Method for skin rejuvenation and cicatricial correction due to laser application

FIELD: medicine.

SUBSTANCE: the present innovation deals with rejuvenating facial skin and correcting cicatrices. Initial laser treatment of facial skin should be carried out at impulse energy being 1000-1200 mJ till the appearance of single drops of "bloody dew". Further laser treatment should be conducted at laser impulse energy ranged 200-600 mJ. On finishing treating the skin with laser, before epithelization one should apply a mask made of transparent cotton tissue with "Aurobin" onto wound surface of patient's skin. One day later the mask should be removed. The innovation enables to prevent considerable lesions of epidermis' basal membrane at the stage of ablation, perform higher compression of collagen fibers at the stage of thermal contraction. The method suggested enables to fulfill treatment with the help of laser till maximally possible smoothing the wrinkles and cicatrices. The method enables to prevent skin infectioning after laser treatment and, also, accelerate the process of epithelization.

EFFECT: higher efficiency.

2 ex

 

The invention relates to medicine, in particular to cosmetology, and is intended for facial rejuvenation and correction of scars using laser.

Known way to rejuvenate the face, neck and body using the erbium laser (patent RF№2190436, class a 61 N 5/067, publication 12.10.2003,), according to which the surface area of the skin is simultaneously affected by an electric current of high frequency and laser electromagnetic radiation in the red and infrared ranges with a power density of 0.2 mW/cm2up to 5 W/cm2. The influence of an electric current of high frequency is performed by d'arsonval apparatus. The number of treatments ranges from 2 to 10 on the course with repeat 2-3 times per year.

This method is a therapeutic method of rejuvenation of the face and neck and allows only a few to increase vascular tone.

The disadvantage of this method is that because it is a therapeutic method, it is fairly time-consuming and requires multiple repetition of procedures to strengthen the results. In addition, the use darsonvalization is contraindicated if you have dry sensitive skin and skin with telangiectasia and, in addition, this method cannot eliminate deep wrinkles and scars.

There is also known a method of skin rejuvenation and aesthetic correction of the skin with p the power of the laser (patent RF №2218138, class. And 61 N 5/067 published 12.10.2003,), according to which the treated areas of skin to form a skin fold of the maximum possible thickness, while its moderate compression to visual poslednee skin in the crease formed. Then carry out the action of high-intensity laser radiation with wavelength 989 nm and the radiation power of 0.5-2 W from a distance of 1-4 mm once, moving the optical fiber along the most convex part of the skin fold with a speed of 0.5-1.5 m/s in the direction of the laser beam perpendicular to the surface. In addition, prior exposure on the treated area of skin is applied cosmetic. According to this method possible additional contact processing of low-intensity laser radiation without the formation of skin folds, and for smoothing a particularly deep wrinkles is laser massage, which is performed in a circular motion along the bottom of the wrinkle.

This method has the following disadvantages. When creating folds loss occurs the General outlines of wrinkles, it is impossible to determine its topography, because the contour lines are not visible, the probability of error processing area and, as a consequence, insufficient cosmetic effect.

All of the above methods are not able to adjust scar skin defects.

Also known way homologe the Iya skin resurfacing CO 2laser, in which getting a good cosmetic effect as if deep and shallow wrinkles and scars. However, this method has significant drawbacks - slow production, prolonged erythema, dyspigmentation, as well as more serious complications such as hyperpigmentation and atrophic scars (scientific almanac "Cosmetics and medicine, No. 2/2000, p.55).

The closest technical solution claimed is a method of facial rejuvenation erbium laser ("Aesthetic medicine". Volume 1. No. 5. 2002 412-422 page).

This method includes two stages of leather processing. The first step performed laser ablation until multiple hemorrhages (petechial hemorrhage) with a pulse energy of 2000 MJ, spot treatment with a diameter of 5 mm and a pulse frequency of 8 Hz with two aisles. The second stage is realized by thermal contraction of the collagen fibers of the dermis in two stages, first in the coagulation mode with radiation energy of 1500 MJ, a pulse frequency of 8 Hz and a spot treatment 5 mm. In these settings is 5 passages, the second stage is conducted by reducing the radiation energy of 800 MJ and still do two passes. Postoperative rehabilitation treatments include within just the first day lotion with furatsilina every three hours and the second day impose drying the wound surface ecsod the reel or naftifine, 4 through 7 all day periorbital area treated with 1% tetracycline ointment or aerosol "Alisol" and, in addition, applies in addition antibacterial therapy, correction of water-electrolyte balance, monitoring of daily diuresis, protein metabolism and hematological parameters. This method using the erbium laser is compared with the processing of CO2laser is less traumatic, more rapid epithelialization and significantly lower percentage of complications.

The disadvantage of this method is that the laser ablation until multiple hemorrhages makes it difficult for the second stage and is dangerous because it can cause damage to the basal membrane and the loss of a significant number of basal cells of the epidermis, which are in the postoperative period the basis for the formation of new epidermis. Therefore, in case of damage to the basal membrane time heal the wound surface is significantly increased. In addition, the second stage in two stages at an energy of the first pulse in 1500 MJ, and then from 1000 to 800 MJ is almost no contractions, and ablation and, as if these settings, remove the weight of the fabric material is significant, there is a weak contraction of the collagen fibers. The result is this regime achieves good results only in the presence of shallow wrinkles and small scars. Another drawback is the use of multiple post-operative measures to complete the rejuvenation process. The facial skin in the way the prototype reaches a normal state not earlier than 5-6 months after the laser peel.

The objective of the invention is to develop a method of facial rejuvenation erbium laser that eliminates the possibility of damage to the basal membrane of the epidermis and get a good cosmetic effect, laser treatment of the skin with deep wrinkles and significant scarring, simplification and reduction of the postoperative rehabilitation period.

The problem is solved in that the rejuvenation of facial skin laser is carried out by treatment of the skin erbium laser in two stages - the first stage is carried out in the ablation mode and the second mode of thermal contraction of the collagen fibers of the dermis with subsequent rehabilitation of the wound surface. According to the invention the ablation is carried out until the emergence of single drops of "blood dew, and thermal contraction of the collagen fibers is carried out with a pulse energy between 200 and 600 MJ. If this passes is carried out until the appearance of yellow-brown film in the processing of deep wrinkles and brown film in the processing of significant scarring. After the laser treatment on wound surface impose clear hlopchatobumazhnoyi mask, which is pre-impregnated with ointment "Aurobin".

Thus, the claimed technical solution has distinctive features as compared to peers and with the prototype and meets the criterion of "novelty".

Due to the fact that the first stage is carried out in the ablation mode until single drops of "blood dew", it becomes possible to prevent significant damage to the basal membrane and properly assess the depth of the surface to start the second stage. The second phase with a pulse energy between 200 and 600 MJ allows you to carry out the second phase is not in the ablation mode and the coagulation mode, and influence due to the temperature at great depth, i.e. on the structure of the dermis, which promotes a stronger contraction of collagen fibers, and thermal contraction until the yellow-brown film when removing wrinkles and brown coagulation of the film at smoothing out scars contributes to the alignment of all skin irregularities and to obtain a good cosmetic effect with the laser treatment of the skin with deep wrinkles and scars. Use in the postoperative period, cotton mask, impregnated with ointment "Aurobin", relieves pain and protects the wound from infection and eliminates the use of antibacterial t is rapee, and in combination with the stated parameters of skin treatment laser to simplify and reduce the postoperative rehabilitation period. In addition, the bandage impregnated "Aurobindo", prevents the appearance of crusts on the skin, which can lead to bleeding and infection, which is possible according to the method, conducted on the prototype, and that will require constant medical supervision in hospital. The second phase according to the prototype mode more than 600 MJ, for example, 800 MJ, means conducting the process in the ablation mode, with no thermal heating of the tissue to the desired depth, and again is only mechanical removal of the upper layers of the epidermis.

The second phase of laser treatment of facial skin at pulse energy of less than 200 MJ is not possible to obtain a marked smoothing of skin defects.

Thus, the claimed technical solution meets the criterion of "inventive step".

The method is as follows.

For laser processing used erbium laser with a wavelength of 2.9 nm. Before the procedure of rejuvenation and smoothing scars trained skin. For this patient was performed whitening, exfoliating treatments 1 time per week during the month glycol peels.

Laser processing (polishing) is carried out at a total managed intravenous anesthesia drugs "dormicum" and "Diprivan".

The first stage ablation, carried out at laser energy 1000-1200 MJ depending on the amount of wrinkles or scars at frequency 8-15 Hz spot diameter and 5 mm Laser processing begins by conducting passages of the laser beam overlap each previous pass by 1/3 in size.

Passages carried out until the single drops of bloody dew, and the pink hue of the epidermis. This indicates the adequacy of the first processing stage and means that mechanical removal of the upper layers of the epidermis completed that allows you to move to the second stage of thermal contraction of the collagen fibers of the dermis. Thermal contraction carried out in the same way, but with a pulse energy between 200 and 600 MJ depending on the depth of wrinkles and the size of the scars, when the pulse frequency of 8 Hz and a spot of 5 mm, Number of passes carried out to the highest possible wrinkles or scars, until the yellow-brown film when removing wrinkles or brown coagulation of the film when the smoothing scars. This thermal effect on the dermis allows you to create a condition for the stimulation of the dermis and, consequently, to eliminate all imperfections.

After the laser treatment on whether what about the superimposed transparent cotton bandage, impregnated "Aurobindo", which was shot in a day, a person was treated furatsilinom and dried. Over the next 7 days was carried out 3-4 times a day, applying a thin layer of ointment "D-panthenol, and morning and evening washing furatsilinom to remove the waste of the ointment.

During these 7 days is complete epithelialization of the skin, the skin becomes pink. Next, patients were prescribed sunscreen for the day and 2% hydroxynonenal cream every night for 2 months.

Examples of the method.

1. Patient B. 55.

Skin is oily, the tone is reduced. Determined pronounced wrinkles around the eyes and lips, the average depth of wrinkles in the brow area and the forehead. Nasolabial folds are expressed due to ptosis of the skin of the cheeks. Phototype - 3 according to Fitzpatrick.

The preparation procedure was conducted glycol peeling within a month with the purpose of peeling and whitening of the epidermis.

The procedure of laser peel.

In terms of operating after 3-fold treatment with 0.5% alcoholic chlorhexidine entire face and total managed intravenous anesthesia drugs "dormicum" and "Diprivan" laser peel erbium laser with a wavelength of 2.9 nm started from the right and left corners of the lower jaw and chin. Peeling was performed on all the face of bottom-up and zakanchivali border scalp forehead.

The first stage was conducted in 4 pass energy of 1000 MJ with a frequency of 5 Hz until the single drops of "blood dew" and the pink hue of the epidermis. For centuries, the first stage was conducted in 3 pass energy of 800 MJ with the same frequency. The tip of the fiber was directed perpendicular to, the spot diameter 5 mm Pink hue of the epidermis indicates the absence of damage to the basal membrane.

The second stage was carried out 3 passes until the yellow-brown film energy from 400 to 600 MJ with a frequency of 5 Hz. In problem areas (around the lips, forehead, upper and lower eyelids) carefully processed "hangers wrinkles until brown film with energies from 200 to 400 MJ in 4 passes with a frequency of 5 Hz. The tip of the fiber was directed perpendicular to, the spot diameter of 5 mm On the first and second stages between each pass overlaps dressing furatsilina for removal of coagulation protein.

The rehabilitation period.

After the laser peel on the face superimposed mask of transparent cotton fabric impregnated with ointment "Aurobin", with subsequent one-hour exposure of an ice pack. On the second day after laser peeling the bandage was removed, the surface of the skin is hyperemic, edematous, with single drops of "blood dew"after a small hemostasis sterile pad superimposed ointment D-Punta ethanol is ol". During the third fifth day face washed furatsilinom 2-3 times a day, and then were treated with ointment "D-panthenol". Subsequently within one month the patient was recommended to use sunscreen and 4% hydroxynonenal ointment. Sunscreen was applied in the morning and 4% hydroxynonenal ointment at night.

The skin condition of the patient after the operation.

The surface of the skin is hyperemic with small petechial bleeding all over the surface. Determined by marked swelling.

The skin condition after 1 week.

There was a complete epithelization, still has a small redness and swelling.

The skin condition of the patient after 1 month.

The surface is slightly redness, swelling is absent. Wrinkles have been smoothed out completely, the skin tone is increased.

The skin condition of the patient after 3 months.

The full smoothing facial wrinkles around the eyes and lips, brow area and the forehead. The skin tone is increased.

2. Patient N. 23 years.

Skin is oily, normal tone. Cheeks are determined scars after acne (from shallow to deep). Phototype - 3 according to Fitzpatrick.

The preparation procedure was conducted glycol peels for peeling and whitening of the epidermis in the course of a month.

The procedure of laser peel.

In the services who were operating after 3-time processing of 0.5% alcoholic chlorhexidine entire face and total managed intravenous anesthesia drugs "dormicum" and "Diprivan", laser peel erbium laser with a wavelength of 2.9 nm started from the right and left corners of the lower jaw and chin. Peeling was performed on all the face upwards and ended at the border of the scalp to the forehead.

The first stage was carried out across the surface of the skin, in addition to age, 4 pass energy of 1000 MJ with a frequency of 5 Hz to the appearance of single drops of "blood dew" and the pink hue of the epidermis. The tip of the fiber was directed perpendicular to, the spot diameter 5 mm, the Second stage was conducted in the cheeks 4 pass until brown film energy from 200 to 400 MJ with a frequency of 5 Hz with an intense working of the edges of the crater each scar. The tip of the fiber was directed perpendicular to, the spot diameter of 3 mm On the first and second stages between each pass overlaps dressing furatsilina for removal of coagulation protein.

The rehabilitation period.

After the laser peel on the face superimposed mask of transparent cotton fabric impregnated with ointment "Aurobin", with subsequent one-hour exposure of an ice pack. On the second day after laser peeling the bandage was removed, the surface of the skin is hyperemic, edematous, with single drops of "blood dew"after a small hemostasis sterile pad superimposed ointment "D-panthenol". During the third five-what's the day the person was laundered furatsilinom 2-3 times a day, then were treated with ointment "D-panthenol". Subsequently within one month the patient was recommended to use sunscreen and 4% hydroxynonenal ointment. Sunscreen was applied in the morning and 4% hydroxynonenal ointment at night.

The skin condition of the patient after the operation.

The surface of the skin is hyperemic with small petechial bleeding all over the surface of the skin of the cheeks. Determined by marked swelling.

The skin condition after 1 week.

There was a complete epithelization, still has a small redness and swelling in the cheeks.

The skin condition of the patient after 1 month.

The surface is slightly redness, swelling is absent. Scars on the cheeks and smoothed out, the skin tone increased.

Thus, the proposed method is compared with the known methods of laser skin treatment allows to obtain a good cosmetic effect in a significant simplification and reduction of the postoperative rehabilitation period.

The method of skin treatment facial laser containing skin treatment at the first stage in the ablation mode, thermal contraction of the collagen fibers in the coagulation mode at the second stage, the implementation of post-operative rehabilitation procedures, including epithelization of the skin, characterized in that the processing of l is zerom mode ablation lead to the emergence of single drops of "blood dew" and thermal contraction of the collagen fibers is carried out at pulse energy between 200 and 600 MJ until the yellow-brown film when removing wrinkles or until brown coagulation of the film at smoothing out scars and after treatment skin laser on wound surface impose a mask made of cotton, soaked in cream "Aurobin".



 

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1 ex

FIELD: medicine, otorhinolaryngological surgery.

SUBSTANCE: one should apply thin layer of "Solcoseryl" gel onto osseous facial walls of frontal and maxillary sinuses at the border with trepanation opening after removing pathological content out of them and before applying a transplant out of flat bone of human fetal cranial arch that exceeds the diameter of trepanation opening by 3-4 mm. Then, one should additionally fix the transplant by affecting with distal edge part of a light guide of semi-conductor laser "ATKUS-15" with contact-type technique at output power of laser radiation being 8 W at constant mode. The method enables to increase fixation density of allobrefobone to osseous walls of sinus along its whole diameter.

EFFECT: higher efficiency of fixation.

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