Department of Dermatology, Chengdu Second People's Hospital, Chengdu, Sichuan, China.
Tribology Research Institute, Key Laboratory for Advanced Technology of Materials of Ministry of Education, Southwest Jiaotong University, Chengdu, China.
Skin Res Technol. 2023 Mar;29(3):e13305. doi: 10.1111/srt.13305.
Laser technology has been widely used in the treatment of hypertrophic scar (HPS). Due to the lack of effective quantitative relationship between laser doses and thermal effect of lesion tissue, the selection of laser doses in clinical laser treatment of HPS is blind, which cannot guarantee the best treatment effect.
The photothermal model of HPS was established by using finite element method. The effects of laser dose parameters such as laser energy density, pulse width, and spot diameter on the thermal effects of laser treatment were analyzed. According to tissue temperature threshold and thermal damage degree of the simulation results, the optimal laser doses of HPS were selected for the laser treatment experiments of rabbit ear HPSs to verify the rationality of the quantitative photothermal model.
The temperature rise and thermal damage degree of HPS following laser treatment were directly correlated to the laser doses, which grew with the increase of energy density and laser pulse width. For the different spot diameters, the temperature rise decreased with the increase of spot diameter, whereas the thermal damage degree worsened with the increase of spot diameter. Both simulation and experimental results show that the optimal treatment parameters of HPS were as follows: The laser energy density was 7.5 J/cm , the pulse width was 4 ms, and the spot diameter was 7 mm.
The laser dose parameters optimized by the photothermal model have achieved good therapeutic effects in the rabbit ear HPS, indicating that the model can be used for quantitative evaluation of laser doses before clinical treatment.
激光技术已广泛应用于治疗增生性瘢痕(HPS)。由于缺乏激光剂量与病变组织热效应之间的有效定量关系,临床激光治疗 HPS 中激光剂量的选择是盲目进行的,无法保证最佳的治疗效果。
采用有限元方法建立 HPS 的光热模型,分析激光能量密度、脉宽和光斑直径等激光剂量参数对激光治疗热效应的影响。根据组织温度阈值和模拟结果的热损伤程度,选择 HPS 的最佳激光剂量进行兔耳 HPS 的激光治疗实验,以验证定量光热模型的合理性。
激光治疗后 HPS 的温升和热损伤程度与激光剂量直接相关,随能量密度和激光脉宽的增加而增加。对于不同的光斑直径,随着光斑直径的增加,温升降低,而热损伤程度随着光斑直径的增加而恶化。模拟和实验结果均表明,HPS 的最佳治疗参数为:激光能量密度为 7.5 J/cm ,脉宽为 4 ms ,光斑直径为 7 mm。
光热模型优化的激光剂量参数在兔耳 HPS 中取得了良好的治疗效果,表明该模型可用于临床治疗前对激光剂量进行定量评估。