超脉冲CO_2激光联合点阵铒激光治疗面部凹陷性瘢痕与增生性瘢痕的疗效比较

目的：比较超脉冲CO2激光联合点阵铒激光治疗面部凹陷性瘢痕与增生性瘢痕的临床效果。方法：2007年3月～2010年1月,我们应用超脉冲CO2激光联合点阵铒激光治疗面部瘢痕患者71例,其中凹陷性瘢痕33例和增生性瘢痕38例,分析两组病例疗效差别及可能的原因。结果：所有患者总有效率为77.5%,凹陷性瘢痕组有效率为87.9%,而增生性瘢痕组为68.4%,两组间有效率差别有统计学意义（P〈0.05）。结论：超脉冲CO2激光联合点阵铒激光是治疗面部瘢痕的方法之一,面部凹陷性瘢痕的疗效优于增生性瘢痕。     

超脉冲CO2激光联合强脉冲光治疗面部瘢痕

目的：观察超脉冲CO2激光联合强脉冲光治疗面部瘢痕的效果。方法：对50例面部瘢痕患者,采用超脉冲CO2激光和强脉冲光联合治疗6次。治疗间隔均为1个月。首先使用超脉冲CO2激光磨削,能量100～200mJ／脉冲,频率10～20脉冲／min。然后使用585nm强脉冲光治疗,脉宽2．5～15ms,能量密度25～35J／cm^2。结果：治疗结束后随访3～6个月,显效者33例,有效者14例,无效者3例。主要并发症为短暂红斑、色素沉着。结论：超脉冲CO2激光与585nm强脉冲光联合治疗面部瘢痕,具有较好的疗效,有操作准确、快捷、损伤小、术后恢复快、并发症少等优点。     

超脉冲CO2激光联合点阵铒激光治疗痤疮凹陷性瘢痕的疗效及影响疗效的因素分析

目的 探讨使用超脉冲CO2激光联合点阵铒激光治疗痤疮凹陷性瘢痕的疗效及影响疗效的因素.方法 对我科自2007年3月至2010年1月收治的33例痤疮凹陷性瘢痕患者的治疗情况进行回顾性分析,结合临床特点分析治疗失败的原因并找出危险因素.结果 本组超脉冲CO2激光联合点阵铒激光治疗痤疮凹陷性瘢痕有效率达87.9%,临床疗效与患者的病史时间(P =0.038)、是否患有其他皮肤病(P =0.002)有关;而本研究中患者性别、病变程度、病损程度与临床预后间无统计学意义.结论 超脉冲CO2激光联合点阵铒激光是治疗痤疮凹陷性瘢痕的有效方法.伴有其他皮肤疾病、病程较长的患者预后可能较差.     

1064-nm Nd:YAG皮秒点阵激光与超脉冲CO2点阵激光治疗面部萎缩性痤疮瘢痕的临床比较

目的 探究1064-nm Nd:YAG皮秒点阵激光与超脉冲CO2点阵激光治疗面部萎缩性痤疮瘢痕的疗 效与安全性。方法 选取2021年6月-2023年6月于我院激光科接受治疗的62例面部萎缩性痤疮瘢痕患者作 为研究对象,按照不同的治疗方法分为皮秒点阵激光组和CO2点阵激光组,各31例。皮秒点阵激光组给予 1064-nm Nd:YAG皮秒点阵激光治疗,CO2点阵激光组给予超脉冲CO2点阵激光治疗,比较两组ECCA权 重评分、疗效自评分、满意度评分及术后不良反应发生情况。结果 两组治疗后ECCA权重评分均较治疗 前降低（P ＜0.05）,且皮秒点阵激光组的ECCA权重评分高于CO2点阵激光组（P ＜0.05）;CO2点阵激光 组疗效自评分高于皮秒点阵激光组（P ＜0.05）;皮秒点阵激光组不良反应发生情况低于CO2点阵激光组 （P ＜0.05）;两组满意度比较,差异无统计学意义（P＞0.05）。结论 1064-nm Nd:YAG皮秒点阵激光与 超脉冲CO2点阵激光均能有效改善面部萎缩性痤疮瘢痕,超脉冲CO2点阵激光疗效更好,而皮秒点阵激光 不良反应发生情况更少。     

超脉冲点阵CO2激光联合强脉冲光在皮肤年轻化治疗中的效果及安全性分析

目的:探讨超脉冲点阵CO2激光联合强脉冲光在皮肤年轻化治疗中的效果及安全性.方法:选取2018年5月-2019年12月笔者医院就诊的110例面部老化行皮肤年轻化治疗的就医者,依照治疗方法将采用单纯超脉冲点阵CO2激光治疗的52例就医者纳入B组,将采用超脉冲点阵CO2激光联合强脉冲光治疗的58例就医者纳入A组,比较两组临...     

CO2点阵激光联合硅酮凝胶治疗面部痤疮瘢痕的疗效观察

目的：观察CO2点阵激光联合硅酮凝胶对面部痤疮瘢痕的疗效及其不良反应。方法：应用cO：点阵激光对40例面部痤疮瘢痕患者进行连续5次治疗,其中治疗组术后联合硅酮凝胶外用,而对照组不外用任何药物,治疗后随访3～5个月。结果：治疗组痤疮瘢痕总有效率为85％,对照组总有效率70％。其中治疗组增生性瘢痕总有效率高于凹陷性瘢痕,而对照组增生性瘢痕总有效率略低于凹陷性瘢痕。术后随访治疗组仅1例出现暂时性色素沉着,对照组有3例出现色素沉着,两组均无1例发生新的瘢痕。结论：点阵CO2激光联合硅酮凝胶治疗面部痤疮瘢痕优于单纯点阵CO2激光治疗,联合治疗可提高增生性瘢痕的疗效。     

像素铒激光结合超脉冲CO2激光磨削治疗重度痤疮瘢痕1例

报道一例面部重度痤疮瘢痕患者应用像素铒激光结合超脉冲CO2激光磨削治疗取得较好效果。患者女,24岁,面部大量痤疮后瘢痕,以“火山口样”及“冰晶样”萎缩性瘢痕为主,同时伴皮脂腺增生。以像素铒激光结合超脉冲CO2激光综合治疗取得较好效果。     

超脉冲点阵CO2激光联合窄谱强脉冲光治疗创伤后早期增生性瘢痕效果分析

目的:分析超脉冲点阵CO2激光联合窄谱强脉冲光(Dye pulse light,DPL)治疗创伤后早期增生性瘢痕的效果.方法:选择2018年12月-2020年9月于笔者医院就诊的86例创伤后增生性瘢痕患者为研究对象,根据治疗方法不同将患者分为观察组45例和对照组41例.对照组采用超脉冲点阵CO2激光治疗,观察组在对照组...     

点阵CO2激光联合2940nm铒像素激光治疗皮肤光老化疗效观察

目的:探讨点阵CO2激光联合2940 nm铒像素激光治疗皮肤光老化的疗效及其安全性.方法:选取2016年3月-2019年10月在笔者医院皮肤科就诊的126例皮肤光老化就医者为研究对象,采用随机数字法分为对照组和观察组,每组63例.对照组应用点阵CO2激光治疗,观察组应用CO2点阵激光联合2940 nm铒像素激光治疗.治...     

超脉冲CO2点阵激光在面部凹陷性疤痕治疗中的应用效果

探究超脉冲CO2点阵激光治疗面部凹陷性瘢痕的临床效果。方法 选取2022年1月-2023年 1月我院收治的88例面部凹陷性瘢痕患者为研究对象，以随机数字表法分为对照组和观察组，各44例。对 照组采用传统点阵激光进行治疗，观察组采用超脉冲CO2点阵激光治疗，比较两组临床疗效、ECCA评分、 不良反应发生情况。结果 观察组治疗总有效率为93.18%，高于对照组的77.27%（P＜0.05）；观察组1、2次治 疗后ECCA评分均低于对照组（P＜0.05）；两组不良反应发生率比较，差异无统计学意义（P ＞0.05）。 结论 对面部凹陷性瘢痕患者采用超脉冲CO2点阵激光治疗效果理想，有利于提高整体治疗效果，改善 患者皮肤状况，并且减少患者严重并发症，安全性较高。     

Effect of laser radiation on tissue during laser angioplasty

The thermal properties of adipose and ceramic atherosclerotic plaque deposits and normal arterial vessel wall were measured in the temperature range of 25-95 degrees C. In general, the data indicate that fatty plaques exhibit the lowest thermal conductivity and thermal diffusivity of the three types, whereas calcified plaques seem to have the highest values. By using a video scanning thermograph, temperature rise was recorded in normal vessel wall and plaque during ablation of tissue. Theoretical analysis suggested that realistic modeling of laser angioplasty should account for scattering of light, water content, and ablation. This paper is a preliminary report of these results.     

Argon laser angioplasty with a laser probe

A preliminary basic study of argon laser angioplasty with the use of a specially designed probe is presented. Arterial specimens were harvested from 10 amputated lower extremities. The studies included the evaluation of coaxial laser angioplasty in 10 partially or totally occluded arteries; the observation of the effect of perpendicularly applied laser energy on 35 thrombi, 54 soft and 10 hard atherosclerotic, and 51 normal arterial walls; the comparison of laser energy requirements for coaxial vessel lumen enlargement or recanalization vs. perpendicular penetration in 10 occluded, hard atherosclerotic arteries; and the spectrographic analysis of calcium density gradient in two specimens. The results showed that the power required for vessel lumen enlargement was 10 +/- 6 J/mm of atherosclerotic vessel (mean +/- standard deviation). The probe followed the original arterial lumen, did not perforate the vessel wall, and created a smooth, enlarged path. The power required to penetrate perpendicularly to a similar depth for thrombi, soft and hard atherosclerotic plaques, and normal arterial walls was 15 +/- 4, 30 +/- 15, 65 +/- 32, and 246 +/- 123 J/mm, respectively. In the hard calcified specimens, laser energy required for coaxial lumen enlargement or recanalization was significantly less than that for perpendicular penetration (p less than 0.05), which correlated with the calcium density map indicating an increase from inside to outside.     

Experimental study of application of excimer laser to laser angioplasty

The possible application of excimer laser to laser angioplasty was studied. In the first experiment, the ablative effects of excimer laser at wavelengths of 248 nm and 308 nm on the pig myocardium were examined in vitro at an air-tissue interface. Crater depth increased with total delivered energy and energy per pulse. Very clear cuts could be observed by histological examination. There was no evidence of thermal damage at a wavelength of 248 nm, at 10 pps. Above 10 pps, a thin bordering zone of suspicious thermal damage was noted with the wavelengths of 248 nm and 308 nm. Thermal damage increased with pulse repetition rate. In the second experiment, the effects of excimer laser irradiation on blood were examined. Five vials, each of which contained 3 ml of blood, were exposed to 37.5 mJ laser beam at 10 pps in repetition rate for 10, 20, 30, 40, 50 seconds. One vial was left untreated as a control. No change in hematocrit value was observed after excimer laser irradiation. In contrast, the level of plasma free hemoglobin rose progressively with each increased duration of exposure. This result indicates that the lysis of erythrocytes does not occur in the laser-exposed cells. However, the damage to erythrocyte membrane took place as it was evidenced by progressive hemoglobin leakage into plasma. In the third experiment, the excimer laser was coupled to a 400 microns quartz optical fiber and the laser energy transmitted through the fiber was measured. At a wavelength of 308 nm, pulse energies up to 9 mJ were noted at the tip of the fiber. At a wavelength of 248 nm, the fiber tip was destroyed. In the fourth experiment, acute and chronic healing responses of normal canine arteries to excimer laser irradiation were studied in 4 mongrel dogs. The artery healed completely at the 18th day after the excimer laser irradiation. There was no evidence of thrombus formation and intimal hyperplasia in these arteries. The results suggest the applicability of excimer laser to laser angioplasty.     

Effects of laser parameters on pulsed Er-YAG laser skin ablation

Previous studies demonstrated that pulsed 2.94m Er-YAG laser radiation allows a precise etching of organic tissue with only minimal thermal damage. This makes the Er-YAG laser a promising tool for the careful removal of superficial skin lesions. In order to provide optimized laser parameters for potential clinical use and to enhance our understanding of the mid-infrared ablation process, we measured the ablation rate, temperature profile and damage zones for various pulse numbers, radiant energies and pulse repetition rates. Ablation is very efficient (about 6m J^–1 cm² for high radiant exposure) and the crater depth is exactly (1Hz) or nearly (2 Hz) linearly related to the radiant exposure. In contrast, no significant effects of the laser parameters on the thermal damage of the epidermis and the crater bottom were observed. In conclusion, for a future clinical use high radiant energies should be applicable without the disadvantage of enhanced damage.     

Endoscopic laser coagulation through an optical laser balloon

An endoscope was equipped with a saline-filled latex rubber balloon at its tip to displace contaminating blood, bile, or gastric contents during operative portoscopy, biliary endoscopy, or upper gastrointestinal endoscopy. A fiber with its tip inside the balloon transmitted energy from an Nd:YAG laser for coagulation of tumors in one bile duct cancer, in six portal vein growths from primary liver cancers, and in a superficially growing stomach cancer. The balloon increased the precision of irradiation by making lesions easier to identify through displacement of bile or blood and by keeping the fiber tip at a fixed position relative to the lesion. The technique, basic experimental studies, and clinical experiences are reported.     

Treatment of hypertrophic scars using laser and laser assisted corticosteroid delivery

Background and Objectives

Hypertrophic scars and contractures are common following various types of trauma and procedures despite skilled surgical and wound care. Following ample time for healing and scar maturation, many millions of patients are burdened with persistent symptoms and functional impairments. Cutaneous scars can be complex and thus the approach to therapy is often multimodal. Intralesional corticosteroids have long been a staple in the treatment of hypertrophic and restrictive scars. Recent advances in laser technology and applications now provide additional options for improvements in function, symptoms, and cosmesis. Fractional ablative lasers create zones of ablation at variable depths of the skin with the subsequent induction of a wound healing and collagen remodeling response. Recent reports suggest these ablative zones may also be used in the immediate post‐operative period to enhance delivery of drugs and other substances. We present a case series evaluating the efficacy of a novel combination therapy that incorporates the use of an ablative fractional laser with topically applied triamcinolone acetonide suspension in the immediate post‐operative period.

Methods

This is a prospective case series including 15 consecutive subjects with hypertrophic scars resulting from burns, surgery or traumatic injuries. Subjects were treated according to typical institutional protocol with three to five treatment sessions at 2‐ to 3‐month intervals consisting of fractional ablative laser treatment and immediate post‐operative topical application of triamcinolone acetonide suspension at a concentration of 10 or 20 mg/ml. Three blinded observers evaluated photographs taken at baseline and six months after the final treatment session. Scores were assigned using a modified Manchester quartile score to evaluate enhancements in dyschromia, hypertrophy, texture, and overall improvement.

Limitations

Small sample size and lack of a control arm.

Results

Combination same session laser therapy and immediate post‐operative corticosteroid delivery resulted in average overall improvement of 2.73/3.0. Dyschromia showed the least amount of improvement while texture showed the most improvement.

Conclusion

Combination same‐session therapy with ablative fractional laser‐assisted delivery of triamcinolone acetonide potentially offers an efficient, safe and effective combination therapy for challenging hypertrophic and restrictive cutaneous scars. Lasers Surg. Med. 45: 135–140, 2013. © 2013 Wiley Periodicals, Inc.     

Fundus laser coagulation using a video system of scanning laser ophthalmoscope

We modified a scanning laser ophthalmoscope for simultaneous photocoagulation of the retina and video recording. Using a diode laser (810 nm wavelength), we produced fundus lesions that scarred within 14 days. © 1993 Wiley-Liss, Inc.     

Intraoral laser welding: ultrastructural and mechanical analysis to compare laboratory laser and dental laser

The Nd:YAG laser has been used since 1970 in dental laboratories to weld metals on dental prostheses. Recently in several clinical cases, we have suggested that the Nd:YAG laser device commonly utilized in the dental office could be used to repair broken fixed, removable and orthodontic prostheses and to weld metals directly in the mouth. The aim of this work was to evaluate, using scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDS) and dynamic mechanical analysis (DMA), the quality of the weld and its mechanical strength, comparing a device normally used in dental laboratory and a device normally used in the dental office for oral surgery, the same as that described for intraoral welding. Metal plates of a Co-Cr-Mo dental alloy and steel orthodontic wires were subjected to four welding procedures: welding without filler metal using the laboratory laser, welding with filler metal using the laboratory laser, welding without filler metal using the office laser, and welding with filler metal using the office laser. The welded materials were then analysed by SEM, EDS and DMA. SEM analysis did not show significant differences between the samples although the plates welded using the office laser without filler metal showed a greater number of fissures than the other samples. EDS microanalysis of the welding zone showed a homogeneous composition of the metals. Mechanical tests showed similar elastic behaviours of the samples, with minimal differences between the samples welded with the two devices. No wire broke even under the maximum force applied by the analyser. This study seems to demonstrate that the welds produced using the office Nd:YAG laser device and the laboratory Nd:YAG laser device, as analysed by SEM, EDS and DMA, showed minimal and nonsignificant differences, although these findings need to be confirmed using a greater number of samples.