Moy R L, Bucalo B, Lee M H, Wieder J, Chalet M D, Ostad A, Dishell W D
UCLA Division of Dermatology, USA.
Dermatol Surg. 1998 Dec;24(12):1390-6.
Carbon dioxide lasers that produce either short pulses or scanned continuous beams have been used for skin resurfacing to improve wrinkles or scars. Using a high peak power, short pulse CO2 laser can produce clinically effective results with minimal thermal damage.
To evaluate the effectiveness of skin resurfacing using the 90-microsecond pulse duration CO2 laser compared to other laser systems. Erythema, healing time, complications, and histological measurement of the depth of ablation and thermal damage per pass with this system were also assessed.
Forty-one patients with facial rhytides and scars underwent resurfacing with a 90 microseconds pulse duration CO2 laser. Using patient survey, patients were evaluated for effectiveness of therapy, healing time, and complication rates. Comparisons of histologic and clinical findings were made with different short pulse CO2 lasers.
Healing time, duration of erythema, and post-operative pain were less with the 90 microseconds pulse CO2 laser than with the 900-microsecond dwell time and 950-microsecond pulse duration lasers, while effectiveness was comparable. Complications were few with the 90-microsecond pulse laser, including three patients (9.1%) developing hyperpigmentation. One pass with the 90-microsecond pulse duration CO2 laser produced 100 microns of ablation with 17 microns of thermal damage. Ablation and damage were additive so that, by six passes, ablation depth was 350 microns and depth of thermal damage was 63 microns. This thermal damage is less than that reported with lasers having a longer pulse duration or dwell time with comparable depths of vaporization.
Treatment with the 90-microsecond pulse duration laser results in a more rapid healing time and shorter duration erythema. The clinical improvements in wrinkles and sun damage were comparable. The 90-microsecond pulse duration laser provides an effective, predictable, and safe means of improving facial rhytides and scars.
能产生短脉冲或扫描连续光束的二氧化碳激光已被用于皮肤磨削，以改善皱纹或疤痕。使用高峰值功率的短脉冲二氧化碳激光可产生临床有效效果，同时热损伤最小。
评估与其他激光系统相比，使用脉宽90微秒的二氧化碳激光进行皮肤磨削的有效性。还评估了该系统每次照射的红斑、愈合时间、并发症以及消融深度和热损伤的组织学测量。
41例有面部皱纹和疤痕的患者接受了脉宽90微秒的二氧化碳激光磨削治疗。通过患者调查，评估患者的治疗效果、愈合时间和并发症发生率。对不同短脉冲二氧化碳激光的组织学和临床结果进行了比较。
与脉宽900微秒和950微秒的激光相比，脉宽90微秒的二氧化碳激光的愈合时间、红斑持续时间和术后疼痛更少，而效果相当。脉宽90微秒的激光并发症较少，包括3例（9.1%）出现色素沉着。脉宽90微秒的二氧化碳激光单次照射产生100微米的消融，热损伤为17微米。消融和损伤是累积的，因此照射6次后，消融深度为350微米，热损伤深度为63微米。这种热损伤小于报道的具有较长脉冲持续时间或停留时间且汽化深度相当的激光所造成的热损伤。
使用脉宽90微秒的激光治疗可使愈合时间更快，红斑持续时间更短。在改善皱纹和阳光损伤方面的临床效果相当。脉宽90微秒的激光为改善面部皱纹和疤痕提供了一种有效、可预测且安全的方法。
