This page contains a Flash digital edition of a book.
TREATMENT GUIDE | wound healing process8 . In fact, the SMA


nozzle incorporates a sophisticated system of lenses that enables piercing holes in the skin, by over 10 000 laser beams, in tiny micro spots of 50 m m. The same approach of inducing a


reactive controlled wound healing phase, guided by a well confined thermal effect is used by the CO2


technology (Alma Lasers, Israel)9


Figure 2 (A) Residual scarring after incisional surgery for tumour removal. (B) 8 months after two treatment sessions, with fractional Rolling Pixel CO2


passage of cosmeceuticals to improve tissue quality The most common and accepted laser


treatment options are: 585–595 nm pulsed dye laser, 1064 nm Nd:YAG laser, 532 nm KTP laser, and IPL devices emitting between 500 and 1200 nm. All are largely used to treat hypertrophic scars and keloids. For atrophic scars the Er:YAG and CO2


ablative


lasers are recommended. Non-ablative lasers such as the 1320 nm Nd:YAG, 1450 nm diode and 1540 nm erbium: glass lasers are also an option. In the case of non-ablative devices, the


aim is to collapse the feeder vessels of the scar tissue and soften its fibrotic condition by means of micro wounds produced during treatment, which will help tissue to remodel. Results are inconsistent and in general, recurrences are often seen. The 2930 nm wavelength Er:YAG laser is probably the most adaptable for the


treatment of elevated and depressed scar tissue. Thanks to its excellent absorption by water, this laser can carry out layer by layer elimination, debulking and/or reshaping fibrotic tissue7


. When


used in fractional mode, and in cases of atrophic lesions, it offers the advantage of eliminating fine shallow layers of the epidermis to activate rapid dermal and epidermal reorganisation. In the authorsÕ experience, the SMA


laser and ultrasound device, for the transepidermal


Pixel Rolling .


MONTH IN PRIME


NEXT


Liposuction & body contouring


To feature your product contact: rosalind.hill@ informa.com


(Space Modulated Ablation) nozzle attached to the Er:YAG laser (Linline , Belarus), makes it possible


to carry out


treatments without anaesthesia (Figure 1). Passes over the scar, using this technology, produce a dermal jellification, separating fibres to remodel fibrotic tissue through, theoretically, re-initialising a modulated


Fractional Pixel laser treatment is followed by the action of an ultrasound device to facilitate transepidermal passage of creams/cosmeceuticals, the ingredients of which help fibrotic tissue re-establish a more normal condition (Figure 2). Treatment in any case and with the various systems will require a number of sessions to achieve notable results. But, in the event of seeking


prevention of a


pathological wound healing, the so-called LASH (Laser Assisted Surgical Healing) can be used10


. In


this approach, a 1540 Er:Glass laser is used at the time of closure of the


wound with stitches (Figure 3). The moderate thermal effect produced, will increase expression of Hsp70 and a predominance of TGF- 3, comparatively to TGF-1 and TGF-2 111,12


. This prophylactic


treatment can be carried out, without violation of the efficacy-Ð afety ratio, for an accurate surgical closure and restoration of skin condition.


MA Trelles, MDPhD, and J Alcolea, MD, Instituto M• dico Vilafortuny, Cambrils, Spaina


Figure 3 (A) Before breast reduction surgery. (B) Six months after surgery, notice the good healing with practically no residual traces of the incisions, achieved by LASH applied at the time of stitching the skin


Reference


1. Clark RAF. Wound repair: Overview and general consideration. In: Clark RAF. ed, The Molecular and Cellular Biology of Wound Repair. 2nd edn. New York: Plenum Press, 1998


2. Carlson MA, Longaker MT. The fibroblast-populated collagen matrix as a model of wound healing: a review of the evidence. Wound Repair Regen 2004; 12(2): 134–47


3. Funayama E, Chodon T, Oyama A, Sugihara T. Keratinocytes promote proliferation and inhibit apoptosis of the underlying


78 ❚


fibroblast: an important role in the pathogenesis of keloid. J Invest Dermatol 2003; 12(6): 1326–31


4. Lee Y. Combination treatments and classification of scars. J Med Scien 2011; 8(6): 312–34


5. Alster TS, Tanzi EL, Lazarus M. The use of fractional laser photothermolysis for the treatment of atrophic scars. Dermatol Surg 2007; 33(3): 295–9


6. Lee Y. Combination treatment of surgical, post-traumatic and post-herpetic scars with ablative


lasers followed by fractional laser and non-ablative laser in Asians. Lasers Surg Med 2009; 4(2): 131–40


7. Trelles MA, Vélez M, Mordon S. Correlation of histological findings of single session Er:YAG skin fractional resurfacing with various passes and energies and the possible clinical implications. Laser Surg Med 2008; 40(3): 171–7


8. Trelles MA. A Preliminary Report On The Linline™ Multiple Wavelength Laser Platform:Laser Treatment For Vascular, Pigmented And Cutaneous Disorders:


Performance And Recovery Ratio Related To Safety And Efficacy White Paper. Linline Belarus, 2011


Increase Efficacy Of Fractional Resurfacing Indications. IMCAS 14th Annual Conference Proceedings, Paris, 26–29 January 2012. Abstract 1628


9. Trelles MA. A Novel Approach Of CO2


Laser And Ultrasound To


10. Mordon S, Trelles MA. Ventajas De La Cicatrización Cutánea Asistida Por Láser (LASH). Cir Plást IberoLatinoam 2011: 37(4): 387–92


11. Capon A. Suture cutanée assistée par laser: étude des mécanismes d’accélération de la cicatrisation sur modèle animal et sur peau humaine. In: Ecole doctorale biologie santé. Lille: Université de Lille 2, 2003


12. Shah M, Foreman DM, Ferguson MW. Neutralization of TGF-beta 1 and TGF-beta 2 or exogenous addition of TGF-beta 3 to cutaneous rat wounds reduces scarring. J Cell Sci 1995; 108(Pt 3): 985–1002


June 2012 | prime-journal.com


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68  |  Page 69  |  Page 70  |  Page 71  |  Page 72  |  Page 73  |  Page 74  |  Page 75  |  Page 76  |  Page 77  |  Page 78  |  Page 79  |  Page 80  |  Page 81  |  Page 82  |  Page 83  |  Page 84