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Low versus High Fluence Parameters in the Treatment of Facial Laceration Scars with a 1,550 nm Fractional Erbium-Glass Laser.

Shim HS, Jun DW, Kim SW, Jung SN, Kwon H - Biomed Res Int (2015)

Bottom Line: Results.Conclusion.We compared the effects of high fluence and low fluence 1,550 nm fractional erbium-glass laser treatment for facial scarring in the early postoperative period and revealed that the high fluence parameter was more effective for scar management.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea, Republic of Korea.

ABSTRACT
Purpose. Early postoperative fractional laser treatment has been used to reduce scarring in many institutions, but the most effective energy parameters have not yet been established. This study sought to determine effective parameters in the treatment of facial laceration scars. Methods. From September 2012 to September 2013, 57 patients were enrolled according to the study. To compare the low and high fluence parameters of 1,550 nm fractional erbium-glass laser treatment, we virtually divided the scar of each individual patient in half, and each half was treated with a high and low fluence setting, respectively. A total of four treatment sessions were performed at one-month intervals and clinical photographs were taken at every visit. Results. Results were assessed using the Vancouver Scar Scale (VSS) and global assessment of the two portions of each individual scar. Final evaluation revealed that the portions treated with high fluence parameter showed greater difference compared to pretreatment VSS scores and global assessment values, indicating favorable cosmetic results. Conclusion. We compared the effects of high fluence and low fluence 1,550 nm fractional erbium-glass laser treatment for facial scarring in the early postoperative period and revealed that the high fluence parameter was more effective for scar management.

No MeSH data available.


Related in: MedlinePlus

5 × 10 mm handpiece tip was applied along the laceration scar.
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Related In: Results  -  Collection


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fig1: 5 × 10 mm handpiece tip was applied along the laceration scar.

Mentions: This prospective study was designed to establish the most effective fluence parameter. After approval of the Institutional Review Board of Uijeongbu St. Mary's Hospital, a total of 57 patients with Fitzpatrick skin types III–V were enrolled [6]. All patients with facial lacerations primarily sutured in the emergency room by the same senior resident of the plastic surgery department were considered candidates. Patients ranging from 15 to 50 years of age were included. Facial laceration was defined as a laceration within a limited area bordered by the forehead hair line, the preauricular area, and the mandibular angle to the chin. Patients with a facial laceration subcutaneous in depth evenly along the length within 6 cm representing a relatively clean cut without maceration were enrolled. However, patients with acute inflammation, a history of previous trauma, and keloid tendency or those using topical agents including steroids were excluded. Laser treatment began approximately 4 weeks after primary closure. The surface was cleansed with chlorhexidine solution and EMLA cream (a lidocaine-based topical anesthetic cream, AstraZeneca AB, Södertälje, Sweden) was applied for 30 minutes prior to treatment. After removal of the anesthetic cream, the scar was treated with a 1,550 nm fractional erbium-glass laser (MOSAIC HP, Lutronic Co., Ltd., Seoul, South Korea); all patients underwent four sessions at 4-week intervals. In each session, the laceration was virtually divided in half and each half was treated with different parameters: low energy portion (L portion), fluence of 10 mJ/spot, and density of 200 spots/cm2; high energy portion (H portion), 50 mJ/spot, and 40 spots/cm2. An equivalent amount of energy was delivered to each portion and the parameters and total energy for each session have been set constantly. With 5 × 10 mm handpiece tip (Figure 1), a total of three shots were delivered to each spot without overlap between the spots. The MOSAIC HP automatically starts with skin contact and stops at the end of each session after delivering a set of energy; hence the operator does not need to control the repetition rate or pulse duration.


Low versus High Fluence Parameters in the Treatment of Facial Laceration Scars with a 1,550 nm Fractional Erbium-Glass Laser.

Shim HS, Jun DW, Kim SW, Jung SN, Kwon H - Biomed Res Int (2015)

5 × 10 mm handpiece tip was applied along the laceration scar.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4508380&req=5

fig1: 5 × 10 mm handpiece tip was applied along the laceration scar.
Mentions: This prospective study was designed to establish the most effective fluence parameter. After approval of the Institutional Review Board of Uijeongbu St. Mary's Hospital, a total of 57 patients with Fitzpatrick skin types III–V were enrolled [6]. All patients with facial lacerations primarily sutured in the emergency room by the same senior resident of the plastic surgery department were considered candidates. Patients ranging from 15 to 50 years of age were included. Facial laceration was defined as a laceration within a limited area bordered by the forehead hair line, the preauricular area, and the mandibular angle to the chin. Patients with a facial laceration subcutaneous in depth evenly along the length within 6 cm representing a relatively clean cut without maceration were enrolled. However, patients with acute inflammation, a history of previous trauma, and keloid tendency or those using topical agents including steroids were excluded. Laser treatment began approximately 4 weeks after primary closure. The surface was cleansed with chlorhexidine solution and EMLA cream (a lidocaine-based topical anesthetic cream, AstraZeneca AB, Södertälje, Sweden) was applied for 30 minutes prior to treatment. After removal of the anesthetic cream, the scar was treated with a 1,550 nm fractional erbium-glass laser (MOSAIC HP, Lutronic Co., Ltd., Seoul, South Korea); all patients underwent four sessions at 4-week intervals. In each session, the laceration was virtually divided in half and each half was treated with different parameters: low energy portion (L portion), fluence of 10 mJ/spot, and density of 200 spots/cm2; high energy portion (H portion), 50 mJ/spot, and 40 spots/cm2. An equivalent amount of energy was delivered to each portion and the parameters and total energy for each session have been set constantly. With 5 × 10 mm handpiece tip (Figure 1), a total of three shots were delivered to each spot without overlap between the spots. The MOSAIC HP automatically starts with skin contact and stops at the end of each session after delivering a set of energy; hence the operator does not need to control the repetition rate or pulse duration.

Bottom Line: Results.Conclusion.We compared the effects of high fluence and low fluence 1,550 nm fractional erbium-glass laser treatment for facial scarring in the early postoperative period and revealed that the high fluence parameter was more effective for scar management.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea, Republic of Korea.

ABSTRACT
Purpose. Early postoperative fractional laser treatment has been used to reduce scarring in many institutions, but the most effective energy parameters have not yet been established. This study sought to determine effective parameters in the treatment of facial laceration scars. Methods. From September 2012 to September 2013, 57 patients were enrolled according to the study. To compare the low and high fluence parameters of 1,550 nm fractional erbium-glass laser treatment, we virtually divided the scar of each individual patient in half, and each half was treated with a high and low fluence setting, respectively. A total of four treatment sessions were performed at one-month intervals and clinical photographs were taken at every visit. Results. Results were assessed using the Vancouver Scar Scale (VSS) and global assessment of the two portions of each individual scar. Final evaluation revealed that the portions treated with high fluence parameter showed greater difference compared to pretreatment VSS scores and global assessment values, indicating favorable cosmetic results. Conclusion. We compared the effects of high fluence and low fluence 1,550 nm fractional erbium-glass laser treatment for facial scarring in the early postoperative period and revealed that the high fluence parameter was more effective for scar management.

No MeSH data available.


Related in: MedlinePlus