Laser in plastic Flashcards
laser therapy for hypertrophic burn and
trauma scars has led to significant improvements
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Photothermal events represent the majority ofmedical laser reactions
and result from an increase oflocal kinetic energy and the generation
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Photomechanical reactions result in structural degradation ofthe chromophore
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Photochemical reactions occur when
the excited state ofthe chromophore has markedly different physical
or chemical properties than the resting state.
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absorption spectrum
ofthe chromophore and its location within the skin. These two factors
will determine the wavelength of the laser medium
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the wavelength selected should minimize collateral injury that could
result in dyspigmentation
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The pulse width should not exceed the TRT
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Increasing the laser spot size allows for more rapid
treatment sessions and a decrease in the relative scatter of light.
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if the spot size is increased, the fluence will likely need to be increase
F if the spot size is increased, the fluence will likely need to be decreased to prevent excessive energy delivery
rate in which pulses
are delivered, is also important to consider in order to avoid excessive
bulk heating.
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treatment of cutaneous vasculature by laser the affect of laser it will be in form of photochemical reaction
F PHTOTHERMAL
Oxyhemoglobin displays an absorption band from 400 to 1200 nm
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Deoxyhemoglobin demonstrates an absorption peak that includes the 755 and 800 nm wavelengths.
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patients with higher FSTs, longer wavelength lasers
should be utilized
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When selecting a pulse width, titrate to the target
(blood vessel) and not the chromophore (hemoglobin)
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Fully ablative lasers targeting water as a chromophore
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Fully ablative lasers may also be used to nonselectively destroy vasculature in the treatment area.
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Without treatment, 65% of
PWSs become hypertrophic, often leading to bleeding, aesthetic
deformation, and psychological stress
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Port winr stiane in children need to treated with longer wavelength lasers
F In infants and
young children, PWSs are erythematous with increased oxyhemoglobin and respond well to shorter wavelength lasers
PWSs in adult
patients are often more violaceous owing to deoxyhemoglobin and
demonstrate increased thickness necessitating use of the longer
wavelength lasers.
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Initiating treatment as early as possible is critical for minimizing laser light scatter due to dermal collagen and
acquired tanning melanin
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selective photothermolysis can be used for all type of haemangioma
F Superficail and ulcerated as
well as resolved hemangiomas with residual vasculature
Endovenous laser ablation represents the gold standard in the management oflarger varicosities
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After successful endovenous laser ablation, spider
veins may be treated with sclerotherapy or vascular laser treatment
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In telangiectasias Optimal treatment includes longer pulse widths and the end point of
durable purpura
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Shorter pulse widths and subpurpuric fluences have been
shown to achieve ideal outcomes in generalized erythema.
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