Presidential Greeting - American Society for Laser Medicine and ...

Results: OCT images showed a partial reversal of xerostomiainduced
mucosal thinning by Product A. Characteristic,
quantifiable, simple optical measures of mucosal rehydration by
Product A were identified and validated using backscattering data
extracted from OCT images. Standard dry mouth questionnaires
and tongue blade adhesion determinations were not able to track
oral response to dry mouth treatments with any degree of
usefulness.
Conclusion: This study demonstrated that in vivo OCT imaging
(which requires < 1 second per scan) can detect and measure oral
epithelial response to dry mouth treatments in patients diagnosed
with severe xerostomia. Using a simple fiber optic probe, images
are produced instantly and the procedure is very well tolerated by
patients.
#49
American Society for Laser Medicine and Surgery Abstracts 81
TREATMENT OF INFANTILE HEMANGIOMAS
WITH THE 595 NM PULSED DYE LASER USING
DIFFERENT PULSE WIDTHS IN AN ASIAN
POPULATION
Yong-Kwang Tay
Changi General Hospital, Singapore, Singapore
Background: The pulsed dye laser (PDL) is effective in the
treatment of hemangiomas. Treatment parameters with varying
fluences (low to high) and varying pulse durations (short to long)
have been used, however optimal parameters are unknown. The
aim was to examine the efficacy and safety of the 595 nm PDL for
the treatment of infantile hemangiomas using short (1.5–
3 milliseconds) versus long (10 milliseconds) pulse durations and
high fluences.
Study: Records were reviewed for all patients with infantile
hemangiomas treated with the 595 nm PDL (V-Beam 1 , Candela)
alone from January 2003 to December 2007. Cases with missing
data and those who defaulted follow-up were excluded. The end
point was complete or near complete clearance of the
hemangioma. Most hemangiomas were treated without
anesthesia, with EMLA cream applied only to larger lesions. For
the short pulse duration group (1.5–3 milliseconds), n ¼ 15
patients, the following parameters were used: 7 mm spot size,
fluence 10–13.5 J/cm 2 (mean 11.2 J/cm 2 ) and dynamic cooling
device (DCD) spray duration of 50 milliseconds (ms) and delay of
30 milliseconds. For the long pulse duration group
(10 milliseconds), n ¼ 8 patients, the following parameters were
used: 7 mm spot size, fluence 10.5–14.5 J/cm 2 (mean 12 J/cm 2 ) and
DCD spray duration of 40 milliseconds and delay of
20 milliseconds. The areas were treated with non-overlapping
pulses. Post-treatment purpura was seen in the short pulse
duration group and minimal or no purpura in the long pulse
duration group.
Results: Twenty-three patients, 19 girls and 4 boys (Fitzpatrick
skin type III–VI) met the study criteria. The age at the start of
treatment ranged from 21 2 months to 19 months (mean 6.5
months). Twenty-one hemangiomas were situated on the face, one
on the neck and one on the left labia majora. Twenty-one
hemangiomas were in the proliferative phase and two were in the
stable phase when treatment was started. Ten children had
superficial hemangiomas and 13 had mixed hemangiomas
(presence of a subcutaneous component). The number of
treatments needed to achieve complete or almost complete
resolution of the hemangioma for the short pulse duration group
ranged from 3 to 14 (mean, 8 treatments, median 7 treatments)
and for the long pulse duration group 4–14 treatments (mean 9,
median 7 treatments). For both groups, more treatments were
needed to achieve clearance of mixed hemangiomas, compared to
superficial hemangiomas (on average, 4–5 treatments more).
Erythema, edema and purpura lasted for about a week for the
short pulse duration group versus 2 days for the long pulse
duration group. Two patients had one episode of blistering each
using 1.5 milliseconds pulse duration which resolved
spontaneously without sequelae versus none for the
10 milliseconds pulse duration group. For the short pulse duration
group, hyperpigmentation was noted in two patients (13%),
hypopigmentation in three patients (20%), and mild textural
changes in two patients (13%). For the long pulse duration group,
hyperpigmentation was noted in one patient (12.5%),
hypopigmentation in one patient (12.5%), and mild textural
change in one patient (12.5%). There was no ulceration or
hypertrophic scarring noted in both groups.
Conclusion: Both short and long pulse durations using
moderately high fluences are equally effective in the treatment of
infantile hemangiomas. Treatments were well tolerated and side
effects mild. Shorter pulse durations (1.5–3 milliseconds) had a
slightly higher incidence of side effects compared to longer pulse
durations (10 milliseconds) in these patients with darker
phototypes. Hemangiomas are tumors with relatively larger
diameter blood vessels compared to port-wine stains and this
provides the basis for the use of longer pulse durations.
Limitations were the retrospective nature and the small sample
size of the study. Larger prospective studies are needed to
determine the optimal parameters for the treatment of infantile
hemangiomas.
NURSING/ALLIED HEALTH
#280
TREATMENT OF SUBCUTANEOUS FAT USING A
NOVEL NON-INVASIVE COOLING DEVICE—COOL
SCULPTING TM BY ZELTIQ TM
Holly Bryan, Tina Alster, Elizabeth Tanzi
Washington Institute of Dermatologic Laser Surgery, Washington,
DC
Background: To outline a nursing guide and provide an
updated discussion of our experience using a novel non-invasive
cooling device for the treatment of subcutaneous fat by inducing
fat cell apoptosis through a process called Cryolipolysis TM .
Study: Understand the theory behind Cryolipolysis TM ; Review
proper patient selection and patient expectations; importance of
clinical photography; outline the treatment protocol; review
expected post-operative side effects; outline timing of expected
clinical results; review procedure set-up, application of device, and
intraoperative patient care.
Conclusion: This FDA approved non-invasive cooling device is a
safe and effective method for the treatment of subcutaneous fat
resulting in volume loss with minimal transient side effects.
Measurable fat reduction was obtained in most patients on
abdomen, back and flank regions. Side effects are limited to
transient erythema, purpura, edema, and reduced sensation at
the treatment site.