Assessment of patients' outcome in laser skin resurfacing

Al-Aissami, Maen (2002) Assessment of patients' outcome in laser skin resurfacing. MSc(R) thesis, University of Glasgow.

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Abstract

Applications of lasers in plastic surgery and dermatology began in the early 1960's, over the last few decades many types have been developed including Ruby laser. Dye laser, Nd:YAG laser, Er:YAG laser, and Carbon dioxide laser. Carbon dioxide (CO2) laser skin resurfacing has rapidly become the treatment of choice for rejuvenation of photo-ageing skin and ablation of other skin lesions. Pulsed Erbium: Yttrium-aluminum-garnet (Er: YAG) laser skin resurfacing is currently being explored for treatment of similar skin conditions. The indications for laser skin resurfacing includes: facial wrinkling, acne scarring, scars, actinic cheilitis, some pigmented lesions, rhinophyma and benign tumours such as syringoma, trichoepithehoma, dermatosis papulosa nigra, xanthelasma, adenoma sebaceum, sebaceous hyperplasia, epidermal naevi, and others. Four mechanisms are involved in laser resurfacing: 1- Single-pulse vaporization. 2- Collagen shrinkage and skin tightening. 3- New collagen formation and remodeling of collagen. 4- Multipulse coagulation of collagen. Both the CO2 laser and the Erb:YAG laser have unique qualities that can be exploited during resurfacing. The CO2 laser is unique in the following ways: 1- Hemostasis is achieved. 2- A plateau of ablation is reached, limiting resurfacing depth if proper treatment protocols are followed. 3- Collagen (skin) tightening occurs as heat-related phenomenon, resulting in correction of loose tissue and atrophic scars. 4- The first pass causes an epidermal/dermal split that allows easy and complete removal of epidermis with a single pass. The Erb:YAG laser is unique in the following ways: 1- Minimal residual thermal damage or tissue heating occurs. 2- This pure-ablation laser continues to ablate with each pass and does not reach an ablation plateau with depth. 3- Only minimal tissue water is required for laser tissue interaction. The most successful use of lasers for skin resurfacing would be to take advantage of each laser's unique benefit and to eliminate any disadvantages as much as possible. Accordingly, a prospective study was arranged to examine the effect of Erb:YAG laser, CO2 laser, and a combined CO2-Er:YAG laser in skin resurfacing in terms of depth of injury and long term effect on histological appearances after laser skin resurfacing by each laser. Twenty patients were recruited and a skin resurfacing test patch was performed using each laser (CO2, Erb:YAG, and combined CO2/Erb:YAG) on the post auricular area. A biopsy was taken from each test patch six hours after the operation. Six months later another biopsy was taken from each test patch area of each laser (CO2, Erb:YAG, CO2/Erb:YAG) in seven patients. One year following the first operation, biopsies were taken from the test patch areas in eight other patients. Biopsies were examined histologically to determine the differences between the three lasers in terms of their effect on the histological appearance related to original depth of injury.

Item Type: Thesis (MSc(R))
Qualification Level: Masters
Additional Information: Adviser: Iain MacKsay
Keywords: Surgery
Date of Award: 2002
Depositing User: Enlighten Team
Unique ID: glathesis:2002-71905
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 17 May 2019 09:31
Last Modified: 17 May 2019 09:31
URI: http://theses.gla.ac.uk/id/eprint/71905

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