medart ® 450 co 2 laser. table of contents co 2 co 2 vs alternatives considerations in co 2...
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MedArt® 450
CO2 laser
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
MedArt® 450 secures even distribution of energy
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
Functionality
Power distribution
Clinical working conditions
Economy
investment
running costs
Power distribution
Articulated arm:
Based on adjustable mirrors
Vulnerable to vibrations
Not movable
Requires regular maintenance
Flexible fibre:
Silver crystaline
Freedom of movement for the operator
Can be used with scanner
No maintenance
Portable
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
MedArt® 450 – a cost efficient safe and versatile treatment tool
The patient
Skin type
Anaesthesia
The technology
Wavelength: 10,600 nm
Power: 0,1 to 10 Watt
Flexible fibre system
Energy delivery: Focused/defocused
Scanner system
Pulse width 5-999 msec.
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, MDDermatol 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, MDJ. 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, CRNAInternational Journal of Dermatology, December 1989 Vol. 28.
