Del Río-Sancho Sergio, Christen-Zaech Stephanie, Alvarez Martinez David, Pünchera Jöri, Merat Rastine, Laubach Hans Joachim
Laser Dermatology Consultation, Division of Dermatology and Venereology, Geneva University Hospitals, Geneva, Switzerland.
Pediatric Dermatology Unit, Departments of Dermatology & Venereology, University Hospital Lausanne, University of Lausanne, Lausanne, Switzerland.
Lasers Surg Med. 2025 Jan;57(1):121-129. doi: 10.1002/lsm.23841. Epub 2024 Sep 8.
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.
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.
The forearms of participating volunteers were treated and ablated with a CO-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.
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.
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.
ClinicalTrials.gov identifier: NCT05614557.
非剥脱性分次光热解技术的出现彻底改变了激光皮肤病学，它提供了一种产生标准化、精确且可重复的微观损伤的方法。这些伤口通常在1至3周内愈合，具体取决于身体部位，永久性瘢痕形成风险极小。这使得非剥脱性分次光热解成为研究皮肤伤口愈合过程的典型体内模型。
本研究旨在评估和比较两种非侵入性成像技术，即反射式共聚焦显微镜（RCM）和线场共聚焦光学相干断层扫描（LC-OCT），在评估非剥脱性分次光热解引起的微观损伤后皮肤伤口愈合情况方面的有效性。
参与研究的志愿者的前臂使用不同功率设置（2.5 - 10 mJ/MTZ）的CO2激光进行分次模式治疗和消融。在激光治疗后的预定时间间隔（从6小时到14天）获取体内RCM和LC-OCT图像。
通过两种成像方式对损伤进行垂直可视化显示，愈合过程的特征是微观表皮坏死碎片向上和向外移动，从而减少损伤深度，同时形成外部痂皮。LC-OCT成像显示的结果更全面，运动伪影更少。相反，两种技术的水平可视化突出了伤口周围角质形成细胞的聚集，表明再生过程开始。RCM在这个水平面上提供了更高的图像清晰度。
RCM和LC-OCT为传统活检方法提供了有价值且互补的非侵入性替代方法，用于评估和表征非剥脱性分次光热解后皮肤伤口的愈合过程。这些发现强调了此类成像技术在增强我们对伤口愈合过程理解方面的潜力。
ClinicalTrials.gov标识符：NCT05614557。
