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Complications of Chemical Peels, Lasers, and Energy-Based Device Procedures Performed by Core Cosmetic Physicians: A Retrospective Analysis 由核心美容医师实施的化学换肤、激光和基于能量的设备程序的并发症：回顾性分析。
IF 2.2 3区 医学 Q2 DERMATOLOGY
Lasers in Surgery and Medicine
Pub Date : 2024-07-25 DOI: 10.1002/lsm.23820
Taryn N. Murray, Rishabh Lohray, Kelly P. Schultz, Sean Boutros, Paul M. Friedman

Background

There has been a proliferation of physicians of different levels of experience and training offering nonsurgical cosmetic procedures. Rising demand, compounded by increasing utilization of new and existing technologies by numerous physician specialties, compels discussion of adequate standardized training and patient safety.

Methods

A retrospective chart review of patients who presented to our single site dermatology clinic for managment of complications following chemical peel, laser or energy-based device treatments performed by core cosmetic physicians between the years of 2013 and 2024 was conducted. Core cosmetic physicians included plastic surgery, facial surgery/otolaryngology, oculoplastic surgery, and dermatology. Charts were reviewed for documentation of the type of complication, procedure causing the complication, and physician credentials, and referral source.

Results

Twenty-five patients were identified as having complications from chemical peeling, laser treatment or energy-based devices. Devices implicated included CO2 laser (fractional or fully ablative), chemical peels, 1064 nm long-pulsed Nd:YAG laser, 1320 nm Nd:YAG laser, intense pulsed light, 595 nm pulsed dye laser, Q-switched Nd:YAG laser, radiofrequency with and without microneedling, and 1550 nm erbium-doped fiber laser. Complications included hypertrophic scarring, atrophic scarring, post-inflammatory erythema, post-inflammatory hyperpigmentation, and post-inflammatory hypopigmentation.

Conclusions

Even in experienced hands, complications can arise. It is imperative that all physicians offering cosmetic treatments are equipped to recognize clinical endpoints, identify and manage complications, or make a timely referral to decrease the risk of a permanent and potentially devastating esthetic outcome for patients.

背景：提供非手术美容手术的医生数量激增，他们的经验和培训水平参差不齐。日益增长的需求以及众多专科医师对新技术和现有技术越来越多的使用，促使人们开始讨论适当的标准化培训和患者安全问题：方法：我们对 2013 年至 2024 年期间在我们的单点皮肤科诊所就诊、接受由核心美容医师实施的化学换肤、激光或能量设备治疗后出现并发症的患者进行了回顾性病历审查。核心美容医师包括整形外科、面部外科/耳鼻喉科、眼部整形外科和皮肤科。对病历进行了审查，以记录并发症的类型、导致并发症的手术、医生资质和转诊来源：结果：25 名患者被确认为因化学换肤、激光治疗或能量设备引起的并发症。涉及的设备包括二氧化碳激光器（点阵式或全烧蚀式）、化学换肤、1064 nm长脉冲Nd:YAG激光器、1320 nm Nd:YAG激光器、强脉冲光、595 nm脉冲染料激光器、Q开关Nd:YAG激光器、带或不带微针的射频以及1550 nm掺铒光纤激光器。并发症包括增生性瘢痕、萎缩性瘢痕、炎症后红斑、炎症后色素沉着和炎症后色素减退：结论：即使是经验丰富的医生，也可能出现并发症。所有提供美容治疗的医生都必须具备识别临床终点、识别和处理并发症或及时转诊的能力，以降低给患者带来永久性和潜在破坏性美容结果的风险。
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引用次数: 0
Blue Light Compromises Bacterial β-Lactamases Activity to Overcome β-Lactam Resistance 蓝光削弱细菌 β-内酰胺酶的活性以克服 β-内酰胺抗药性
IF 2.2 3区 医学 Q2 DERMATOLOGY
Lasers in Surgery and Medicine
Pub Date : 2024-07-22 DOI: 10.1002/lsm.23819
Carolina dos Anjos, Yin Wang, Que Chi Truong-Bolduc, Paul K. Bolduc, Matthew Liu, David C. Hooper, R. Rox Anderson, Tianhong Dai, Leon G. Leanse

Objective

In this study, we evaluated the effectiveness of antimicrobial blue light (aBL; 410 nm wavelength) against β-lactamase-carrying bacteria and the effect of aBL on the activity of β-lactamases.

Methods

Pseudomonas aeruginosa, Escherichia coli, and Klebsiella pneumoniae strains carrying β-lactamases as well as a purified β-lactamase enzymes were studied. β-lactamase activity was assessed using a chromogenic cephalosporin hydrolysis assay. Additionally, we evaluated the role of porphyrins in the photoreaction, as well as protein degradation by sodium dodecyl-sulfate polyacrylamide gel electrophoresis (SDS-PAGE). Finally, we investigated the bactericidal effect of combined aBL-ceftazidime exposure against a metallo-β-lactamase expressing P. aeruginosa strain.

Results

Our study demonstrated that aBL effectively killed β-lactamase-producing bacteria and reduced β-lactamase activity. After an aBL exposure of 1.52 J/cm2, a 50% reduction in enzymatic activity was observed in P. aeruginosa. Additionally, we found a 40% decrease in the photoreaction activity of porphyrins following an aBL exposure of 64.8 J/cm2. We also revealed that aBL reduced β-lactamase activity via protein degradation (after 136.4 J/cm2). Additionally, aBL markedly improved the bactericidal effect of ceftazidime (by >4-log10) in the metallo-β-lactamase P. aeruginosa strain.

Conclusion

Our results provide evidence that aBL compromises bacterial β-lactamase activity, offering a potential approach to overcome β-lactam resistance in bacteria.

研究目的在这项研究中，我们评估了抗菌蓝光（aBL；波长 410 nm）对携带 β-内酰胺酶细菌的有效性以及 aBL 对 β-内酰胺酶活性的影响：研究了携带β-内酰胺酶的铜绿假单胞菌、大肠埃希菌和肺炎克雷伯菌株以及纯化的β-内酰胺酶。此外，我们还评估了卟啉在光反应中的作用，以及十二烷基硫酸钠聚丙烯酰胺凝胶电泳（SDS-PAGE）对蛋白质降解的影响。最后，我们研究了 aBL 与头孢唑肟联合暴露对表达金属-β-内酰胺酶的铜绿假单胞菌菌株的杀菌效果：结果：我们的研究表明，aBL 能有效杀死产β-内酰胺酶的细菌，并降低β-内酰胺酶的活性。在暴露于 1.52 J/cm2 的 aBL 后，铜绿假单胞菌的酶活性降低了 50%。此外，我们还发现，在暴露于 64.8 J/cm2 的 aBL 后，卟啉的光反应活性降低了 40%。我们还发现，aBL 通过蛋白质降解降低了 β-内酰胺酶的活性（136.4 J/cm2 后）。此外，aBL 还显著改善了头孢唑肟对金属-β-内酰胺酶铜绿葡萄球菌菌株的杀菌效果（>4-log10）：我们的研究结果提供了 aBL 可抑制细菌 β-内酰胺酶活性的证据，为克服细菌对 β-内酰胺的耐药性提供了一种潜在的方法。
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引用次数: 0
Treatment of Iron-Induced Cutaneous Hyperpigmentation With Energy-Based Devices 利用基于能量的设备治疗铁诱导的皮肤色素沉着。
IF 2.2 3区 医学 Q2 DERMATOLOGY
Lasers in Surgery and Medicine
Pub Date : 2024-07-15 DOI: 10.1002/lsm.23825
Ajay N. Sharma, Nicole M. Golbari, Solomiya Grushchak, Adriana Ribas Andrade, Christopher B. Zachary

Objectives

Iatrogenic cutaneous siderosis is a well-recognized dermatologic complication after parenteral iron infusion. The condition manifests as discrete, hyperpigmented patches near the site of injection. Most cases do not resolve spontaneously, leading to significant aesthetic and psychological distress to patients. A recent case of iatrogenic cutaneous siderosis at our institution prompted a systematic review of the efficacy of energy-based devices previously reported in the treatment of this condition.

Methods

PubMed and Cochrane databases were searched for all peer-reviewed articles published using the following search terms: “iron OR heme OR hemosiderosis OR siderosis” and “hyperpigmentation OR staining OR tattoo.” Articles reporting on energy-based devices in the treatment of iron-induced hyperpigmentation were included.

Results

A total of seven articles and 54 total patients were included in this review. All patients, including the patient treated at our institution, were female, with an average age of 44 years. Hyperpigmentation was most commonly associated with intravenous iron infusion (48/54, 89%), on the arm or forearm (44/54, 81%), and used for the treatment of underlying iron deficiency anemia (54/54, 100%). The application of six different nanosecond or picosecond quality-switched laser systems was reported in the treatment of cutaneous siderosis, with wavelengths ranging from 532 to 1064 nm. Spot sizes varied between 2 and 7 mm, with energy fluences spanning 0.5–40 J/cm2 depending on both the device and spot size. Outcomes were measured after an average of 5.4 laser treatments and 10.4 months, with over half of all reported patients experiencing complete clearance (27/50, 54%). Our patient received treatment in three test areas with picosecond alexandrite 785 nm, nanosecond Nd:YAG 532 nm, and picosecond Nd:YAG 532 nm devices. The nanosecond Nd:YAG 532 nm treated area demonstrated the greatest improvement, and the entire arm was subsequently treated with this device.

Conclusions

Despite the often intractable nature of iatrogenic cutaneous siderosis, laser surgery is a reasonable and safe treatment modality for patients seeking cosmetic improvement of this dyschromia. Dermatologists should be aware of this entity and the efficacy of the energy-based devices currently in our armamentarium. A combination approach may need to be utilized with different wavelengths and pulsed widths to target iron pigment in both dermal and subcutaneous layers.

目的：先天性皮肤巩膜病是一种公认的肠外输注铁剂后的皮肤并发症。这种病症表现为注射部位附近不连续的色素沉着斑块。大多数病例不会自行消退，会给患者带来严重的美观和心理困扰。我院最近接诊了一例先天性皮肤巩膜沉着症患者，这促使我们对之前报道过的治疗这种病症的能量设备的疗效进行了系统性回顾：方法：在 PubMed 和 Cochrane 数据库中搜索所有同行评审发表的文章，搜索关键词如下："铁或血红素或血色素沉着或蚕豆病 "和 "色素沉着或染色或纹身"。结果：共有 7 篇文章和 54 名患者被纳入本综述。所有患者（包括在我院接受治疗的患者）均为女性，平均年龄为 44 岁。色素沉着最常见于静脉输注铁剂（48/54，89%）、手臂或前臂（44/54，81%），以及用于治疗潜在缺铁性贫血（54/54，100%）。据报道，有六种不同的纳秒或皮秒质量开关激光系统被用于治疗皮肤巩膜沉着症，波长从 532 纳米到 1064 纳米不等。光斑大小从 2 毫米到 7 毫米不等，能量流从 0.5 焦耳/平方厘米到 40 焦耳/平方厘米不等，具体取决于设备和光斑大小。结果在平均 5.4 次激光治疗和 10.4 个月后进行了测量，超过半数的患者（27/50，54%）获得了完全清除。我们的患者在三个测试区域接受了皮秒紫翠宝石 785 nm、纳秒 Nd:YAG 532 nm 和皮秒 Nd:YAG 532 nm 设备的治疗。纳秒 Nd:YAG 532 nm 治疗区域的改善幅度最大，随后整个手臂都使用了这种设备进行治疗：结论：尽管先天性皮肤菱形细胞增多症往往难以治愈，但激光手术是一种合理、安全的治疗方法，可帮助患者改善这种色素沉着症的外观。皮肤科医生应了解这种病症以及目前我们所使用的能量设备的疗效。可能需要使用不同波长和脉冲宽度的组合方法来针对真皮层和皮下层的铁色素。
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引用次数: 0
Combined CO2 Laser Vaporization and Bleomycin Injection to Treat Huge Adult Laryngeal Vascular Anomalies: Innovative Application of CO2 Laser in Otolaryngology 联合二氧化碳激光汽化和博莱霉素注射治疗巨大成人喉血管畸形：二氧化碳激光在耳鼻喉科的创新应用。
IF 2.2 3区 医学 Q2 DERMATOLOGY
Lasers in Surgery and Medicine
Pub Date : 2024-07-11 DOI: 10.1002/lsm.23824
Xiufa Wu, Jing Zhang, Rui Fang, Chunsheng Wei

Objectives

The aim of this study was to assess the value of CO2 laser vaporization in treating huge adult laryngeal vascular anomalies (HALVAs) by combining it with bleomycin injection.

Materials and Methods

This study retrospectively reviewed the records of 13 adult patients who underwent 18 different procedures. Methods to treat HALVAs include traditional bleomycin injection and CO2 laser vaporization combined with bleomycin injection between September 2009 and January 2023. Treatment results were evaluated by the grade of lumen constriction.

Results

A total of five males and eight females, with an average age of 46.3 years (range, 22–66 years), were included in the study. The huge adult laryngeal vascular anomalies in our study were greater than 1633.71 mm3, and the long diameters of the bases were longer than 15 mm. Compared with the bleomycin injection-only group, the results with the CO2 laser vaporization and bleomycin injection combined were better.

Conclusions

Both bleomycin injection and CO2 laser vaporization are safe treatment methods. Their combination may produce better results for huge adult laryngeal vascular anomalies.

研究目的本研究旨在评估二氧化碳激光气化术与博莱霉素注射相结合治疗巨大成人喉血管畸形（HALVAs）的价值：本研究回顾性审查了 13 名成年患者的病历，他们接受了 18 种不同的手术。2009年9月至2023年1月期间，治疗HALVA的方法包括传统的博莱霉素注射和二氧化碳激光汽化联合博莱霉素注射。治疗结果根据管腔收缩程度进行评估：共有 5 名男性和 8 名女性参与了研究，平均年龄为 46.3 岁（22-66 岁）。我们研究中的巨大成人喉血管畸形大于1633.71立方毫米，基底长径大于15毫米。与仅注射博莱霉素组相比，二氧化碳激光汽化和博莱霉素注射联合治疗的效果更好：博莱霉素注射和二氧化碳激光汽化都是安全的治疗方法。结论：博来霉素注射法和二氧化碳激光汽化法都是安全的治疗方法，两者结合治疗巨大成人喉血管畸形可能会取得更好的效果。
{"title":"Combined CO2 Laser Vaporization and Bleomycin Injection to Treat Huge Adult Laryngeal Vascular Anomalies: Innovative Application of CO2 Laser in Otolaryngology","authors":"Xiufa Wu,&nbsp;Jing Zhang,&nbsp;Rui Fang,&nbsp;Chunsheng Wei","doi":"10.1002/lsm.23824","DOIUrl":"10.1002/lsm.23824","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aim of this study was to assess the value of CO<sub>2</sub> laser vaporization in treating huge adult laryngeal vascular anomalies (HALVAs) by combining it with bleomycin injection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This study retrospectively reviewed the records of 13 adult patients who underwent 18 different procedures. Methods to treat HALVAs include traditional bleomycin injection and CO<sub>2</sub> laser vaporization combined with bleomycin injection between September 2009 and January 2023. Treatment results were evaluated by the grade of lumen constriction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of five males and eight females, with an average age of 46.3 years (range, 22–66 years), were included in the study. The huge adult laryngeal vascular anomalies in our study were greater than 1633.71 mm<sup>3</sup>, and the long diameters of the bases were longer than 15 mm. Compared with the bleomycin injection-only group, the results with the CO<sub>2</sub> laser vaporization and bleomycin injection combined were better.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Both bleomycin injection and CO<sub>2</sub> laser vaporization are safe treatment methods. Their combination may produce better results for huge adult laryngeal vascular anomalies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141590683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correction to “Analysis of Penetration Depth and Healing Process of a Needleless Laser Lancet Using Swept-Source Optical Coherence Tomography” 利用扫源光学相干断层扫描分析无针激光柳叶刀的穿透深度和愈合过程 "的更正。
IF 2.2 3区 医学 Q2 DERMATOLOGY
Lasers in Surgery and Medicine
Pub Date : 2024-07-09 DOI: 10.1002/lsm.23826

D. H. Mun, P. S. Chung, S. H. Woo, and J. B. Eom, “Analysis of Penetration Depth and Healing Process of a Needleless Laser Lancet Using Swept-Source Optical Coherence Tomography,” Lasers in Surgery and Medicine 54, no. 10 (December 2022): 1278–1287, https://doi.org/10.1002/lsm.23616.

In the article, the current Acknowledgments section reads as follows:

“This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Education (grant: 2021R1I1A3061025), and by the Korea Medical Device Development Fund grant funded by the Korean government (the Ministry of Science and ICT, the Ministry of Trade, Industry and Energy, the Ministry of Health & Welfare, the Ministry of Food and Drug Safety) (Project Number: RS-2020-KD000024).” This information in this section is incorrect.

The correct Acknowledgments should read as:

“This research was supported by the research fund of Dankook University in 2020.”

We apologize for our mistake and any inconvenience it may have caused.

D.D. H. Mun, P. S. Chung, S. H. Woo, and J. B. Eom, "Analysis of Penetration Depth and Healing Process of a Needleless Laser Lancet Using Swept-Source Optical Coherence Tomography," Lasers in Surgery and Medicine 54, no..在这篇文章中，目前的致谢部分内容如下："本研究得到了韩国教育部资助的韩国国家研究基金会（NRF）基础科学研究项目的支持（资助号：2021R1I1A3061025），以及韩国政府（科学和信息通信技术部、贸易、工业和能源部、保健福祉部、食品和药品安全部）资助的韩国医疗设备开发基金资助（项目编号：RS-2020-KD000024）"。本节中的信息有误，正确的致谢应为："本研究得到了韩国檀国大学 2020 年研究基金的支持"。
{"title":"Correction to “Analysis of Penetration Depth and Healing Process of a Needleless Laser Lancet Using Swept-Source Optical Coherence Tomography”","authors":"","doi":"10.1002/lsm.23826","DOIUrl":"10.1002/lsm.23826","url":null,"abstract":"<p>D. H. Mun, P. S. Chung, S. H. Woo, and J. B. Eom, “Analysis of Penetration Depth and Healing Process of a Needleless Laser Lancet Using Swept-Source Optical Coherence Tomography,” <i>Lasers in Surgery and Medicine</i> 54, no. 10 (December 2022): 1278–1287, https://doi.org/10.1002/lsm.23616.</p><p>In the article, the current Acknowledgments section reads as follows:</p><p>“This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Education (grant: 2021R1I1A3061025), and by the Korea Medical Device Development Fund grant funded by the Korean government (the Ministry of Science and ICT, the Ministry of Trade, Industry and Energy, the Ministry of Health &amp; Welfare, the Ministry of Food and Drug Safety) (Project Number: RS-2020-KD000024).” This information in this section is incorrect.</p><p>The correct Acknowledgments should read as:</p><p>“This research was supported by the research fund of Dankook University in 2020.”</p><p>We apologize for our mistake and any inconvenience it may have caused.</p>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lsm.23826","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Addressing Burn Hypertrophic Scar Symptoms Earlier: Laser Scar Revision May Begin as Early as 3–6 Months After Injury 提早解决烧伤肥厚性疤痕症状：激光疤痕修复最早可在受伤后 3-6 个月开始。
IF 2.2 3区 医学 Q2 DERMATOLOGY
Lasers in Surgery and Medicine
Pub Date : 2024-07-07 DOI: 10.1002/lsm.23822
Victoria Slavinsky, Jasmine H. Wong, Bonnie C. Carney, Davon T. Lee, Rebekah Allely, Jeffrey W. Shupp, Shawn Tejiram, Taryn E. Travis

Objectives

Fractional ablative CO2 laser (FLSR) is used to treat hypertrophic scars (HTSs) resulting from burn injuries, which are characterized by factors, such as erythema, contracture, thickness, and symptoms of pain and itch. Traditionally, waiting a year after injury for scar maturation before starting laser treatment has been recommended; however, the potential benefits of earlier intervention have gained popularity. Still, the optimal timing for beginning laser intervention in patients with HTSs remains uncertain. This study aims to evaluate the ideal timing for the initiation of FLSR for HTSs using several qualitative and quantitative assessment measures. It was hypothesized that early intervention would lead to similar improvement trends as later intervention, however, would be more ideal due to the shortened time without symptom relief for patients.

Methods

Patients who received three or more laser treatment sessions and completed both pre- and posttreatment evaluations were included in this analysis (n = 69). FLSR treatment was administered at 4–8-week intervals. Patients starting treatment before 6 months after injury were classified as the early-stage intervention group and those beginning treatment at 6–12 months after injury were classified as the late-stage intervention group. Demographic data, including the age of patients at the time of first treatment, age of scars at the time of first treatment, biological sex, ethnicity, Fitzpatrick skin type, and use of laser-assisted drug delivery, were collected by retrospective chart review. Patients were evaluated on six subjective scales and objectively for scar stiffness with durometry. For all scales, higher scores indicate worse scars. A two-way ANOVA, Student's t-test, and Mann–Whitney U-test were used to compare scores from the pre- to posttreatment evaluations.

Results

There were no significant differences between the groups for any of the demographic or scar-specific variables; thus, differences in outcome can be attributed to the timing of intervention. Both groups demonstrated an improvement in scars with treatment over time (p < 0.05). Both early- and middle-stage initiation showed scar symptom improvement in five out of six scales. In the late-stage intervention, the Patient and Observer Scar Assessment Scale-Patient average score did not show improvement. In the early-stage intervention, the Vancouver Scar Scale total did not show improvement. Quantitative evaluation of scar stiffness by durometry did not show symptom improvement in

目的：点阵烧蚀二氧化碳激光（FLSR）用于治疗烧伤导致的增生性疤痕（HTSs），这些疤痕的特征包括红斑、挛缩、厚度以及疼痛和瘙痒症状。传统上，建议在受伤一年后待疤痕成熟后再开始激光治疗；然而，提早干预的潜在益处已广为流行。不过，HTS 患者开始激光治疗的最佳时机仍不确定。本研究旨在通过几种定性和定量评估方法，评估开始对 HTSs 进行 FLSR 治疗的理想时机。假设早期干预会导致与晚期干预相似的改善趋势，但由于患者症状未缓解的时间缩短，因此早期干预更为理想：方法：接受过三次或三次以上激光治疗并完成治疗前和治疗后评估的患者被纳入本次分析（n = 69）。FLSR治疗间隔为4-8周。伤后 6 个月前开始治疗的患者被列为早期干预组，伤后 6-12 个月开始治疗的患者被列为晚期干预组。通过回顾性病历审查收集了患者的人口统计学数据，包括首次治疗时的年龄、首次治疗时的疤痕年龄、生理性别、种族、菲茨帕特里克皮肤类型以及激光辅助给药的使用情况。对患者进行了六项主观评分，并使用硬度计对疤痕硬度进行了客观评估。在所有量表中，疤痕越深表示疤痕越严重。采用双向方差分析、学生 t 检验和 Mann-Whitney U 检验来比较治疗前和治疗后的评估得分：结果：两组在人口统计学或疤痕特定变量方面均无明显差异；因此，结果差异可归因于干预时机。随着治疗时间的推移，两组患者的疤痕都有所改善（p 结论：激光治疗可改善部分患者的疤痕：激光治疗在开始的每个阶段都能使疤痕在至少一个尺度上得到改善。两组干预时间的结果相当，在对烧伤疤痕进行 FLSR 治疗时，应考虑早期干预，以尽早缓解症状。
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引用次数: 0
Investigations of Laser-Assisted Renal Denervation for Treatment of Resistant Hypertension 激光辅助肾脏去神经化治疗顽固性高血压的研究。
IF 2.2 3区 医学 Q2 DERMATOLOGY
Lasers in Surgery and Medicine
Pub Date : 2024-07-04 DOI: 10.1002/lsm.23823
Junghyun Hwang, Hwarang Shin, Minwoo Jung, Hyun Wook Kang

Background and Objectives

Renal denervation (RDN) is an emerging surgical treatment for resistant hypertension. However, the current RDN using radiofrequency can cause undesirable thermal damage to the medial and luminal layers due to direct contact between the arterial lumen and energy source. The aim of this study is to evaluate the feasibility of the new laser-assisted RDN by exploring the potential treatment conditions.

Methods

For ex vivo testing, six different treatment conditions (10 and 20 W applied for delivery of 300, 450, and 600 J) were tested on the porcine liver and renal artery (RA) by using a continuous wave 1064 nm laser wavelength. The ablated area in the liver tissue was measured to estimate the extent of the coagulated area. Histological evaluation was performed on the treated RA tissues to confirm the extent of thermal nerve damage.

Results

The ablated depth, length, and area in the liver tissue increased with laser power and total energy. According to the histological results, 20 W groups yielded more significant damage to the RA nerves than 10 W groups at the total energy of 300 J (0.0 ± 0.0 mm for 10 W vs. 2.9 ± 1.0 mm for 20 W), 450 J (1.9 ± 0.6 mm for 10 W vs. 6.8 ± 1.5 mm for 20 W), and 600 J (2.9 ± 0.4 mm for 10 W vs. 7.3 ± 0.8 mm for 20 W). The treated RA exhibited insignificant medial injury in depth (medial thinning ≤ 25%), and no difference in the medial thinning was found among the six groups (p = 0.4).

Conclusion

The current study demonstrated that the 1064 nm laser at 20 W with delivery of 450 J could effectively damage the RA nerves with no or minimal injury to the surrounding tissue. The proposed laser-assisted RDN may enhance physiological effects with insignificant complications in in vivo situations. Further in vivo studies will be conducted to validate the current findings by evaluating the extent of blood pressure reduction and norepinephrine changes after the laser-assisted RDN on a large animal model.

背景和目的：肾脏去神经支配（RDN）是治疗抵抗性高血压的一种新兴手术疗法。然而，由于动脉管腔与能量源直接接触，目前使用射频的 RDN 会对内侧和管腔层造成不良的热损伤。本研究旨在通过探索潜在的治疗条件，评估新型激光辅助 RDN 的可行性：在体外测试中，使用波长为 1064 nm 的连续波激光，在猪肝和肾动脉（RA）上测试了六种不同的治疗条件（10 W 和 20 W，输出功率分别为 300、450 和 600 J）。测量肝脏组织的消融面积，以估计凝固区域的范围。对处理过的 RA 组织进行组织学评估，以确认热神经损伤的程度：结果：肝组织中的烧蚀深度、长度和面积随着激光功率和总能量的增加而增加。组织学结果显示，在总能量为 300 J（10 W 为 0.0 ± 0.0 mm，20 W 为 2.9 ± 1.0 mm）、450 J（10 W 为 1.9 ± 0.6 mm，20 W 为 6.8 ± 1.5 mm）和 600 J（10 W 为 2.9 ± 0.4 mm，20 W 为 7.3 ± 0.8 mm）时，20 W 组比 10 W 组对 RA 神经的损伤更明显。治疗后的 RA 在深度上表现出不明显的内侧损伤（内侧变薄≤25%），六组之间的内侧变薄没有差异（P = 0.4）：目前的研究表明，功率为20 W、输出功率为450 J的1064 nm激光可有效损伤RA神经，而对周围组织无损伤或损伤极小。拟议中的激光辅助 RDN 可增强生理效应，且并发症不明显。我们还将进行进一步的体内研究，通过在大型动物模型上评估激光辅助 RDN 后血压降低的程度和去甲肾上腺素的变化来验证目前的研究结果。
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引用次数: 0
Simple Characterization of Cylindrical Diffuser Fibers With a Fluorescent Layer 带有荧光层的圆柱形扩散纤维的简单表征。
IF 2.2 3区 医学 Q2 DERMATOLOGY
Lasers in Surgery and Medicine
Pub Date : 2024-06-25 DOI: 10.1002/lsm.23821
Herbert Stepp, Ronald Sroka

Objectives

A fast, simple, versatile, and reliable method to record light emission intensity profiles of cylindrical light diffusers (CDFs) in air and transparent liquids has been developed.

Methods

A fluorescent color glass filter (RG695) converts red light emitted by a cylindrical diffuser fiber into near-infrared light in an emission angle-independent manner. The red light was provided from a diode laser system at 635 nm. Near-infrared fluorescence from the RG695 was imaged with a camera. Images from this camera were processed to obtain emission intensity profiles. Cylindrical diffuser fiber profiles of four different manufacturers were compared.

Results

The proposed method provides angle-independent intensity profiles of cylindrical diffuser fibers with a single camera shot. It could be demonstrated that dependent on the underlying principle of how the diffuser fiber tips emit light, the emission profile can change significantly in media with different refractive indices.

Conclusions

By converting the light emitted by a diffuser fiber tip into fluorescence light one can eliminate the dependence of the recorded profile on the emission angle from the diffusor. This approach allows for easily taking into account refraction-index (mis)matching by placing the equipment into a suitable liquid. The proposed measurement principle bears potential for quality assurance measurements of CDFs used for interstitial laser thermotherapy or photodynamic therapy.

目标：开发出一种快速、简单、通用且可靠的方法，用于记录空气和透明液体中圆柱形光扩散器（CDF）的发光强度曲线：开发了一种快速、简单、通用且可靠的方法，用于记录空气和透明液体中圆柱形光扩散器（CDF）的光发射强度曲线：方法：荧光彩色玻璃滤光片（RG695）以与发射角无关的方式将圆柱形光扩散纤维发出的红光转换成近红外线。红光由波长为 635 nm 的二极管激光系统提供。RG695 发出的近红外荧光通过照相机成像。对相机拍摄的图像进行处理，以获得发射强度曲线。对四家不同制造商的圆柱形扩散器光纤轮廓进行了比较：结果：所提出的方法只需一次相机拍摄，就能获得与角度无关的圆柱形扩散器光纤的强度曲线。可以证明，根据扩散器光纤尖端如何发射光线的基本原理，在不同折射率的介质中，发射轮廓会发生显著变化：通过将扩散器光纤尖端发射的光转换为荧光，可以消除记录的轮廓对扩散器发射角的依赖。这种方法可以通过将设备放入适当的液体中，轻松考虑折射率（误）匹配。所提出的测量原理可用于间质激光热疗或光动力疗法中 CDF 的质量保证测量。
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引用次数: 0
Evaluation of a Novel Dermal Cooling System for the Treatment of Benign Pigmented Lesions in Asians 评估用于治疗亚洲人良性色素病变的新型皮肤冷却系统。
IF 2.2 3区 医学 Q2 DERMATOLOGY
Lasers in Surgery and Medicine
Pub Date : 2024-06-23 DOI: 10.1002/lsm.23809
Christina S. M. Wong, Mandy W. M. Chan, Samantha Y. N. Shek, Chi Keung Yeung, Henry H. L. Chan

Objective

Our study aimed to evaluate the efficacy of this novel dermal cooling system (DCS) in reducing pigmentation in benign pigmented lesions in Asian patients and its potential side effects.

Methods

It was a prospective open-label single-center study. Asian patients, with the presence of benign pigmented lesions mainly including lentigines, melasma, nevus spilus, ephelides, café au lait, and seborrheic keratosis were recruited for a novel DCS. The DCS provided localized cooling of the epidermal layer below freezing but was less intense than cryotherapy. Each patient received DCS at Week 0 and repeated at 4-week intervals up to 10 sessions. Global aesthetic improvement scores (GAIS) by blinded physicians and subjects were recorded at 2, 6, and 12 months posttreatment follow-up.

Results

Eighty-one patients were recruited with a total of 305 sessions performed and 1716 lesion sites treated. At 2-month posttreatment, 76.5% and 58.6% treatment sites showed obvious to marked improvement respectively and the improvement sustained at 6 and 12 months. Only minor adverse events were reported. Erythema and edema were the most commonly anticipated effects immediately after treatment. The pain was minimal. Postinflammatory hyperpigmentation was only reported in 2.2% (38/1716) treated sites.

Conclusion

To our knowledge, this study was the first study to demonstrate that this novel DCS was an effective, safe, and well-tolerated treatment for benign pigmented lesions in Asians.

研究目的我们的研究旨在评估这种新型皮肤冷却系统（DCS）在减少亚洲患者良性色素病变中色素沉着的疗效及其潜在的副作用：这是一项前瞻性开放标签单中心研究。方法：这是一项前瞻性开放标签单中心研究。研究招募了存在良性色素病变的亚洲患者，这些病变主要包括色斑、黄褐斑、太田痣、表皮松解症、咖啡斑和脂溢性角化病。DCS 对表皮层进行局部冷却，冷却程度低于冷冻疗法，但强度低于冷冻疗法。每位患者在第 0 周接受 DCS 治疗，每 4 周重复一次，最多 10 次。在治疗后 2 个月、6 个月和 12 个月的随访中，由盲人医生和受试者记录全球美学改善评分（GAIS）：招募了 81 名患者，共进行了 305 次治疗，治疗了 1716 个病变部位。治疗后 2 个月，分别有 76.5% 和 58.6% 的治疗部位出现明显改善，6 个月和 12 个月后仍有改善。只有轻微的不良反应报告。红斑和水肿是治疗后最常见的不良反应。疼痛感很小。仅有 2.2%（38/1716）的治疗部位出现炎症后色素沉着：据我们所知，这项研究首次证明了这种新型 DCS 是治疗亚洲人良性色素病变的一种有效、安全且耐受性良好的方法。
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引用次数: 0
Port Wine Birthmark Therapy: A New Direction 波特酒胎记疗法：新方向
IF 2.2 3区 医学 Q2 DERMATOLOGY
Lasers in Surgery and Medicine
Pub Date : 2024-06-21 DOI: 10.1002/lsm.23810
Feben Messele, William Van Trigt, Lisa Arkin, Christopher C. W. Hughes, Kristen M. Kelly
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引用次数: 0
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