Raulin Christian, Grema Hortensia
Laserklinik Karlsruhe, Karlsruhe, Germany.
Arch Dermatol. 2004 Nov;140(11):1333-6. doi: 10.1001/archderm.140.11.1333.
Ablative skin resurfacing with carbon dioxide (CO(2)) and erbium:YAG lasers is still considered the gold standard for treating rhytides, photodamage, and acne scars. However, the prolonged downtime and undesired concomitant effects that are involved have sent dermatologists looking for less invasive nonablative laser techniques to rejuvenate skin.
To combine cold-air cooling with single-pass CO(2) laser skin resurfacing to generate as much benefit as possible while minimizing the spectrum of adverse effects.
The efficacy of single-pass CO(2) laser skin resurfacing on perioral and periorbital wrinkles was examined prospectively during a 6-month follow-up period. In a side-by-side comparison, the influence of simultaneous cold-air cooling on concomitant effects, pain tolerance, therapeutic success, and patient satisfaction was also studied. Eight patients with perioral and/or periorbital wrinkles underwent the procedure. During laser treatment, only the right half of each face was cooled using a cold-air system.
Six months after treatment, a mild improvement of the wrinkles was observed in all cases. The use of cold-air cooling did not have any impact on the long-term results, although in a direct comparison between sides, it was observed that cooling reduced the recovery period from 3.9 +/- 1.5 (mean +/- SD) days to 3.5 +/- 1.4 days (P = .09) and helped postoperative erythema fade more quickly, from an average of 21.3 +/- 17.9 days to 11.7 +/- 3.9 days (P = .17). The reduction of pain was significant, which led to a much higher level of patient acceptance: on a numerical analog scale of 1 to 10, the rate decreased from an average of 6.8 +/- 1.8 (mean +/- SD) to 3.6 +/- 1.7 (P = .006).
Given the clear decline in demand for invasive laser technologies, single-pass CO(2) laser skin resurfacing in conjunction with cold-air cooling is a worthwhile alternative both to conventional resurfacing and to conventional subsurfacing. The use of cold-air cooling not only minimizes intraoperative and postoperative adverse effects, it also contributes strongly to patient satisfaction.
二氧化碳（CO₂）激光和铒激光剥脱性皮肤磨削术仍被视为治疗皱纹、光损伤和痤疮瘢痕的金标准。然而，其较长的停工期和不良伴随效应促使皮肤科医生寻找侵入性较小的非剥脱性激光技术来实现皮肤年轻化。
将冷空气冷却与单次通过CO₂激光皮肤磨削术相结合，以在将不良反应范围降至最低的同时尽可能多地产生益处。
在为期6个月的随访期内，前瞻性地研究单次通过CO₂激光皮肤磨削术对口周和眶周皱纹的疗效。在一项平行对照研究中，还研究了同步冷空气冷却对伴随效应、疼痛耐受性、治疗效果和患者满意度的影响。8例有口周和/或眶周皱纹的患者接受了该手术。在激光治疗期间，仅使用冷空气系统对每侧面部的右半侧进行冷却。
治疗6个月后，所有病例的皱纹均有轻度改善。尽管在两侧直接比较中观察到，冷空气冷却使恢复期从3.9±1.5（均值±标准差）天缩短至3.5±1.4天（P = 0.09），并有助于术后红斑更快消退（从平均21.3±17.9天降至11.7±3.9天，P = 0.17），但冷空气冷却的使用对长期效果没有任何影响。疼痛减轻显著，这使得患者接受度大大提高：在1至10的数字模拟量表上，疼痛评分从平均6.8±1.8（均值±标准差）降至3.6±1.7（P = 0.006）。
鉴于对侵入性激光技术需求明显下降，单次通过CO₂激光皮肤磨削术结合冷空气冷却对于传统磨削术和传统非磨削术而言都是一种值得采用的替代方法。使用冷空气冷却不仅能将术中及术后不良反应降至最低，还极大地提高了患者满意度。
