Transcript Power - Guano Grafik

®
MedArt
CO2 laser
450
Table of contents
 CO2
 CO2 vs alternatives
 Considerations in CO2 treatments
 Summary
 The MedArt® 450
 The MedArt® 456
 Recommended reading
CO2
Principle:
The laser works on the principle of selective photothermolysis.
The specific wavelength targets one or more chromophores in the
tissue. The chromophore will be heated and the controlled dosis of
laser light will produce the desired treatment result (based on the
principle of thermal relaxation time).
Wavelength:
10,600 nm targets water. Water in the tissue will be heated and
thus ablate up to 30 microns of epidermal tissue. The heat
diffusion will however mean that an additional up to 1 mm
epidermal tissue is coagulated.
CO2 treatments
Skin resurfacings
 Full face
 Perioral area
 Periorbital area
 Glabellar area
 Cheek area
Benign skin lesions
 Acne scars, xanthelasma, verrucae
seborrhoica, etc. etc.
CO2 vs. alternatives
Er:YAG
 At 2940 nm this ablative laser can basically do the same
treatments as the CO2 but:
 More passes are needed to produce the same result as
with the co2.
 Bleeding = risk of infection
IPL
 Non-ablative technique to reverse photoaging.
 Only limited rhytide reduction.
 Not applicable for other skin lesion types.
Considerations in co2 treatment
The patient
Comfort and safety
 Skin type
Anaesthesia
Clinical aspects
 Power
 Pulse delivery
 Spot shape
Functionality
Power distribution
 Clinical working
conditions
 Economy
- Investment
- Running costs
The patient
Comfort and safety:
 No bleeding
 Shorter procedure time
 Controlled energy distribution
Skin type:
 Classic Fitzpatrick – skin type I-III
 Darker skin types treatable but with considerably
higher risk of dyspigmentation postop.
Anaesthesia:
 For full skin resurfacing:
 General anaesthesia is recommended.
 For all other treatments:
 Local anaesthesia by injection or EMLA creme.
Clinical aspects
 Power
 Pulse delivery
 Spot shape
Power
 Power output is measured in Watt.
 The indicated treatments are done with very low power output.
 Since power output is low it has to be very stable.
 Stable power output is the key to safe and efficient ablative treatments
 Power can be delivered as pulses or continuous wave
MedArt® 450 has less than 10% power deviation
Pulse delivery
Focus mode:
 Focal point irradiation achieves
evaporation of tissue
 This technique is e.g. used for skin
resurfacing with the help of a
scanner.
Defocus mode:
 A defocusing of the irradiation
achieves coagulation of tissue
 The treated area will peel off within
2-10 days (ideal for e.g. wart
removal)
Spot shape
Important to secure even distribution of energy into the tissue to
secure a good treatment result.
Beam profile:
Crystaline profile
Traditional CO2 profile
Scanning patterns:
MedArt® 456 scanning pattern
Traditional CO2 scanning patterns
MedArt® 450 secures even distribution of energy
Functionality
Power distribution
Clinical working conditions
Economy
 investment
 running costs
Power distribution
Flexible fibre:
 Silver crystaline
 Freedom of movement for the operator
 Can be used with scanner
 No maintenance
 Portable
Articulated arm:
 Based on adjustable mirrors
 Vulnerable to vibrations
 Not movable
 Requires regular maintenance
MedArt® 450
Clinical working conditions
Scanning technology:
 Important in terms of skin resurfacings or treatment on larger
body areas.
 Scanning patterns
 Feathering
Smoke extraction:
 An external smoke extraction tube can be easily attached to the
scanner.
Economy
Investment
 Ideal tool for the smaller private practice with a wish to treat skin lesions
and/or do skin resurfacings
Running costs
 No consumables
 We recommend a general service checkup every two years.
Summary
The patient
The technology
 Skin type
 Wavelength: 10,600 nm
 Anaesthesia
 Power: 0,1 to 10 Watt
 Flexible fibre system
 Energy delivery: Focused/defocused
 Scanner system
 Pulse width 5-999 msec.
MedArt® 450 – a cost efficient safe and versatile treatment tool
MedArt® 450 laser technology
Flexible fibre delivery system
 compact, easily movable in/between
facilities.
No extra running costs
 No consumables (dye, filters, liquid, filling,
lamps)
 No regular requirements for adjustments
and calibration
 No need for regular service calls
Recommended reading
”Principles of CO2/Erbium Laser Safety” (411)
Darrell J. Fader, MD and Désirée Ratner, MD
Dermatol Surg 2000;26:235-239
”Studies on the Transmission of Viral Disease via the CO2 Laser Plume and Ejecta” (35)
Peter M. Wisniewski, M, Michael J. Warhol, MD, et al.
The Journal of Reproductive Medicine, vol. 35, No. 12, December 1990
”Treatment of Xanthelasma Palperarum with the Carbon Dioxide Laser” (23)
David B. Apfelberg, MD, Morton R. Maser, MD, Harvey Lash, MD, David N. White, MD
J. Dermatol. Surg. Oncol. 13:2 February 1987
”Benefits of the CO2 laser for verruca resistant to other modalities of treatment’ (27)
David B. Apfelberg, MD, David Druker, MD, Morton R. Maser, MD, et al.
J. Dermatol. Surg. Oncol. 15:4 April 1989
”Anesthesia for the Dermatologic Surgeon” (400)
Dwight Scarborough, MD, Emil Bisaccia, MD, Wendy Schuen, MD, Rick Swensen,
CRNA
International Journal of Dermatology, December 1989 Vol. 28.