Comparing Line-Field Confocal Optical Coherence Tomography and Reflectance Confocal Microscopy on the In Vivo Healing Process of Lesions Induced by Fractional Photothermolysis.

IF 2.2 3区医学 Q2 DERMATOLOGY Lasers in Surgery and Medicine Pub Date : 2024-09-08 DOI:10.1002/lsm.23841

Sergio Del Río-Sancho, Stephanie Christen-Zaech, David Alvarez Martinez, Jöri Pünchera, Rastine Merat, Hans Joachim Laubach

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Abstract

Background: The advent of ablative fractional photothermolysis has revolutionized laser dermatology by providing a method to produce well-standardized, precise, and repeatable microscopic lesions. These wounds typically heal within 1-3 weeks, depending on the body site, with a minimal risk of permanent scarring. This positions ablative fractional photothermolysis as an exemplary in vivo model for studying the skin's wound healing processes.

Objectives: This study aims to evaluate and compare the effectiveness of two noninvasive imaging techniques, reflectance confocal microscopy (RCM) and line-field confocal optical coherence tomography (LC-OCT), in assessing skin wound healing following microscopic injuries induced by ablative fractional photothermolysis.

Methods: The forearms of participating volunteers were treated and ablated with a CO₂-Laser in a fractional pattern using varying power settings (2.5-10 mJ/MTZ). In vivo RCM and LC-OCT images were obtained at predefined time intervals post-laser treatment, ranging from 6 h to 14 days.

Results: Vertical visualization of the lesions through both imaging modalities revealed a healing process characterized by the upward and outward movement of microscopic epidermal necrotic debris, thereby reducing the depth of the injury while forming an external crust. LC-OCT imaging demonstrated more comprehensive results with fewer movement artifacts. Conversely, horizontal visualization with both techniques highlighted a gathering of keratinocytes around the wounds, indicating the initiation of the regenerative process. RCM provided superior image clarity in this horizontal plane.

Conclusions: RCM and LC-OCT offer valuable and complementary noninvasive alternatives to conventional biopsy methods for the assessment and characterization of the skin's wound healing process post-ablative fractional photothermolysis. These findings underscore the potential of such imaging techniques in enhancing our understanding of the wound healing process.

Trial registration: ClinicalTrials.gov identifier: NCT05614557.

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比较线场共聚焦光学相干断层扫描和反射共聚焦显微镜对点阵光热解诱导的病变体内愈合过程的影响

背景：烧蚀点阵光热解技术的出现为激光皮肤病学带来了革命性的变化，它提供了一种可以产生标准化、精确、可重复的微小病变的方法。这些伤口通常在 1-3 周内愈合，具体时间取决于身体部位，永久性疤痕的风险极低。这就使烧蚀点阵光热解成为研究皮肤伤口愈合过程的典范：本研究旨在评估和比较反射共聚焦显微镜（RCM）和线场共聚焦光学相干断层扫描（LC-OCT）这两种无创成像技术在评估消融点阵光热解术诱导的微小损伤后皮肤伤口愈合方面的有效性：方法：使用不同功率设置（2.5-10 mJ/MTZ）的 CO2 激光以点阵模式对参与志愿者的前臂进行治疗和消融。在激光治疗后的预定时间间隔（6 小时至 14 天不等）内获取体内 RCM 和 LC-OCT 图像：结果：通过这两种成像模式对病变进行垂直观察，发现愈合过程的特点是微小的表皮坏死碎片向上和向外移动，从而减少了损伤深度，同时形成了外部结痂。LC-OCT 成像显示的结果更全面，移动伪影更少。相反，两种技术的水平成像都能突出显示伤口周围角质细胞的聚集，表明再生过程的开始。RCM 在这一水平面的图像清晰度更高：结论：RCM 和 LC-OCT 为评估和描述消融点阵光热解术后皮肤伤口愈合过程提供了有价值的非侵入性替代方法，是传统活检方法的补充。这些发现强调了此类成像技术在增进我们对伤口愈合过程的了解方面的潜力：试验注册：ClinicalTrials.gov identifier：NCT05614557.

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来源期刊

Lasers in Surgery and Medicine 医学-外科

CiteScore

5.40

自引率

12.50%

发文量

119

审稿时长

1 months

期刊介绍： Lasers in Surgery and Medicine publishes the highest quality research and clinical manuscripts in areas relating to the use of lasers in medicine and biology. The journal publishes basic and clinical studies on the therapeutic and diagnostic use of lasers in all the surgical and medical specialties. Contributions regarding clinical trials, new therapeutic techniques or instrumentation, laser biophysics and bioengineering, photobiology and photochemistry, outcomes research, cost-effectiveness, and other aspects of biomedicine are welcome. Using a process of rigorous yet rapid review of submitted manuscripts, findings of high scientific and medical interest are published with a minimum delay.