Objective: Importance of laser pulsing parameters and tissue's mechanical properties in the Er:YAG laser skin-tissue ablation is not adequately understood. The goal here was to develop a computational model that incorporates skin tissue's mechanical properties to investigate the influence of Er:YAG laser pulsing parameters on tissue ablation and coagulation. Methods: Tissue's mechanical properties were incorporated by modeling ablation as a tissue water vaporization occurring under elevated pressures that depend on tissue's stress-strain relationships. Tissue deformation was assumed unidirectional; therefore, a one-dimensional model was utilized. Analytical solution and experimental results were used to verify and validate the model. Then, influence of pulse duration (10 µs-2 ms) and fluence (0-30 J cm-2) on coagulation depth and ablation efficiency was explored. Results: Verification and validation results suggested that the model is acceptably accurate. Minimal effect of pulse duration on coagulation depth was predicted at sub-ablative conditions. At those conditions, coagulation depth increased asymptotically to ∼90 µm with increasing pulse fluence. At ablative conditions, coagulation depth decreased asymptotically to 22-28 µm with increasing pulse irradiance. Ablation efficiency plateaued at high pulse fluences and long pulse durations. Mechanical properties were important as about 50% increase in coagulation depth and 25% decrease in ablation efficiency were predicted when considering the high strain-rate loading effect in comparison with quasi-static loading. Conclusions: Proper tuning of Er:YAG laser pulsing parameters can substantially improve its therapeutic outcomes. The effect of these parameters varies and depends on whether the laser-tissue conditions are ablative or sub-ablative.
Keywords: Model; ablation; mechanical properties; pulse duration; pulse fluence; thermo-mechanical.