Cutaneous laser resurfacing

Ratner, Désirée; Tse, Yardy; Marchell, Nancy L.; Goldman, Mitchel P.; Fitzpatrick, Richard; Fader, Darrell J.

doi:10.1016/s0190-9622(99)70110-6

Cited by 134 publications

(87 citation statements)

References 252 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A(Q) is the single MTZ cross-sectional area as a function of pulse energy, Q Á D is the MTZ/cm 2 /pass setting used in the treatment, and n is the number of passes performed within the same treatment area. Equation (1) implies that the treatment coverage is dependent upon the pulse energy, Q, densityper-pass setting, D, and the number of passes, n, performed. This formulation provides a reasonable estimation of the level of treatment coverage from the probabilistic standpoint due to the quasi-random nature of fractional treatment after multiple passes, accounting for overlapping of micro-lesions.…”

Section: Discussionmentioning

confidence: 99%

“…Resurfacing of photoaged facial skin with ablative lasers represents a significant advance as a method of rejuvenation [1]. Numerous studies have clearly demonstrated the clinical efficacy of this treatment modality using infrared laser sources such as CO 2 or Erbium:YAG [2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

“…Numerous studies have clearly demonstrated the clinical efficacy of this treatment modality using infrared laser sources such as CO 2 or Erbium:YAG [2][3][4][5]. However, these treatment modalities suffer from side effects such as prolonged post-treatment downtime, post-inflammatory pigmentary alterations, persistent erythema, edema, infection, and scarring [1,[6][7][8]. Hence ablative laser resurfacing, once the mainstay of skin rejuvenation, has been significantly less popular in recent years.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Ex vivo histological characterization of a novel ablative fractional resurfacing device

et al. 2006

View full text Add to dashboard Cite

Background and Objectives: We introduce a novel CO 2 laser device that utilizes ablative fractional resurfacing for deep dermal tissue removal and characterize the resultant thermal effects in skin. Study Design/Materials and Methods: A prototype 30 W, 10.6 mm CO 2 laser was focused to a 1/e 2 spot size of 120 mm and pulse duration up to 0.7 milliseconds to achieve a microarray pattern in ex vivo human skin. Lesion depth and width were assessed histologically using either hematoxylin & eosin (H&E) or lactate dehyrdogenase (LDH) stain. Pulse energies were varied to determine their effect on lesion dimensions. Results: Microarrays of ablative and thermal injury were created in fresh ex vivo human skin irradiated with the prototype CO 2 laser device. Zones of tissue ablation were surrounded by areas of tissue coagulation spanning the epidermis and part of the dermis. A thin condensed lining on the interior wall of the lesion cavity was observed consistent with eschar formation. At 23.3 mJ, the lesion width was approximately 350 mm and depth 1 mm. In this configuration, the cavities were spaced approximately 500 mm apart and interlesional epidermis and dermis demonstrated viable tissue by LDH staining. Conclusion: A novel prototype ablative CO 2 laser device operating in a fractional mode was developed and its resultant thermal effects in human abdominal tissue were characterized. We discovered that controlled microarray patterns could be deposited in skin with variable depths of dermal tissue ablation depending on the treatment pulse energy. This is the first report to characterize the successful use of ablative fractional resurfacing as a potential approach to dermatological treatment. Lasers Surg. Med. 39:87-95, 2007. ß

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Ex vivo histological characterization of a novel ablative fractional resurfacing device

et al. 2006

View full text Add to dashboard Cite

show abstract

“…However, these procedures are painful, have significant downtime and adverse side effects such as infection, pigment alterations, long-lasting erythema, and scarring [5][6][7][8][9]. The downtime from the recovery process encompasses both the time for physiological processes associated with re-epithelization to occur and the time needed for the patient to return to normal activity without any psychological discomfort resulting from the appearance of the treated areas.…”

Section: Introductionmentioning

confidence: 99%

“…The downtime from the recovery process encompasses both the time for physiological processes associated with re-epithelization to occur and the time needed for the patient to return to normal activity without any psychological discomfort resulting from the appearance of the treated areas. Full-surface ablative procedures with a CO 2 laser, for example, have been shown to produce 1-2 weeks of downtime and erythema lasting for an average of 2-4.5 months [5]. Extended downtime and long-lasting erythema are obvious drawbacks for patients undergoing this procedure.…”

Section: Introductionmentioning

confidence: 99%

Micro‐fractional ablative skin resurfacing with two novel erbium laser systems

et al. 2008

View full text Add to dashboard Cite

Background and Objectives: Fractional ablation offers the potential benefits of full-surface ablative skin resurfacing while minimizing adverse effects. The purpose of this study was to evaluate the safety, damage profile, and efficacy of erbium fractional lasers. Materials and Methods: Histology from animal and human skin as well as clinical evaluations were conducted with erbium YAG (2,940 nm) and erbium YSGG (2,790 nm) fractional lasers varying pulse width, microbeam (mb) energy, number of passes, and stacking of pulses. Results: Single-pulse treatment parameters from 1 to 12 mJ per 50-70 mm diameter microbeam and 0.25-5 milliseconds pulse widths produced microcolumns of ablation with border coagulation of up to 100 mm width and 450 mm depth. Stacking of pulses generated deeper microcolumns. Clinical observations and in vivo histology demonstrate rapid re-epithelization and limited adverse side effects. Facial treatments were performed in the periorbital and perioral areas using 1-8 passes of single and stacked pulses. Treatments were well-tolerated and subjects could resume their normal routine in 4 days. A statistically significant reduction in wrinkle scores at 3 months was observed for both periorbital and perioral wrinkles using blinded grading. For periorbital treatments of four passes or more, over 90% had !1 score wrinkle reduction (0-9 scale) and 42% had !2. For perioral wrinkles, over 50% had substantial improvements (!2). Conclusion: The clinical observations and histology findings demonstrate that micro-fractional ablative treatment with 2,790 and 2,940 nm erbium lasers resulted in safe and effective wrinkle reduction with minimal patient downtime. The depth and width of the ablated microcolumns and varying extent of surrounding coagulation can be controlled and used to design new treatment procedures targeted for specific indications and areas such as moderate to severe rhytides and photodamaged skin.

show abstract

Erbium:YAG Laser and Cultured Epidermis in the Surgical Therapy of Stable Vitiligo

Guerra¹,

Primavera²,

Raskovic³

et al. 2003

Arch Dermatol

View full text Add to dashboard Cite

To induce complete and reproducible repigmentation of large "stable" vitiligo lesions by means of autologous cultured epidermal grafts using a rapid, simple, and minimally invasive surgical procedure.Design: Achromic epidermis was removed by means of appropriately settled erbium:YAG laser, and autologous epidermal grafts were applied onto the recipient bed. Melanocyte content was evaluated by dopa reaction. The percentage of repigmentation was calculated using a semiautomatic image analysis system.Setting: A biosafety level 3-type cell culture facility, a surgical ambulatory department, and a dermatological department in a hospital.Patients: Twenty-one patients with different types of vitiligo were admitted to the study and treated with autologous cultured epidermal grafts. Inclusion criteria were failure of at least 2 standard medical approaches; no therapy for at least 12 months; no progression of old lesions or appearance of new lesions; no Koebner phenomenon within the past 18 months; and no autoimmune disorders. Results:The average percentage of repigmentation in 21 patients was 75.9% (1759.7 cm 2 repigmented/2315.8 cm 2 transplanted). Three patients showed a reactivation of their vitiligo and did not show repigmentation. The remaining 18 patients, with 43 distinct lesions, showed an average percentage of repigmentation of 90% (1759.7 cm 2 repigmented/1953.4 cm 2 transplanted).Conclusions: Under appropriate conditions, cultured epidermal grafts induce complete repigmentation of stable vitiligo lesions. Erbium:YAG laser surgery can supply a fast and precise tool for disepithelialization, hence allowing treatment of large vitiligo lesions during a single surgical operation.

show abstract

Cutaneous laser resurfacing

Cited by 134 publications

References 252 publications

Ex vivo histological characterization of a novel ablative fractional resurfacing device

Ex vivo histological characterization of a novel ablative fractional resurfacing device

Micro‐fractional ablative skin resurfacing with two novel erbium laser systems

Erbium:YAG Laser and Cultured Epidermis in the Surgical Therapy of Stable Vitiligo

Contact Info

Product

Resources

About