In vivo histological evaluation of a novel ablative fractional resurfacing device

Background and Objectives A novel carbon dioxide (CO2) laser device employing ablative fractional resurfacing was tested on human skin in vivo for the first time. Study Design/Materials and Methods An investigational 30 W, 10.6 µm CO2 laser system was focused to a 1/e2 spot size of 120 µm to generat...

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Published in:Lasers in surgery and medicine 2007-02, Vol.39 (2), p.96-107
Main Authors: Hantash, Basil M., Bedi, Vikramaditya P., Kapadia, Bhumika, Rahman, Zakia, Jiang, Kerrie, Tanner, Heather, Chan, Kin Foong, Zachary, Christopher B.
Format: Article
Language:English
Subjects:
Biopsy
Carbon Dioxide
CO2
collagen
Dermatology - instrumentation
Dose Fractionation
Epithelial Cells
epithelialization
Er:YAG
Forearm
fractional photothermolysis
heat shock
HSP72 Heat-Shock Proteins - metabolism
Humans
Immunohistochemistry
infrared
Lasers
MEND
MTZ
Skin - injuries
Skin - pathology
Skin - radiation effects
wound healing
Wound Healing - radiation effects
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Summary:Background and Objectives A novel carbon dioxide (CO2) laser device employing ablative fractional resurfacing was tested on human skin in vivo for the first time. Study Design/Materials and Methods An investigational 30 W, 10.6 µm CO2 laser system was focused to a 1/e2 spot size of 120 µm to generate an array of microscopic treatment zones (MTZ) in human forearm skin. A range of pulse energies between 5 and 40 mJ was tested and lesion dimensions were assessed histologically using hematoxylin & eosin. Wound healing of the MTZ's was assessed immediately‐, 2‐day, 7‐day, 1‐month, and 3‐month post treatment. The role of heat shock proteins was examined by immunohistochemistry. Results The investigational CO2 laser system created a microscopic pattern of ablative and thermal injury in human skin. The epidermis and part of the dermis demonstrated columns of thermal coagulation that surrounded tapering ablative zones lined by a thin eschar layer. Changing the pulse energy from 5 to 30 mJ resulted in a greater than threefold increase in lesion depth and twofold increase in width. Expression of heat shock protein (hsp)72 was detected as early as 2 days post‐treatment and diminished significantly by 3 months. In contrast, increased expression of hsp47 was first detected at 7 days and persisted at 3 months post‐treatment. Conclusion The thermal effects of a novel investigational ablative CO2 laser system utilizing fractional resurfacing were characterized in human forearm skin. We confirmed our previous ex vivo findings and show for the first time in‐vivo, that a controlled array of microscopic treatment zones of ablation and coagulation could be deposited in human skin by varying treatment pulse energy. Immunohistochemical studies of heat shock proteins revealed a persistent collagen remodeling response lasting at least 3 months. We successfully demonstrated the first in‐vivo use of ablative fractional resurfacing (AFR™) treatment on human skin. Lasers Surg. Med. 39:96–107, 2007. © 2007 Wiley‐Liss, Inc.
ISSN:0196-8092
1096-9101
DOI:10.1002/lsm.20468