Guidelines of care for clinical laser treatments: Why are they useful?

2021 ◽  
Author(s):  
Sarah A. Ibrahim ◽  
Bianca Y. Kang ◽  
Emily Poon ◽  
Murad Alam
Keyword(s):  
Laser Treatments

Ethics in Cosmetic Laser Treatments

2007 ◽  
Vol 38 (5) ◽  
pp. 14-15 ◽  
Author(s):  
THOMAS E. ROHRER
Keyword(s):  
Laser Treatments

Improved results of treatment purulent destructive diseases of soft tissues using laser treatments

2016 ◽  
pp. 94-97
Author(s):  
R. R. Sadykov ◽  
O. R. Teshaev ◽  
A. S. Murodov
Keyword(s):  
Soft Tissues ◽  
Results Of Treatment ◽  
Laser Treatments

33 An Evidence Based Laser Therapy Algorithm for the Treatment of Burn Scars

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S26-S27
Author(s):  
Rajiv Sood
Keyword(s):  
Laser Treatment ◽  
Laser Therapy ◽  
Co2 Laser ◽  
Statistical Significance ◽  
Evidence Based ◽  
Baseline Measurement ◽  
Burn Scar ◽  
Therapy Algorithm ◽  
Laser Treatments ◽  
The Impact

Abstract Introduction Hypertrophic scarring after burn injury can be extremely painful, cause profound itching, and affect the way patients view themselves and how the outside world perceives them. We have utilized laser therapy as a modality for scar modulation for our patients since 2013. In 2014, we initiated and completed a prospective IRB approved study to evaluate the outcome of scars treated with fractional CO2 laser therapy (FLT) utilizing objective and subjective tools. Recently, we have completed a prospective study evaluating the use of pulse dye laser (PDL) therapy and the impact on post-burn pruritis. In reviewing the outcomes from these two studies, we have developed an evidence-based laser therapy algorithm for burn scar management. Methods The FLT study entailed a series of three CO2 laser treatments minimally 4–6 weeks apart with scar measurements and POSAS form completion performed prior to each laser treatment and four weeks after the last FLT. Scar measurements that included color, pliability, and scar thickness; and completion of the POSAS form were obtained prior to each laser therapy session and four weeks after the third laser treatment. The measurements of color, pliability, and scar thickness were measured with the Colorimeter, Cutometer, and ultrasound. The PDL study utilized the 5-D Itch scale to evaluate post-burn pruritis. A baseline measurement was obtained prior to any laser treatments. Each patient underwent two PDL sessions and a 5-D itch scale was completed four to six weeks after the second PDL session. The baseline measurement was then compared to the final 5-D itch scale measurement. Results Data from the FLT study is in Table 1 and shows that there were statistically significant improvements in the Patient and Observer POSAS scores, patient rated Itch score, scar thickness, and measured skin density. Changes to patient rated scar pain, scar color, and pliability were noted but were not of statistical significance. Data from the PDL study is in Table 2 and shows a statistically significant decrease in the treated patients’ post-burn pruritis. Conclusions In reviewing the outcomes of these two studies, we have developed an algorithm based on our studies. All of our patients undergoing laser therapy receive two PDL sessions that are four to six weeks apart followed by 3 FLT sessions. The use of both PDL and FLT decreases post-burn pruritis, decreases scar thickness, decreases pain, and increases patient satisfaction as shown in our research.

scholarly journals Experimental investigation on a novel approach for laser surface hardening modelling

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
L. Orazi ◽  
A. Rota ◽  
B. Reggiani
Keyword(s):  
Surface Hardening ◽  
Carbon Diffusion ◽  
Industrial Applications ◽  
Laser Surface ◽  
Simplified Approach ◽  
Laser Surface Hardening ◽  
Novel Approach ◽  
Laser Treatments ◽  
High Flexibility ◽  
Short Time

AbstractLaser surface hardening is rapidly growing in industrial applications due to its high flexibility, accuracy, cleanness and energy efficiency. However, the experimental process optimization can be a tricky task due to the number of involved parameters, thus suggesting for alternative approaches such as reliable numerical simulations. Conventional laser hardening models compute the achieved hardness on the basis of microstructure predictions due to carbon diffusion during the process heat thermal cycle. Nevertheless, this approach is very time consuming and not allows to simulate real complex products during laser treatments. To overcome this limitation, a novel simplified approach for laser surface hardening modelling is presented and discussed. The basic assumption consists in neglecting the austenite homogenization due to the short time and the insufficient carbon diffusion during the heating phase of the process. In the present work, this assumption is experimentally verified through nano-hardness measurements on C45 carbon steel samples both laser and oven treated by means of atomic force microscopy (AFM) technique.

Does interval time between pulsed dye laser treatments for port-wine stains influence outcome? A systematic review and meta-analysis

2021 ◽  
Author(s):  
Igor Snast ◽  
Moshe Lapidoth ◽  
Ran Kaftory ◽  
Adi Nosrati ◽  
Emmilia Hodak ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Dye Laser ◽  
Pulsed Dye Laser ◽  
Port Wine ◽  
Port Wine Stains ◽  
Interval Time ◽  
Laser Treatments

Sensitivity of Macro- and Micro-Residual Stress States of Steel Surfaces to Thermal Influences Caused by Grinding Burn and Laser Treatments

2013 ◽  
Vol 768-769 ◽  
pp. 412-419
Author(s):  
Bernd Eigenmann ◽  
Antje Zösch ◽  
Martin Seidel
Keyword(s):  
Residual Stress ◽  
Threshold Values ◽  
Materials Properties ◽  
X Ray ◽  
Grinding Burn ◽  
Laser Treatments ◽  
Annealing Effects ◽  
Calibration Samples ◽  
Steel Surfaces ◽  
Stress States

Thermal influences, introduced intentionally or unintentionally do have significant effects on surfaces of steel components. Materials properties are reduced by annealing effects or even re-hardening zones can occur. Grinding, one of the most important technological processes for preci-sion manufacturing of hardened steel components, is an important source of thermal influences to steel surfaces. In pronounced cases, these influences are referred to as grinding burn. They are known as possible reasons for gray stains as well as development of cracks and pittings on heavy-duty gears and on roller bearings. The basic effect of thermal influences on the material is a change of the macro- and micro-residual stress states. Therefore, the knowledge of these residual stress states is of fundamental importance. The paper treats the mechanisms of grinding which can lead to thermal influences. Some characteristic appearances of grinding burn are shown and characterized by X-ray macro- and micro residual stress determinations. It is shown that defined laser treatments can be used to create reproducible thermal influences similar to grinding burn. Their effects are also characterized by X-ray residual stress measurements. The sensitivities of X-ray and metallographical investigations are compared. Defined laser traces are proposed as calibration samples for magnetic and eddy current measurements which allow to determine threshold values for the actual apparatus and measuring problem.

A 6-Year Experience of Laser Treatments for Burn Scars in a Regional Burn Center—Safety, Efficacy, and Quality Improvement

2020 ◽  
Author(s):  
Christopher Q Zhang ◽  
Christina Gogal ◽  
Trent Gaugler ◽  
Sigrid Blome-Eberwein
Keyword(s):  
Common Adverse Effect ◽  
Treatment Method ◽  
Outpatient Setting ◽  
Modest Improvement ◽  
Burn Scar ◽  
Moderate Sedation ◽  
Burn Center ◽  
Average Improvement ◽  
Study Results ◽  
Laser Treatments

Abstract Laser treatments have long been used as a treatment method for burn scars. Since 2012, more than 1800 laser treatments were performed at Lehigh Valley Health Network Burn Center, far exceeding any previous cohort in studies exploring laser treatments for burn scars. Although previous research has looked at improving scar appearance and physiology with laser treatments, very few have focused on safety. The purpose of the study was to determine whether laser treatments are a safe treatment option for burn scars. Four hundred and fourteen patients who had undergone at least one laser treatment in the outpatient burn center since 2012 were analyzed. Electronic medical records (EPIC) were reviewed. The data were entered in REDCap and later exported to Microsoft Excel and R Studio for statistical analysis. Most of the complications found were related to the moderate sedation during the procedures and were mild, ie, nausea. The most common adverse effect was prolonged recovery time, which can affect practice flow. The overall postoperative complication rate for laser treatments with and without moderate sedation was minimal at 2.2% and 1.4%, respectively. Pain during and after the procedure averaged 3.9 and 1.7, respectively, on a 1 to 10 scale. The Vancouver Scar Scale showed modest improvement in scar appearance over time with an average improvement of 1.4. The high variability of the Vancouver Scar Scale observed in this series underlines its lack of sensitivity. The study results show that laser treatments for burn scars in the outpatient setting generally are safe for patients in need of burn scar intervention. Some practice flow adjustments need to be taken into consideration when offering these procedures in an outpatient setting.

Light and Laser Treatments for Keratosis Pilaris: A Systematic Review

2020 ◽  
Vol 46 (11) ◽  
pp. 1397-1402
Author(s):  
Elio Kechichian ◽  
Samer Jabbour ◽  
Lena El Hachem ◽  
Roland Tomb ◽  
Josiane Helou
Keyword(s):  
Systematic Review ◽  
Laser Treatments

O270 EVOLUTION FROM INVASIVE TO NON INVASIVE LASER TREATMENTS IN VAGINAL REJUVENATION

2012 ◽  
Vol 119 ◽  
pp. S356-S356
Author(s):  
A. Gaspar ◽  
J. Elias ◽  
A. Carbone
Keyword(s):  
Non Invasive ◽  
Vaginal Rejuvenation ◽  
Laser Treatments

scholarly journals LIBERTI: A SMART study in plastic surgery

2018 ◽  
Vol 15 (3) ◽  
pp. 286-293
Author(s):  
Jonathan C Hibbard ◽  
Jonathan S Friedstat ◽  
Sonia M Thomas ◽  
Renee E Edkins ◽  
C Scott Hultman ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Precision Medicine ◽  
Laser Treatment ◽  
Population Level ◽  
Patient Characteristics ◽  
Patient Response ◽  
Multiple Assignment ◽  
Laser Treatments ◽  
Treatment Plans ◽  
Treatment Rules

Background/aims: Laser treatment of burns scars is considered by some providers to be standard of care. However, there is little evidence-based research as to the true benefit. A number of factors hinder evaluation of the benefit of laser treatment. These include significant heterogeneity in patient response and possible delayed effects from the laser treatment. Moreover, laser treatments are often provided sequentially using different types of equipment and settings, so there are effectively a large number of overall treatment options that need to be compared. We propose a trial capable of coping with these issues and that also attempts to take advantage of the heterogeneous response in order to estimate optimal treatment plans personalized to each individual patient. It will be the first large-scale randomized trial to compare the effectiveness of laser treatments for burns scars and, to our knowledge, the very first example of the utility of a Sequential Multiple Assignment Randomized Trial in plastic surgery. Methods: We propose using a Sequential Multiple Assignment Randomized Trial design to investigate the effect of various permutations of laser treatment on hypertrophic burn scars. We will compare and test hypotheses regarding laser treatment effects at a general population level. Simultaneously, we hope to use the data generated to discover possible beneficial personalized treatment plans, tailored to individual patient characteristics. Results: We show that the proposed trial has good power to detect laser treatment effect at the overall population level, despite comparing a large number of treatment combinations. The trial will simultaneously provide high-quality data appropriate for estimating precision-medicine treatment rules. We detail population-level comparisons of interest and corresponding sample size calculations. We provide simulations to suggest the power of the trial to detect laser effect and also the possible benefits of personalization of laser treatment to individual characteristics. Conclusion: We propose, to our knowledge, the first use of a Sequential Multiple Assignment Randomized Trial in surgery. The trial is rigorously designed so that it is reasonably straightforward to implement and powered to answer general overall questions of interest. The trial is also designed to provide data that are suitable for the estimation of beneficial precision-medicine treatment rules that depend both on individual patient characteristics and on-going real-time patient response to treatment.

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