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CO2 Laser Resurfacing (co2 + laser_resurfacing)

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Medical Sciences	100%

Selected Abstracts

Occlusive Dressing versus Oxygen Mist Therapy Following CO2 Laser Resurfacing

DERMATOLOGIC SURGERY, Issue 6 2000
Teri Onouye BA
Background. Oxygen is an essential element for collagen synthesis and reepithelialization. The use of topical oxygen after CO2 laser resurfacing has not been studied. Objective. To compare the rate and quality of healing in wounds treated with an oxygen mist to those treated with occlusive dressing following CO2 laser resurfacing. Methods. Three patients underwent CO2 laser resurfacing to each half of the face 3 weeks apart. Postoperatively, half of the face was treated with an oxygen mist protocol for 5 days, while the other half was treated with occlusive dressing for 4 days. Results. At postoperative day 5, significantly less crusting was observed on the half of the face treated with the oxygen mist protocol (p < 0.05). Conclusion. The oxygen mist postoperative protocol may offer patients similar overall healing rates and significantly less crusting compared to occlusive dressing. [source]

Delayed Wound Healing After Three Different Treatments for Widespread Actinic Keratosis on the Atrophic Bald Scalp

DERMATOLOGIC SURGERY, Issue 10 2003
Patricia J. F. Quaedvlieg MD
Background. Actinic keratosis is an exceedingly common premalignant lesion that can develop into squamous cell carcinoma. There is an increasing prevalence of actinic keratosis with increasing age. Numerous treatment options are available for the treatment of actinic keratosis on the scalp. Although we know that atrophic skin heals slowly, one should be careful but should not hesitate to treat. Objective. We present three patients with widespread actinic keratotic lesions on the atrophic bald scalp who received different treatments. Methods. Patient 1 was treated with medium-depth chemical peel, patient 2 with cryopeel, and patient 3 with CO2 laser resurfacing. In all patients, the entire surface area was treated. Results. Despite the different treatment methods used, all three patients had severly delayed wound healing as a complication. Remarkably, all patients had a prolonged period of re-epithelialization. Conclusion. Care has to be taken in patients with widespread actinic keratosis on the atrophic bald scalp when treating the entire surface area regardless the treatment modality. [source]

Occlusive Dressing versus Oxygen Mist Therapy Following CO2 Laser Resurfacing

Comparison of Electrodessication with CO2 Laser for the Treatment of Actinic Cheilitis

DERMATOLOGIC SURGERY, Issue 4 2000
Richard A. Laws MD
Background. Actinic cheilitis is a common premalignant condition that is most often treated with destructive therapy. The most effective technique is usually considered to be CO2 laser resurfacing. Little has been written on the use of electrodessication for this condition. Objective. We designed a study to compare these two treatment modalities for the treatment of biopsy-confirmed actinic cheilitis. Methods. A random half of the lower lip was treated with electrodessication. The contralateral half was then treated with CO2 laser. Healing time, subjective pain during healing, and clinical outcome at 3 months was compared. Results. The side treated with electrodessication took significantly longer to heal than the side treated with the CO2 laser (23 versus 14 days, P < .001). There was no difference in subjective pain or clinical appearance at 3 months. Conclusion. Although the healing time is longer with electrodessication, this modality represents an inexpensive practical ablative treatment method for actinic cheilitis. [source]

Long-term efficacy of a fractional resurfacing device,,§

LASERS IN SURGERY AND MEDICINE, Issue 2 2010
Arisa E. Ortiz MD
Abstract Background and Objective Recently, there has been much debate regarding the long-term efficacy of fractional resurfacing devices. While pulsed CO2 laser resurfacing is considered a highly effective treatment, fractionated resurfacing is a newer modality and its long-term efficacy has yet to be assessed. We report the long-term outcomes of subjects previously treated with fractional CO2 resurfacing for photodamaged skin and acne scars. Study Design/Materials and Methods Ten subjects from our previous studies who received fractional resurfacing for the treatment of acne scarring and photodamage returned for long-term follow-up visits at 1 and 2 years, respectively. Investigators graded maintenance of improvement on a quartile scale based on clinical photography. Results Subjects maintained 74% of their overall improvement at their long-term visits compared to 3-month follow-up visits. While clinical improvement was maintained long-term, the results were not as remarkable as those seen at 3-month visits. The authors speculate that results seen at 3 months may be enhanced by persistent inflammatory changes, as evidenced by heat shock protein 47 activity and ongoing collagen remodeling seen in previous histologic studies. Relaxation of tightening is to be expected with any procedure along with the natural progression of aging. However, patient satisfaction was upheld long-term. Conclusion Fractional CO2 laser resurfacing does have long-term efficacy and persistence of improvement of acne scarring and photodamage compared to baseline. However, additional treatments may be necessary to enhance long-term results. Lasers Surg. Med. 42:168,170, 2010. © 2010 Wiley-Liss, Inc. [source]

Complications of fractional CO2 laser resurfacing: Four cases

LASERS IN SURGERY AND MEDICINE, Issue 3 2009
Douglas J. Fife MD
Abstract Background and Objective Fractional ablative laser therapy is a new modality which will likely be widely used due to its efficacy and limited side-effect profile. It is critical to recognize, characterize, and report complications in order to acknowledge the limits of therapeutic efficacy and to improve the safety of these devices. Study Design/Materials and Methods The photographs, treatment parameters, and clinical files of four female patients aged 54,67 who had scarring or ectropion after fractional CO2 laser resurfacing on the face or neck were carefully reviewed to search for any possible linking factors. Results Patient 1 developed erosions and swelling of the right lower eyelid 2 days postoperatively, which developed into scarring and an ectropion. Patient 2 developed linear erosions and beefy red swelling on the right side of the neck which developed into a tender, band-like scar over 1-month. Patient 3 developed stinging and yellow exudate in multiple areas of the neck 3 days postoperatively. Cultures grew methicillin-resistant Staphylococcus aureus. Despite appropriate treatment, she developed multiple areas of irregular texture and linear streaking which developed into scars. Patient 4 developed an asymptomatic patchy, soft eschar with yellowish change on the left side of the neck. Azithromycin was started, however at 2-week follow-up she had fibrotic streaking which developed into horizontal scars and a vertical platysmal band. The treatment and final outcome of each patient are described. Conclusion Scarring after fractional CO2 laser therapy may be due to overly aggressive treatments in sensitive areas (including excessive energy, density, or both), lack of technical finesse, associated infection, or idiopathic. Care should be taken when treating sensitive areas such as the eyelids, upper neck, and especially the lower neck and chest by using lower energy and density. Postoperative infections may lead to scarring and may be prevented by careful taking of history, vigilant postoperative monitoring and/or prophylactic antibiotics. Lasers Surg. Med. 41:179,184, 2009. © 2009 Wiley-Liss, Inc. [source]

Hypertrophic scarring of the neck following ablative fractional carbon dioxide laser resurfacing

LASERS IN SURGERY AND MEDICINE, Issue 3 2009
Mathew M. Avram MD
Abstract Background Ablative fractional carbon dioxide (CO2) laser treatments have gained popularity due to their efficacy, shortened downtime, and decreased potential for scarring in comparison to traditional ablative CO2 resurfacing. To date, scarring with fractional CO2 lasers has not been reported. Objective Five patients treated with the same fractional CO2 laser technology for photodamage of the neck were referred to our practices 1,3 months after treatment. Each patient developed scarring. Of the five cases, two are discussed in detail. The first was treated under general anesthesia on the face and anterior neck at a pulse energy of 30 mJ (859 µm depth) with 25% coverage. Eleven days after treatment, three non-healing areas along the horizontal skin folds of the anterior neck were noted. At 2 weeks after CO2 ablative fractional resurfacing, these areas had become thickened. These raised areas were treated with a non-ablative fractionated 1,550 nm laser to modify the wound healing milieu. One week later, distinct firm pale papules in linear arrays with mild hypopigmentation had developed along involved neck skin folds. Skin biopsy was performed. For the second patient, the neck was treated at a pulse energy of 20 mJ (630 µm depth) with 30% coverage of the exposed skin, with a total treatment energy of 5.0 kJ. Minimal crusting was noted on the neck throughout the initial healing phase of 2 weeks. She then experienced tightness on her neck. Approximately 3 weeks after treatment, she developed multiple vertical and horizontal hypertrophic scars (HS). Results Histopathology for the first case confirmed the presence of a hypertrophic scar. The papules in this case completely resolved with mild residual hypopigmentation after treatment with topical corticosteroids. HS failed to resolve in the second case to date after 1 month. Conclusion As with traditional ablative CO2 laser resurfacing, HS is a potential complication of ablative fractional CO2 laser resurfacing, particularly on the neck. With early diagnosis and appropriate treatment HS of neck skin may be reversible. We urge caution when treating the neck with this device and close attention to wound care in the post-operative period. Lasers Surg. Med. 41:185,188, 2009. © 2009 Wiley-Liss, Inc. [source]