präsentation nr. 1 · pdf fileby courtesy of dr. daniel, cassuto, milano, italy . 35 044...
TRANSCRIPT
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The third generation of the Dermablate series
MCL 29 Dermablate Dermablate D1 MCL 30 Dermablate
MCL29, the first Er:YAG laser for Dermatology, was introduced in 1996.
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Specifications
Wavelength: 2,940 nm
Power: max. 12 W; voltage 230; 100; 120 V
Puls energy: max. 1.5 J
Fluence: 2 – 10 J/cm² (Ablation, limited)
2 – 100 J/cm² (Ablation, without fluence filter)
1 J/cm² in thermal mode
2 – 162 J/cm² (MicroSpot)
Frequency: 1 / 4 / 8 / 10 / 15 Hz in ablation mode
20 Hz in thermal mode
Spot size: 1 – 6 mm with VarioTEAM handpiece
(Ablation, thermal mode)
13x13 mm with MicroSpot handpiece
(Fractional, 169 MicroSpots with Ø 250 µm and 5% cover rate)
Laser class: 4
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Evidence of clinical success
• 1990: First clinical trials by R. Kaufmann et al.
• 1996: First Er:YAG Laser in dermatology introduced by Asclepion
MCL 29 Dermablate by Asclepion-Meditec, more than 800 systems worldwide
• Germany: the Dermablate has became a standard tool for dermatologists in the treatment of a wide range of cutaneous lesions
• advantages of the Erbium laser compared to CO2 lasers:
- precise and safe ablation
- very limited thermal damage (necrotic zone 30µm/70µm)
- superficial treatments possible as well as deep ablation
- reduced risk of scarring and pigmentation changes
- many treatments require no anaesthesia
- short healing process, little side effects
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• Integrated suction system
• VarioTEAM handpiece
• Subablative mode (coagulation mode)
• Adjustable internal filter system
• Sterilizable distance holder
• Most homogenious beam profile
• Thermal mode
• Unbeaten reliability
• Fast amortisation
• Ugradeable with super fractional extension set (SFE)
USPs
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1 filter - set contains:
• 1 HEPA filter • 1 active coal – filter • 3 pre-filter
sufficiant for 30 hours active use
Integrated filter system
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VarioTEAM handpiece (Ablation)
with TEAM-Technology
(Total Evacuation of Ablated Material)
Very effective smoke evacuation
Lowest smell nuisance
No assistance necessary
Cost reduction
Patents: US 6 162 218 DE 197 106 76
with VarioSpot-Technology
Spot size from 1 to 6 mm
(adjustable in 1mm steps)
Automatic spot size detection
Automatic fluence adaption
VarioTEAM handpiece
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linear correlation
constant ablation depth of 5 µm per 1 J/cm² (above ablation treshhold)
Thermal Mode
Specs: 1 J/cm², 20 Hz, N = 5 ...
coagulation zone up to 400 µm depth (with single impulse up to 40 µm)
Ab
latio
n in
µm
Ablation vs. Fluence
- Different Mechanism of Er:YAG -
Koagulation
Fluence in J/cm2
Ablation
Ablation vs. Coagulation
Recommended parameters 5 – 6 J/cm² conservative 7 – 8 J/cm² normal 9 – 10 J/cm² aggressive treatment
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FLUENCE directly adjustable:
Easy to use
No difficult calculation between energy and spot size
Flat-Top-Profile: most homogenious spot ablation fractional
Other Advantages
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0.0001
0.001
0.01
0.1
1
10
100
1000
10000
100000
100 1000 10000
Wavelength [nm]
Abs
orpt
ion
Coe
ffici
ent [
cm-1
]
400030002000 5000500400300200
Melanin
Protein Water
Scattering
Desoxy-Hemoglobin
Oxy-Hemoglobin
Laser – Selective absorption
High absorbtion in water
Low absorbtion in melanin and hemoglobine
Selective thermolysis (effective targeting and low side effects)
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• Removal of dermal and epidermal lesions:
epidermal naevi, seborrhoic ceratoses, warts, naevuscellnaevus, hypertrophic scars, acne scars, xanthelasma, rhynophym, wrinkles, lentigines, actinic keratoses, syringoma
• full skin resurfacing
• soft laser peel
• skin refreshing
• New fractional laser therapy
By soft and precise ablation.
Indications
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Seborrhoic ceratoses
3 weeks after treatment
By courtesy of Dr. Paul Wood, Proderma, Bad Homburg, Germany
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Dermal / epidermal Naevus
6 months after treatment
By courtesy of Dr. Paul Wood, Proderma, Bad Homburg, Germany
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Verruca seborrhoica pigmentosa
6 months after treatment
By courtesy of Dr. W. Petrow, Bonn, Germany
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Verruca seborrhoica pigmentosa
6 months after treatment
By courtesy of Dr. W. Petrow, Bonn, Germany
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• involvement of the whole epidermis in the healing process • Formation of heat shock proteins deep in the dermis • Resulting in neocollagenesis
MicroSpot Superfractional Extension Set
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• new designed and patented handpiece
• automatic suction and lens cleaning
• cooling outlets integrated in distance holders
• maintenance free
• Microlens technology with 169 fractional spots per shot
• Up to 20 Hz (quickest fractional technology available)
MicroSpot Superfractional Extension Set
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MicroSpot Superfractional Extension Set
Parameter:
Handpiece 13×13mm
Fluence 54 – 72 J/cm²
Micro Pulse 3 – 4
Pass 1 – 3
immediately after
one day after
two days after
three days after
By courtesy of Dr. Daniel, Cassuto, Milano, Italy
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2 treatment within 4 weeks, each treatment with 2 passes, 10 J/cm2, cover rate 15% and 4 shots on the same fractional spots, 2 months
MicroSpot Superfractional Extension Set
By courtesy of Dr. Daniel, Cassuto, Milano, Italy
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2 treatment within weeks, each treatment with 2 passes, 10 J/cm2, cover rate 10% and 4 shots on the same fractional spots, 2 months
MicroSpot Superfractional Extension Set
By courtesy of Dr. Daniel, Cassuto, Milano, Italy
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Post traumatic scar, 1 treatment , 2 passes, 10 J/cm2, cover rate 15% and 4 shots on the same fractional spots
MicroSpot Superfractional Extension Set
By courtesy of Dr. Daniel, Cassuto, Milano, Italy
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By courtesy of Dr. Feller-Heppt, University Hospital, Mannheim, Germany
MicroSpot Superfractional Extension Set
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Single treatment, 20 J/cm2, 10 % cover rate, 3 shots on the same fractional spots, 1 and 7 days
MicroSpot Superfractional Extension Set
By courtesy of Dr. Feller-Heppt, University Hospital, Mannheim, Germany
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Periorbital treatment only (forehead): single treatment, 20 J/cm2, 10 % cover rate, 3 shots on the same fractional spots, 1 and 7 days
MicroSpot Superfractional Extension Set
By courtesy of Dr. Feller-Heppt, University Hospital, Mannheim, Germany
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BEFORE AFTER 3 treatments MCL 30 Dermablate 126 J/cm² , 13x13 mm fractional
By courtesy of Prof. Kabir Sardana, Delhi
MicroSpot Superfractional Extension Set
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BEFORE AFTER 2 treatments MCL 30 Dermablate 126 J/cm² , 13x13 mm fractional 2 treatments, 2 Passes
MicroSpot Superfractional Extension Set
By courtesy of Prof. Kabir Sardana, Delhi
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BEFORE AFTER 3 treatments MCL 30 Dermablate 162 J/cm² , 13x13 mm fractional 3 treatments, 3 Passes
MicroSpot Superfractional Extension Set
By courtesy of Prof. Kabir Sardana, Delhi
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Dermal lesions 1. Khatri KA. Ablation of cutaneous lesions using an erbium:YAG laser. J Cosmet Laser Ther 2003; 5:1-4 2. Kaufmann R, Beier C. Erbium YAG laser therapy of skin lesions. Med Laser Appl 2001;16:252-263 3. Doi H, Ogawa Y, Hatoko M. Treatment of melanin-induced benign dermal lesions by an Erbium-YAG laser system. J Plast
Reprod Surg 2000; 0:90-95 4. Wollina U, Konrad H, Karamfilov T. Treatment of common warts and actinic keratosis by Er:YAG laser. J Cutan Laser Ther
2001;3:63-66 5. Beier C, Kaufmann R. Efficacy of erbium:YAG laser ablation in Darier disease and Hailey-Hailey disease. Arch Dermatol. 1999;
135(4):378-80 Aesthetic lesions (Skin Resurfacing) 1. Jasin ME. Achieving superior resurfacing results with the Erbium:YAG laser. Arch Facial Plast Surg 2002; 4:262-266 2. Perez MI, Bank DE. Facial skin resurfacing with the Erbium:YAG laser: new findings. Cosmetic Dermatology 1998;5:27-37 3. Khatri KA, Machado A, Magro C, Davenport S. Laser peel: facial rejuvenation with a superficial erbium:YAG laser treatment. J
Cutaneous Laser Ther 2000;2:119-123 4. Khatri KA, Ross V, Grevelink JM, Magro CM, Andersson RR. Comparison of erbium:YAG and carbon dioxide lasers in
resurfacing of facial rhytids. Arch Dermatol 1999;135(4):391-7
Bibliography Er:YAG-Laser