgical wound edges improves postoperative scar appearance compared with untreated wound edges following Mohs micrographic surgery (MMS).

This is a randomized, split-scar clinical study. After patients undergo the MMS surgery and before the wound is closed one half of the wound edge will be treated with a CO2 laser and the other half will be untreated. The side of the would receiving the laser treatment will be determined by random assignment. The study aims to evaluate if the wound edge that is laser treated will have an improved scar appearance compared to the non-laser treated wound edge.

Inclusion Criteria:

• Adults aged 18-89 years
• Diagnosis of cutaneous malignancy treated with MMS
• Surgical defect suitable for primary linear or flap closure with adequate length to permit split-scar design
• Ability to understand and provide informed consent

Exclusion Criteria:

• Pregnancy
• Inability to provide informed consent
• Non-English speaking patients
• History of abnormal wound healing (e.g., keloid disorder)
• Active infection at the surgical site
• Immunosuppression felt to significantly impair wound healing
• Use of isotretinoin within the past 6 months
• Prior radiation therapy to the surgical site
• Patients belonging to vulnerable populations including prisoners, children, or individuals unable to consent