Great Ormond Street Hospital for Children NHS Foundation Trust: Information for Referrers
Carbon dioxide laser surgery
for skin lesions This leaflet explains how carbon dioxide (CO2) lasers can be used to treat skin lesions and what to expect when your child comes to Great Ormond Street Hospital for treatment.
What is a carbon dioxide What are the alternatives
(CO2) laser? to laser surgery? Lasers are used in various ways at Great Traditional surgery is usually the most Ormond Street Hospital including the suitable treatment where the birthmark treatment of birthmarks and other skin is excised. lesions. Carbon dioxide (CO2) lasers work by sending out a concentrated beam of light that can remove raised or scaly Pre-admission clinic areas of skin. This is an outpatient appointment where you will be able to discuss your childs planned operation, test or procedure with Why does my child the team before coming in to hospital for need laser surgery? your admission. Your child will also have When a birthmark or skin lesion is various tests and investigations carried causing problems, either physical or out during this appointment. This avoids psychological, it may be best to remove it any delays on the day of the operation, depending on the type of birthmark. CO2 test or procedure. We may also ask for laser surgery is sometimes suggested as photographs to be taken of your childs an alternative to traditional surgery as it skin lesion to record it before treatment, can remove the top layers of the lesion, so that the improvement afterwards can often with less scarring. be measured.
Depending on your childs age and the
type and location of the lesion, he or What happens she may have treatment under local anaesthetic (where just the area treated is before laser surgery? made numb) or general anaesthetic. The You will receive information on how to surgeon will discuss this with you before prepare your child for the operation in the procedure is scheduled. his or her admission letter. The surgeon will need to see you to explain the
Sheet 1 of 3 Ref: 2014F0689 GOSH NHS Foundation Trust August 2014
laser surgery in more detail, discuss any What happens afterwards? worries you may have and ask you to Once your child has recovered from the give permission for the surgery by signing general anaesthetic and is comfortable, a consent form. If your child has any you will be able to go home. Depending medical problems, such as allergies, please on how the lesion has been treated, the tell the surgeon. area may be covered with a dressing to protect it for the first few days. The ward nurses will advise you about the care What does needed. Sometimes we ask for help from laser surgery involve? your GP or district nurse. An appointment Once your child is under anaesthetic in our dressing clinic may be arranged for (either local or general), the area being after treatment. We will give you details treated is removed in layers using the before you go home. laser. At the end of treatment, the area will look like a graze, which will heal and hopefully leave few scars. When you get home You should give your child regular pain relief such as paracetamol according to Are there any the instructions on the bottle for the risks involved? first two or three days at home. The risks of laser surgery are the same as Your child may be given a course of with traditional surgery. The area of skin medicines, usually flucoxacillin and treated will feel sore afterwards and will acyclovir, to take for five days. The need careful looking after for the first entire course should be finished. few weeks. A regular dose of paracetamol Laser treatment removes the top layer according to the instructions on the bottle of skin leaving a wound similar to a is usually enough to take away the pain. graze or burn. The treated area will be Putting an ice pack wrapped in a clean pink and the new skin is very fragile. It tea towel over the treated area can also will remain like this for several months. help to ease the pain. As with any wound, The area may weep yellow fluid for the there is a small chance that it could get first few days. This is normal. infected, in which case antibiotics will be needed. The treatment can change the The treated area must be kept moist colour of the skin making it darker or with liquid paraffin to prevent it lighter. Sometimes, pre-treatment creams becoming crusty. It is difficult to keep are used to reduce this risk. a liquid paraffin dressing on the face or neck, so we suggest applying liquid paraffin emollient cream regularly. If a dressing is in place, it is usually a sandwich of paraffin gauze dressing, plain gauze dressing secured with a bandage.
Sheet 2 of 3 Ref: 2014F0689 GOSH NHS Foundation Trust August 2014
We will advise when your child can Notes have a shower or bath but the water temperature should not be too hot. Wash the skin including the treated area with a mild soap or aqueous cream and gently pat the area dry with a towel. Do not rub the skin as this will make it sore. When the treated area has stopped crusting, usually in a week or two, you can smooth on some bland moisturising cream such as E45 or Nivea. You should apply the cream three to four times a day. Avoid exposure to the sun as sun can darken the treated area. Always use a total sunblock of SPF 30 or higher whenever your child goes outside and avoid excess sun exposure.. Make up should be avoided on the treated area for one to two weeks. Your child should not go swimming for two to four weeks and avoid PE or games for one to two weeks.
You should call us if:
Your child is in a lot of pain and pain relief does not seem to help Your child has a temperature of 38C and paracetamol does not bring it If you have any questions, down please contact the clinical nurse The treated area of skin oozes a specialists for plastic surgery on great deal or starts to smell 020 7405 9200 ext 6945
Compiled by Plastic Surgery in collaboration with the Child and Family Information Group
Great Ormond Street Hospital for Children NHS Foundation Trust
Great Ormond Street London WC1N 3JH
www.gosh.nhs.uk
Sheet 3 of 3 Ref: 2014F0689 GOSH NHS Foundation Trust August 2014