Conventional surgery has used the scalpel to cut or excise tissue during surgical procedures. The scalpel, however, has limitations as a surgical tool. When an area of tissue is excised haemorrhage may be difficult to control and a skin graft or flap may be needed to cover the defect or prevent scarring. Cutting or coagulating diathermy cause damage to the adjacent tissues. The physical effects of cold and lasers offer alternative methods of removing or devitalising tissue. They work in different ways and they will be considered in turn.
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