Université Francois Rabelais de Tours, Tours, France.
Dermatol Surg. 2011 May;37(5):596-603. doi: 10.1111/j.1524-4725.2011.01943.x. Epub 2011 Mar 29.
Fractional resurfacing is a new laser treatment used mainly for treating photoaging and acne scars.
To demonstrate the efficacy of carbon dioxide (CO(2) ) fractional resurfacing laser treatment using high-resolution ultrasound imaging and to evaluate factors predictive of response to the treatment.
A prospective observational study was undertaken from January 2007 to August 2009. Laser treatment was performed using a CO(2) fractional resurfacing device. Patients were offered high-resolution ultrasound imaging to follow up their treatment. Dermal and subepidermal nonechogenic band (SENEB) thicknesses were measured.
Twenty-four consecutive patients were included, allowing follow-up of 107 areas. Statistical analysis showed a significant increase in dermal thickness (mean variation +25.1%, (95% confidence interval=19.0-31.2). SENEB thickness was not changed. Older age and greater initial thickness were associated with a smaller increase in dermal thickness according to multivariate analysis. The region treated was also found to be a significant predictive factor. Smoking, topical anesthesia, severity of local side effects induced by the laser treatment, and phototype were not associated with significant modification of dermal thickness after laser treatment.
This is the first report on the use of high-resolution ultrasound imaging to assess the efficacy of fractional laser operating with standard parameters. Increase in dermal thickness was evidenced, possibly explained by collagen neosynthesis or conformational changes in the extracellular matrix component, increasing dermal hydration, although there was no modification of SENEB thickness, suggesting that the skin retains the sequelae of ageing. The treatment appeared to be more effective in younger patients, probably because their fibroblasts are more prone to synthesizing collagen. Thinner skins were more effectively treated than thicker skins because they could be stimulated throughout their thickness with the treatment parameters used.
分碎式焕肤是一种新型激光治疗手段，主要用于治疗光老化和痤疮瘢痕。
采用高分辨率超声成像来证明二氧化碳（CO(2) ）分碎式焕肤激光治疗的疗效，并评估治疗反应的预测因素。
2007 年 1 月至 2009 年 8 月进行了一项前瞻性观察研究。使用 CO(2) 分碎式焕肤设备进行激光治疗。为了随访治疗情况，向患者提供了高分辨率超声成像。测量真皮和表皮下无回声带（SENEB）的厚度。
共纳入 24 例连续患者，可对 107 个部位进行随访。统计分析显示真皮厚度显著增加（平均变化+25.1%，95%置信区间=19.0-31.2）。SENEB 厚度无变化。根据多变量分析，年龄较大和初始厚度较大与真皮厚度增加较小相关。治疗区域也被发现是一个显著的预测因素。吸烟、局部麻醉、激光治疗引起的局部副作用的严重程度和皮肤类型与激光治疗后真皮厚度的显著变化无关。
这是首次采用高分辨率超声成像来评估标准参数操作的分碎式激光治疗效果的报道。真皮厚度增加，这可能是由于胶原的新合成或细胞外基质成分的构象变化，增加了真皮的水合作用，尽管 SENEB 厚度没有变化，这表明皮肤保留了老化的痕迹。该治疗方法在年轻患者中似乎更有效，这可能是因为他们的成纤维细胞更倾向于合成胶原。较薄的皮肤比较厚的皮肤治疗效果更好，因为它们可以用所使用的治疗参数刺激整个厚度。
