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Background and Objectives: The development of chronic non-healing wounds is multifactorial and can lead to increased patient morbidity. When traditional wound care methods fail, alternative treatments are needed to prevent chronic ulcer complications. Ablative fractional laser resurfacing (AFR) is an emerging therapy for chronic wounds. We report the successful use of AFR to facilitate the healing of chronic wounds in two pediatric patients., Study Design/materials and Methods: This is a case series including two patients with chronic wounds within scars that were treated with a micro-fractionated carbon dioxide (CO2 ) laser in a single pass at a pulse energy of 50 mJ and a treatment density of 5%. One patient had one treatment and the other had two treatments 1 month apart., Results: AFR led to rapid healing of chronic wounds in both pediatric patients. The wounds remained epithelialized after 9 months in one patient and 4 months in the other. There were no complications., Conclusions: The combination of tolerability and efficacy observed in these cases introduces AFR as a potential promising adjunct to existing treatments for chronic, non-healing wounds in the pediatric population., (© 2015 Wiley Periodicals, Inc.)

Background/objective: The purpose of this study was to assess the effects of fluence, pulse stacking, and multiple passes on the depth of injury caused by a fractionated Er:YAG laser in an in vivo farm pig model. DESIGN/MATERIAL/METHODS: A fractionated 2,940 nm Er:YAG laser (Pixel, Alma Lasers, Caesarea, Israel) was applied to the flank skin of a Yorkshire cross pig. The 11 mmx11 mm handpiece was comprised of either 49 or 81 microbeams (200 microm diameter), depending on the tip configuration. There were six different parameter sets divided according to total energy per pulse (150, 285, and 500 mJ) and tip type (81 or 49 microbeams per 11 mmx11 mm macrospot). Each of these six groups was subdivided according to number of stacked pulses (1, 3, and 6) and number of passes (1, 3, and 6). This resulted in a total of 36 treatment parameters., Results: With the 49 microbeam configuration, a single pulse resulted in partial epidermal ablation at 150 mJ, complete epidermal ablation at 285 mJ and partial dermal ablation at 500 mJ to a depth of 90 microm. Stacking the pulses resulted in a significant increase in ablation with each fluence with the maximal depth of ablation measured at 140 microm after six stacked pulses at 500 mJ. Increasing the number of passes did not result in a significant increase in ablative depth, but did create a larger surface area of ablation. Residual thermal damage (RTD) was minimal and remained between 10 and 20 microm., Conclusions: The fractionated Er:YAG laser exhibited some of the same tissue interactions as its fully ablative counterparts. An increase in fluence resulted in an increase in ablative depth with minimal RTD. Additionally, RTD was unaffected by pulse stacking or by additional passes. Differences were that pulse stacking appeared to yield a more rapid decrease in ablation efficiency and additional passes did not seem to increase the depth of ablation.

Background and Objectives: Acne scarring is a common and difficult to treat condition. The plasma skin regeneration (PSR) system is a novel device that causes delayed ablation of the epidermis and controlled thermal modification to the underlying dermis. PSR has previously been shown to be a safe and effective treatment for facial rhytides and benign skin lesions. In this study, we investigated the safety and efficacy of single-treatment, high-energy, double-pass PSR for the treatment of acne scarring., Study Design/materials and Methods: Ten patients with acne scarring and Fitzpatrick skin types I-III were included in the study. All patients underwent a single PSR treatment with two high-energy passes (3.5-4.0 J). Treatments were performed in an outpatient clinic setting. Nine patients completed 6 months of follow-up. Improvement was determined by patient questionnaires and physician evaluation of digital photographs taken prior to treatment and at 3 and 6 months post-treatment., Results: On average, patients reported 34% improvement in their acne scarring at 3 months and 33% improvement at 6 months. Blinded physician ratings of patient photos demonstrated 19% improvement at 3 months and 34% at 6 months. Re-epithelialization was complete by 4-6 days after treatment, and no serious adverse events were encountered., Conclusion: PSR appears to provide a safe and effective single treatment, minimal downtime alternative for the treatment of acne scarring. Additional studies are warranted to further demonstrate the safety and efficacy of this device.