Purpose Carbon dioxide(CO_(2))lasers enable precise vaporization of lesions with minimal bleeding and have been widely used to excise a wide variety of lesions with good results.Papillomatosis is a disorder characteri...Purpose Carbon dioxide(CO_(2))lasers enable precise vaporization of lesions with minimal bleeding and have been widely used to excise a wide variety of lesions with good results.Papillomatosis is a disorder characterized by a wart-like growth that tends to recur relentlessly after surgical removal or medical treatment.Treatment of pediatric facial papillomatosis by utilizing a CO_(2)laser is a viable alternative strategy.This paper presents a case of an 8-month-old child with facial papilloma,that we treated by ablation using a CO_(2)laser,and discusses the efficacy of this treatment modality.Methods A case of pediatric facial papilloma treated with CO_(2)laser ablation was reported,and the benefits of this treatment modality were reviewed and analyzed in the context of the existing literature.Results Under general anesthesia,the lesional tissue of the left lip was excised,and the pathological diagnosis was confirmed to be maxillofacial papilloma.The lesions were surgically ablated in stages using a CO_(2)laser,and erythromycin ointment was applied to the treated areas after surgery.A total of three rounds of CO_(2)laser treatment were performed.The child had no complications during or after the operations;the child’s facial appearance was significantly improved,and there was no sign of recurrence during the 6-month follow-up.Conclusions The CO_(2)laser was useful for resection of this patient who had pediatric facial papillomatosis,and it can restore an aesthetic facial soft tissue profile without significant residual facial deformity.The CO_(2)laser can achieve precise vaporization resection of diseased tissue with minimal blood loss and a good cosmetic result.展开更多
Background:Fractional CO_(2) laser plays an important role in scar management post split-thickness skin graft by loosening the graft contracture and restoring the smoothness of the surface.However,the optimal treatmen...Background:Fractional CO_(2) laser plays an important role in scar management post split-thickness skin graft by loosening the graft contracture and restoring the smoothness of the surface.However,the optimal treatment protocol remains unknown.This study applied a dual-scan protocol to achieve both releasing and ablation of contracted skin graft.We comprehensively describe this treatment method and compare the efficacy and safety between this dual-scan method and the conventional mono-scan mode.Methods:A hypercontracted scar model after split-thickness skin grafting in red Duroc pigs was established.All scars meeting the inclusion criteria were randomly divided into four groups:high fluence–low density(HF–LD),low fluence–high density(LF–HD),combined group and control group.The energy per unit areawas similar in the HF–LD and LF–HD groups.Two laser interventions were performed at a 6-week interval.The efficacy of the treatment was evaluated by objective measures of scar area,release rate,elasticity,thickness and flatness,while the safetywas evaluated based on adverse reactions and melanin index.Collagen structurewas observed histologically.The animals were followed up for a maximum of 126 days after modeling.Results:A total of 28 contracted scars were included,7 in each group.At 18 weeks postoperatively,the HF–LD and the combined groups showed significantly increased scar release rate(p=0.000)and elasticity(p=0.036)and decreased type I/III collagen ratio(p=0.002)compared with the control and LF–HD groups.In terms of flatness,the combined group was significantly better than the HF–LD group for elevations<1mm(p=0.019).No significant skin side effects,pigmentation or scar thickness changes were observed at 18 weeks.Conclusions:Dual-scan protocol could achieve superficial ablation and deep release of contracted split-thickness skin graft in a single treatment,with similar contraction release and texture improvement compared to a single deep scan.Its main advantage is to restore a smoother scar appearance.Adequate laser penetration was necessary for the release of contracted scars.展开更多
基金supported by grants from the Guangzhou Science and Technology Project(#202103000093)The Key Laboratory of Malignant Tumour Gene Regulation and Target Therapy of Guangdong Higher Education Institutes,Sun Yat-sen University(Grant KLB09001)the Key Laboratory of Malignant Tumour Molecular Mechanism and Translational Medicine of Guangzhou Bureau of Science and Information Technology([2013]163).
文摘Purpose Carbon dioxide(CO_(2))lasers enable precise vaporization of lesions with minimal bleeding and have been widely used to excise a wide variety of lesions with good results.Papillomatosis is a disorder characterized by a wart-like growth that tends to recur relentlessly after surgical removal or medical treatment.Treatment of pediatric facial papillomatosis by utilizing a CO_(2)laser is a viable alternative strategy.This paper presents a case of an 8-month-old child with facial papilloma,that we treated by ablation using a CO_(2)laser,and discusses the efficacy of this treatment modality.Methods A case of pediatric facial papilloma treated with CO_(2)laser ablation was reported,and the benefits of this treatment modality were reviewed and analyzed in the context of the existing literature.Results Under general anesthesia,the lesional tissue of the left lip was excised,and the pathological diagnosis was confirmed to be maxillofacial papilloma.The lesions were surgically ablated in stages using a CO_(2)laser,and erythromycin ointment was applied to the treated areas after surgery.A total of three rounds of CO_(2)laser treatment were performed.The child had no complications during or after the operations;the child’s facial appearance was significantly improved,and there was no sign of recurrence during the 6-month follow-up.Conclusions The CO_(2)laser was useful for resection of this patient who had pediatric facial papillomatosis,and it can restore an aesthetic facial soft tissue profile without significant residual facial deformity.The CO_(2)laser can achieve precise vaporization resection of diseased tissue with minimal blood loss and a good cosmetic result.
基金supported by Shanghai Municipal Education Commission Gaofeng Clinical Medicine Grant Support(20152227)The national natural science foundation of China(81772098)Scientific research foundation of Shanghai Municipal Commission of Health and Family Planning(20154Y0023).
文摘Background:Fractional CO_(2) laser plays an important role in scar management post split-thickness skin graft by loosening the graft contracture and restoring the smoothness of the surface.However,the optimal treatment protocol remains unknown.This study applied a dual-scan protocol to achieve both releasing and ablation of contracted skin graft.We comprehensively describe this treatment method and compare the efficacy and safety between this dual-scan method and the conventional mono-scan mode.Methods:A hypercontracted scar model after split-thickness skin grafting in red Duroc pigs was established.All scars meeting the inclusion criteria were randomly divided into four groups:high fluence–low density(HF–LD),low fluence–high density(LF–HD),combined group and control group.The energy per unit areawas similar in the HF–LD and LF–HD groups.Two laser interventions were performed at a 6-week interval.The efficacy of the treatment was evaluated by objective measures of scar area,release rate,elasticity,thickness and flatness,while the safetywas evaluated based on adverse reactions and melanin index.Collagen structurewas observed histologically.The animals were followed up for a maximum of 126 days after modeling.Results:A total of 28 contracted scars were included,7 in each group.At 18 weeks postoperatively,the HF–LD and the combined groups showed significantly increased scar release rate(p=0.000)and elasticity(p=0.036)and decreased type I/III collagen ratio(p=0.002)compared with the control and LF–HD groups.In terms of flatness,the combined group was significantly better than the HF–LD group for elevations<1mm(p=0.019).No significant skin side effects,pigmentation or scar thickness changes were observed at 18 weeks.Conclusions:Dual-scan protocol could achieve superficial ablation and deep release of contracted split-thickness skin graft in a single treatment,with similar contraction release and texture improvement compared to a single deep scan.Its main advantage is to restore a smoother scar appearance.Adequate laser penetration was necessary for the release of contracted scars.
