treatment of mild to moderate periorbital aging in Asians with ultrapulsed fractional CO 2 laser / 中华医学美学美容杂志

Objective:To evaluate the clinical effect of ultrapulse fractional CO 2 laser in the treatment of mild to moderate orbital aging in Asians. Methods:From January 2018 to December 2018, 36 patients (72 eyes) with mild to moderate orbital aging were enrolled, 22 women and 14 men, with an average age of 32.4 years. Each patient was randomly divided into two groups. In the traditional operation group, 36 eyes received blepharoplasty through traditional inferior conjunctival approach. In the ultrapulsed fractional CO 2 laser group, 36 eyesunderwent blepharoplasty through the lower eyelid conjunctival approach assisted by optoelectronics. Both groups were treated with ultrapulsed fractional CO 2 laser for periorbital aging. The operation time, detumescence time and postoperative complications were compared. At the same time, the periorbital skin relaxation was treated by the combination of the two groups. The patients were followed up for 12 months. Results:In the traditional operation group, 11 cases were evaluated as Barton grade Ⅰ preoperatively, and the efficacy score was 0.64±0.21. In 25 cases of Barton grade Ⅱ the efficacy score was 1.34±0.34. 17 cases were Barton Ⅰ in photoelectric assisted group, and the efficacy score was 0.92±0.18. In 19 cases of Barton grade Ⅱ, the efficacy score was 1.71±0.42. There was a statistically significant difference between the two groups in Barton Ⅰ efficacy score, P<0.05 ( P=0.016); There was also a statistically significant difference between the two groups in efficacy score of Barton Ⅱ, P<0.05 ( P=0.039). The operation time of the photoelectric assisted group was (12.00±1.82) minutes, and the edema duration was (4.0±1.8) days. The duration of operation in the conventional surgery group was (16.00±3.75) minutes, and the duration of edema was (7.0±2.4) days. The operation time and edema duration in the photoelectric assisted group were both shorter than those in the traditional operation group, and the differences were statistically significant ( P<0.05). Conclusions:The blepharoplasty through traditional inferior conjunctival approach assisted with ultrapulsed fractional CO 2 laser has no obvious bleeding, with shorter operation time, swelling reduction time and the number of complications than the traditional operation.This method can solve the symptoms of blepharoplasty, lower eyelid skin relaxation and wrinkles around eyes. This method is worthy of promotion in the treatment of patients with mild to moderate periorbital aging.

Histological changes of the dermal-epidermal junction of superficial scarin rabbit ears induced by ultrapulse CO2 fractional laser / 中华医学美学美容杂志

Objective To explore the effects of wound healing and histological changes by utilizing ultrapulse CO2 fractional laser for the treatment of superficial scar in dermal-epidermal junction (DEJ) in rabbit ears.Methods We adopted traditional iodophor treatment and moist exposed burn ointment treatment repairing the wound and utilizing ultra pulse CO2 fractional laser for the treatment of rabbit ears superficial scar.The superficial scars in rabbit ear were induced with ultra pulse CO2 fractional laser.In 1,2,4,8 weeks tissue samples would be taken.Using electron microscopy we observed DEJ ultrastructure and light microscopy to observe the histological changes of the dermal papilla and PAS staining for epidermis basement membrane.Results The wound healing time of moist exposed burn ointment group was shorter than that of iodophor group (P＜0.05).The number of hemidesmosomes and anchoring fibers in the moist exposed burn ointment group on the 8th week was more than the 1th week,The number of hemidesmosomes and anchoring fibers in the iodophor group on 8th week was more than 1th week (P ＜0.05).The number of hemidesmosomes and anchoring fibers in the iodophor group was less than the moist exposed burn ointment group (P＜0.05).Conclusions U1trapulse CO2 fractional laser can cause ultra structural changes in scarring dermal-epidermal junction area,wet wound healing environment promotes the reconstruction of DEJ district organization,and rebuilding the function of the scar skin has the positive significance.

A Case of Vulvar Lymphangioma Circumscriptum Treated with an UltraPulse Carbon Dioxide Laser / 대한피부과학회지

Lymphangioma circumscriptum is a rare, benign disorder of no specific etiology involving the lymphatic channels in the deep dermal and subcutaneous layers. Lymphangioma circumscriptum can occur as either a congenital abnormality or as acquired damage to previously normal lymphatic channels. It can occur at any site in the body, especially the thigh, buttock, upper arm, axilla, and tongue, but rarely the vulva. Surgical management and laser therapy are usually performed, but other management strategies have been suggested because of frequent recurrence and cosmetic problems. We report a 64-year-old female patient who had lymphangioma circumscriptum of the vulva and who was successfully treated with an UltraPulse CO2 laser.

Application of ultra-pulse CO2 laser in blepharoplasty / 中华医学美学美容杂志

Objective To explore the applied values of ultra-pulse CO2 laser in blepharoplasty by shortening procedure time, improving the surgical satisfactory result and alleviating the operative and postoperative hemorrhage. Methods 238 patients with bulging, redundant skin in the upper and lower eye lids, including brow lift (26 cases), double eye lid surgery (48 cases), and lower lash line incision (159 cases). Laser incision was implemented with the ultra-pulse CO2 laser system. Results Bleeding was scant in 238 cases and hence local swelling subsided quickly with excellent healing. No eetropion, he-matoma and diplopia ever occurred. 3 months to 3 years follow-up showed satisfactory for all the patients. The result was quite satisfied in clinical observation and postoperative follow-up. Conclusion Utilizing the ultra-pulse CO2 laser in blepharoplasty has confirmed the satifisfatory surgical results, decreasing the surgical time, and reducing the intraoperative and postoperative bleeding.

The Establishment of a Wound Model Induced by Ultrapulse CO2 Laser / 대한피부과학회지

BACKGROUND: Wound model is important for the development of dressing materials used in dermatologic practice. Most of the wound healing models are not standardized, individualized ones for each special situation. OBJECTIVES: The purpose of our study is to establish a standardized wound model for evaluating the efficiency of wound healing of dressing material and the effect of epidermal growth factor(EGF) on artificially induced wounds. METHODS: Using ultrapulse CO2 laser and rats, we calibrates the most effective level of energy, frequency, and pulse duration for a wound model of upper dermis. Then, we evaluated the effect of various dressing materials such as vaseline gauze, collagen sponge, collagen sponge containing EGF and hydrogel on wound healing. RESULTS: We obtained relatively even and uniformed wound models of upper dermal level with the setting of ultrapulse CO2 laser; continuous mode, 800watt, frequency of 100Hz, and pulse duration of 0.3ms. Wounds applied with collagen sponge containing EGF showed relatively accelerated wound healing, but wounds with hydrogel or collagen sponge only showed delayed healing of wounds CONCLUSION: Ultrapulse CO2 laser could make a wound model of uniform depth level and could be used as a tool for making standardized wound models.

Experimental Analysis of Skin Regeneration after Ablation of Ultrapulse and Clearpulse Laser

Lasers are used increasingly in the surgical field. As far as plastic surgery is concerned, CO2 lasers are the most frequently used lasers especially in removing superficial skin lesions. But the traditional continuous mode CO2 lasers causes thermal injury in the surrounding tissues by heat diffusion, thus preventing the widespread clinical use. However, CO2 lasers of the continuous mode are being replaced by pulsed type, which emit high-energy pulse in a short period of time. Keeping the pulse length below the thermal relaxation time, these pulsed CO2 lasers vaporize tissues with less thermal injuries in the surrounding tissues. We irradiated Clearpulse and Ultrapulse lasers on the back of two swine models, Seven spots with 3 mm diameter were measured. We observed the histological changes of injuries and regeneration, and analyzed the depth of the thermal injury and the thickness of the regenerating epidermis quantitatively with image analyzer according to the time sequence(immediate, 1 day, 3 days, 1 week, 2 weeks, 3 weeks, 4weeks). In Clearpulse group, there was epidermolysis and the depth of thermal injury was 432 +/- 12.7micrometer, whereas in Ultrapulse group, the epidermis showed just coagulation necrosis and the depth of thermal injury was measured as 217 +/- 8.7micrometer. Clearpulse group showed the healing pattem of dermis, while Ultrapulse group showed the healing pattern of epidermis. That means Ultrapulse group is superior to Clearpulse group considering healing time. But all specimens obtained the complete healing of skin around 4th week after ablation.

Vaporization of Orbital Lymphangioma with Ultrapulse CO2 Laser

Orbital lymphangioma is a benign vascular hamartoma that may be found in the conjunctiva, eyelids, orbit, or elsewhere in the head and neck region. Deep lymphangiomatous lesions are classically characterized by acute onset of a fulminant proptosis resulting from spontaneous hemorrhage within the orbit. Complete surgical excision is often difficult because of the infiltrative nature of the tumor. Moreover, because of the hemorrhagic and friable nature of the tumor, conventional surgical techniques are frequently complicated by bleeding. We treated a case of pathologically-proven orbital lymphangioma with the ultrapulse CO2 laser. The ultrapulse CO2 laser permits a precise form of treatment with the ultimate form of hemostasis[tissue vaporization], resulting in minimal trauma, edema, and scarring, and thus offers a safe alternative to surgical excision of this lesion. The ultrapulse CO2 laser is an best ideal instrument for subtotal excision of this lesion because of its hemostatic cutting-vaporizing actions.