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Fractional CO2 Laser (fractional + co2_laser)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Fractional CO2 laser: a novel therapeutic device upon photobiomodulation of tissue remodeling and cytokine pathway of tissue repair

DERMATOLOGIC THERAPY, Issue 2009
F. Prignano
ABSTRACT Minimally ablative fractional laser devices have gained acceptance as a preferred method for skin resurfacing. Notable improvements in facial rhytides, photodamage, acne scarring, and skin laxity have been reported. The aim of the present work was to compare how different CO2 laser fluences, by modulating the secretory pathway of cytokines, are able to influence the wound-healing process, and how these fluences are associated with different clinical results. Eighteen patients, all with photodamaged skin, were treated using a fractional CO2 laser (SmartXide DOT, Deka M.E.L.A., Florence, Italy) with varying laser fluences (2.07, 2.77, and 4.15 J/cm2). An immunocytochemical study was performed at defined end points in order to obtain information about specific cytokines of the microenvironment before and after treatment. The secretory pathway of cytokines changed depending on the re-epithelization and the different laser fluences. Different but significant improvements in wrinkles, skin texture, and hyperpigmentation were definitely obtained when using 2.07, 2.77, and 4.15 J/cm2, indicating fractional CO2 laser as a valuable tool in photorejuvenation with good clinical results, rapid downtime, and an excellent safety profile. [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]