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Zhang P, Pei H, Zhou G, Fu Q, Bai R, Lin P, Wu Q, Xu X, Chen M. Effectiveness and Safety of Micro-Plasma Radiofrequency Treatment Combined With Autologous Chyle Fat Grafting Treatment for Hypertrophic Scars: A Retrospective Study. J Cosmet Dermatol 2025; 24:e16728. [PMID: 39731280 DOI: 10.1111/jocd.16728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2024] [Revised: 11/23/2024] [Accepted: 12/02/2024] [Indexed: 12/29/2024]
Abstract
BACKGROUND Hypertrophic scar (HS) is a fibroproliferative disorder resulting from abnormal healing of skin tissue after injury. Although various therapies are currently employed in clinical to treat HSs, there is no widely accepted standard therapy. Micro-plasma radiofrequency (MPR) and autologous chyle fat grafting are emerging treatments for this condition, and they have demonstrated promising therapeutic outcomes in clinical applications. The aim of this study is to investigate the effectiveness and safety of combining MPR with autologous chyle fat grafting for the treatment of HSs. METHODS We performed a retrospective study on patients diagnosed with HS in a single center between January 2020 and December 2023. According to the treatments, patients were divided into three groups, with 6 months follow-up. The single therapy group received MPR alone for two times. The combined therapy Group 1 first received the MPR treatment followed by the combined treatment. The combined therapy Group 2 first received the combined treatment and then received the MPR treatment. The effectiveness of treatment was evaluated using the Vancouver Scar Scale (VSS) and the Patient Scar Assessment Scale (PSAS). The Visual Analog Scale (VAS) was used to assess the patients' pain on the day of treatment and 1 day after treatment. Adverse events and complications were recorded to assess the safety of treatment. RESULTS A total of 73 patients diagnosed with HS were enrolled in this study, including 35 patients in the single therapy group, 18 patients in the combined therapy Group 1, and 20 patients in the combined therapy Group 2. After the treatments were completed, all three groups exhibited significant effectiveness. The two combined therapy groups scored lower after treatments in the VSS, which includes height, vascularity, pliability, and total scores, as well as in the PSAS, which includes color, stiffness, thickness, and total scores, compared to the single therapy group, with a statistically significant difference. Regarding pain response to treatment, there was no statistical difference in VAS among the three groups. No statistical difference in the overall incidence of adverse events was observed among the three groups, and no severe complications were recorded. CONCLUSIONS This study revealed the combination of MPR and autologous chyle fat grafting showed superior effectiveness compared to MPR alone in treating HSs, without any observed increase in overall adverse event frequency. For patients diagnosed with HS, this combination therapy stands as a promising and effective clinical intervention.
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Affiliation(s)
- Peixuan Zhang
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Haina Pei
- Department of Burn and Plastic Surgery, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, China
| | - Guiwen Zhou
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Qiang Fu
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Ruiqi Bai
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Pianpian Lin
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Qian Wu
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xiao Xu
- Department of Ophthalmology, The Third Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Minliang Chen
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
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Meng F, Wu Q, Zheng C, Fu Q, Zhou G, Ding H, Xu X, Chen M. The Comparison of Efficacy and Safety Between General and Topical Anesthesia on Micro-Plasma Radiofrequency Treatment for Hypertrophic Scar: A Retrospective Cohort Study. Aesthetic Plast Surg 2024; 48:451-460. [PMID: 37884619 DOI: 10.1007/s00266-023-03706-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 09/30/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND While micro-plasma radiofrequency (MPR) treatment has a significant impact on hypertrophic scars, patients often require anesthesia to alleviate substantial discomfort. Currently, patients with similar degrees of scarring may choose surface anesthesia or general anesthesia based on their personal preferences. Nevertheless, the effectiveness and safety of different anesthesia modalities remain uncertain. OBJECTIVE To assess the effectiveness and safety of both general and surface anesthesia in MPR treatment for hypertrophic scars. METHODS We conducted a retrospective cohort study involving 101 patients diagnosed with hypertrophic scars who underwent MPR with different anesthesia methods. The primary measures of efficacy included the Vancouver Scar Scale (VSS) scores assessed before the first treatment and six months after the final treatment. Pain relief was evaluated using Visual Analog Scale (VAS) scores. Safety was assessed by comparing the incidence of adverse reactions between the two groups. RESULTS Patients in the general anesthesia group showed a significant difference in scar pigmentation 6 months after the treatment and lower pain level than those in the surface anesthesia group in the treatment of MPR. The difference in safety was not statistically significant. After adjusting for confounding factors and propensity score matching, the outcome of VSS and VAS scores was stable. CONCLUSION General anesthesia, as opposed to surface anesthesia, appears to enhance both the effectiveness and safety of MPR while reducing postoperative pain in the treatment of hypertrophic scars. For patients with heightened pain sensitivity, general anesthesia may be the preferred treatment option. LEVEL OF EVIDENCE II This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .
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Affiliation(s)
- Fanting Meng
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Forth Medical Center of Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 10048, China
| | - Qian Wu
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Forth Medical Center of Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 10048, China
| | - Can Zheng
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Forth Medical Center of Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 10048, China
| | - Qiang Fu
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Forth Medical Center of Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 10048, China
| | - Guiwen Zhou
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Forth Medical Center of Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 10048, China
| | - Hongfan Ding
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Forth Medical Center of Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 10048, China
| | - Xiao Xu
- Department of Ophthalmology, The Third Medical Center of Chinese PLA General Hospital, No. 69 Yongding Road, Haidian District, Beijing, 100039, China.
| | - Minliang Chen
- Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Forth Medical Center of Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 10048, China.
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Delavar S, Tehrani S, Hassanzadeh H, Tehrani S. Keloid Treatment Using Plasma Exeresis: A Pilot Trial Study. J Lasers Med Sci 2023; 14:e7. [PMID: 37089764 PMCID: PMC10114038 DOI: 10.34172/jlms.2023.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 01/22/2023] [Indexed: 04/25/2023]
Abstract
Introduction: Keloid scars and hypertrophic scars are more commonly seen after surgeries, suture placements, or other skin damages. Scars can be treated using a variety of methods, including topical compounds, surgery, and lasers. The aim of this study is to evaluate the effects of plasma exeresis on the treatment of keloid scars. Methods: This experimental study was conducted on patients with keloid scars, defined as a treatment-resistant subtype of scars with extension beyond the primary skin defect and cauliflower appearance, in different parts of the body. The patients were treated with 2-to-3-session plasma exeresis. Scars were examined based on the Vancouver scar scale (VSS) before and 5 months after the treatment. Results: A total number of 24 scars were enrolled in this study. The number of patients was 16. There was a decrease in the mean thickness of keloids from 2.20 to 0.54 (P=0.000). The mean pigmentation and pliability scores decreased from 1.54 and 2.16 to 0.375 and 0.541, respectively (P=0.001, 000). There was a significant reduction in the keloid scar vascularity score from 1.666 to 0.541 (P=0.000). There was a decrease from 0.708 to 0.00 (P=0.004) in the mean itchiness score. After the intervention, the mean pain score was 0.000, compared to 0.7500 before the intervention (P=0.003). There was a decrease in the total score from 8.958 to 2.000 (P=0.000). Conclusion: The plasma exeresis procedure is effective in destroying small keloid scars. Furthermore, results in less itching and pain, as well as no significant complications or recurrences.
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Affiliation(s)
- Shohreh Delavar
- Dermatology Department, Faculty of Medicine Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Setareh Tehrani
- Dermatology Department, Faculty of Medicine Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Hournaz Hassanzadeh
- Dermatology Department, Faculty of Medicine Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Sepideh Tehrani
- Dermatology Department, Faculty of Medicine Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
- Correspondence to Sepideh Tehrani,
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Muacevic A, Adler JR, Owayda AM. The Effectiveness of Plasma Skin Regeneration (PSR) in the Treatment of Chronic Cleft Lip Scars in an Adult Syrian Sample: A Cohort Study on a Novel Technique. Cureus 2022; 14:e32989. [PMID: 36712709 PMCID: PMC9879585 DOI: 10.7759/cureus.32989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2022] [Indexed: 12/28/2022] Open
Abstract
Objectives The current study aimed to evaluate the effectiveness of plasma skin regeneration (PSR) in the treatment of cleft lip scars in cleft lip patients. Materials and methods Twenty patients, 10 females and 10 males, with a mean age of 19 years and who had a cleft lip scar, were included in the current study. All patients were treated with a plasma skin regeneration pen device in one treatment session. The thickness, relief, and pliability of the scars were assessed by external observers using a 10-point numeric rating scale (NRS). Results The thickness, relief, and pliability of the scar were significantly improved according to the observers' opinions (51.67%, 50.25%, and 46.33%, respectively). Conclusions Within the limits of this study, the PSR appeared to be safe and effective for treating cleft lip scars with minimal complications.
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Shakouri R, Khani MR, Samsavar S, Jezeh MA, Abdollahimajd F, Hosseini SI, Dilmaghanian A, Ghasemi E, Alihoseini MR, Shokri B. In vivo study of the effects of a portable cold plasma device and vitamin C for skin rejuvenation. Sci Rep 2021; 11:21915. [PMID: 34753995 PMCID: PMC8578492 DOI: 10.1038/s41598-021-01341-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 10/26/2021] [Indexed: 01/01/2023] Open
Abstract
Nowadays, cold atmospheric plasma shows interesting results in dermatology. In the present study, a new portable cold plasma was designed for plasma skin rejuvenation (PSR) purposes. This device is safe and easy to use at beauty salons and homes. The effects of this device were investigated on the rat skins. Also, as a new method to improve PSR results, vitamin C ointment was combined with plasma. In this study, there were four groups of 5 Wistar rats. The first group received vitamin C ointment, the second received 5 min of high-voltage plasma, and the third and the fourth groups received 5 min of high- and low-voltage plasma and vitamin C ointment. This process was done every other day (3 sessions per week) for 6 weeks. To evaluate the thermal effect of plasma, the skin temperature was monitored. Also, the presence of reactive species was demonstrated by the use of optical spectroscopy. In addition, mechanical assays were performed to assess the effect of plasma and vitamin C on the tissue's mechanical strength. The mechanical assays showed a positive impact of plasma on the treated tissue compared to the control group. Also, changes in the collagen level and thickness of the epidermal layer were examined in histological studies. The results indicated an increase in collagen levels after using plasma alone and an accelerated skin reaction after using vitamin C combined with plasma therapy. The epidermal layer's thickness increased after applying high-voltage plasma, which indicates an increase in skin elasticity. This study demonstrates the positive effect of using the portable plasma device with vitamin C ointment on effective parameters in skin rejuvenation.
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Affiliation(s)
- Reza Shakouri
- Laser and Plasma Research Institute, Shahid Beheshti University, G.C., P.O. Box 19839-6941, Tehran, Iran
- Physics Department of Shahid, Beheshti University, G.C., P.O. Box 19839-6941, Tehran, Iran
| | - Mohammad Reza Khani
- Laser and Plasma Research Institute, Shahid Beheshti University, G.C., P.O. Box 19839-6941, Tehran, Iran.
| | - Shirin Samsavar
- Laser and Plasma Research Institute, Shahid Beheshti University, G.C., P.O. Box 19839-6941, Tehran, Iran
- Physics Department of Shahid, Beheshti University, G.C., P.O. Box 19839-6941, Tehran, Iran
| | - Mahya Aminrayai Jezeh
- Laser and Plasma Research Institute, Shahid Beheshti University, G.C., P.O. Box 19839-6941, Tehran, Iran
| | - Fahimeh Abdollahimajd
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Clinical Research Development Unit, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Iman Hosseini
- Faculty of Physics, Shahrood University of Technology, Shahrood, 3619995161, Iran
| | - Aydin Dilmaghanian
- Department of Basic Sciences, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Erfan Ghasemi
- Laser and Plasma Research Institute, Shahid Beheshti University, G.C., P.O. Box 19839-6941, Tehran, Iran
| | - Mohammad Reza Alihoseini
- Laser and Plasma Research Institute, Shahid Beheshti University, G.C., P.O. Box 19839-6941, Tehran, Iran
| | - Babak Shokri
- Laser and Plasma Research Institute, Shahid Beheshti University, G.C., P.O. Box 19839-6941, Tehran, Iran
- Physics Department of Shahid, Beheshti University, G.C., P.O. Box 19839-6941, Tehran, Iran
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Ting W, Chong Y, Xu J, Huang J, Yu N, Liu Z. Treatment of Keloids Using Plasma Skin Regeneration Combined with Radiation Therapy Under the Evaluation of Patient and Observer Scar Assessment Scale. Clin Cosmet Investig Dermatol 2021; 14:981-989. [PMID: 34385829 PMCID: PMC8353170 DOI: 10.2147/ccid.s321348] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 07/21/2021] [Indexed: 02/03/2023]
Abstract
Purpose Keloids are caused by uncontrolled excessive proliferation of fibrous tissue. Multiple treatment strategies including steroid injection, surgical excision, laser therapy and radiation therapy have been reported. Few studies have evaluated the performance of plasma skin regeneration (PSR) in the treatment of keloid. This study aimed to evaluate the effectiveness of PSR combined with radiation therapy for keloids on different body parts. Patients and Methods A total of 71 patients with 98 keloids were enrolled in this study. Keloids <4 mm thick underwent single-dose PSR, while keloids ≥4 mm thick were administered compound betamethasone injection beforehand. Radiation therapy was administered after 24 hours and again 7 days later after PSR. The outcome was evaluated using the patient and observer scar assessment scale at 12 months post-treatment. Results Patient-reported average scores for all keloids significantly decreased from 35.05±9.94 to 21.84±7.04 (p < 0.05). Keloids on face and neck, chest, and back responded better than those on shoulders and limbs. The recurrence rate was observed to be 15.3% (15 out of 98). Adverse effects were mild. Conclusion PSR combined with radiation therapy is an effective and safe strategy to treat keloids. Location could be a factor that affects curative effects.
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Affiliation(s)
- Wenyun Ting
- Department of Plastic and Aesthetic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Yuming Chong
- Department of Plastic and Aesthetic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China.,Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Jing Xu
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Jiuzuo Huang
- Department of Plastic and Aesthetic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Nanze Yu
- Department of Plastic and Aesthetic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Zhifei Liu
- Department of Plastic and Aesthetic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
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Du Y, Lv GZ, Yu S, Wang D, Tan Q. Long-term medical treatment of patients with severe burns at exposed sites. World J Clin Cases 2020; 8:3515-3526. [PMID: 32913858 PMCID: PMC7457097 DOI: 10.12998/wjcc.v8.i16.3515] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 05/18/2020] [Accepted: 07/14/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Body parts such as the face and hands are highly exposed during daily life and burns may accumulate in these areas. In addition, residual wounds, scar hyperplasia and contracture often exist in the late stage of a deep burn in these areas, which may affect patients’ appearance, movements, and mental health. However, inadequate attention has been paid to this issue which can result in problems, such as difficulty in healing, possibility of carcinoma, chronic pain and a heavy mental burden.
AIM To investigate the long-term medical treatment of patients with severe burns at exposed sites following a mass burn casualty event.
METHODS A retrospective analysis of 13 patients with severe burns at exposed sites was performed to determine their respective long-term medical treatment. A combined wound dressing scheme consisting of traditional Chinese and Western medicine was introduced to repair residual wounds. Active and passive functional exercises with massage, Chinese herbal baths and compression fixation were proposed to ameliorate the condition of the hands. A combination of physical, chemical and photoelectrical measures was adopted for anti-scar treatment. A psychological intervention and recovery guide was provided which corresponded to the patients’ psychological status.
RESULTS Compared to patients who did not simultaneously receive the same treatment, patients who underwent systematic treatment recovered with a lower wound infection rate (P < 0.05), a shorter healing time (13.6 ± 3.2 d) compared with (19.1 ± 3.5 d) and more bearable pain during wound dressing at three days, one week and two weeks after a Chinese herbal bath (P < 0.05). Satisfactory results were achieved with regard to restored function of patients’ joints and blood supply to nerve endings, closure of the eyelids and the size of mouth opening tended to be normal, and only 7.1% of patients were diagnosed with severe scar hyperplasia and contracture deformity compared with 30.7% in the control group. In addition, the color, thickness, vascular distribution and softness score of the scars improved (P < 0.01), and the effects of the psychological intervention was remarkable as shown by the Self-Rating Anxiety Scale and Self-Rating Depression Scale.
CONCLUSION A better prognosis can be achieved in patients in the late stage of a burn with active residual wound repair, limb functional exercise, anti-scar and psychological rehabilitation.
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Affiliation(s)
- Yong Du
- Department of Burns and Plastic Surgery, Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu Province, China
- Department of Burns and Plastic Surgery, The Drum Tower Clinical College of Nanjing Medical University, Nanjing 210008, Jiangsu Province, China
| | - Guo-Zhong Lv
- Department of Burns and Plastic Surgery, Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu Province, China
| | - Shun Yu
- Department of Burns and Plastic Surgery, Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu Province, China
| | - Dan Wang
- Department of Burns and Plastic Surgery, Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu Province, China
| | - Qian Tan
- Department of Burns and Plastic Surgery, The Drum Tower Clinical College of Nanjing Medical University, Nanjing 210008, Jiangsu Province, China
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Zhang W, Liu Z, Zhu L, Zeng A, Ting W, Wang X, Yu N, Xia G. Combining micro-plasma radio-frequency with hypofractionated electron-beam radiation as a novel treatment of keloids: A case series. Medicine (Baltimore) 2019; 98:e18094. [PMID: 31770227 PMCID: PMC6890320 DOI: 10.1097/md.0000000000018094] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Micro-plasma radio-frequency (MPR) technology has been demonstrated a safe and effective treatment for kinds of scars, but there is no report about the application of the MPR on keloids. In this investigation, we creatively use MPR technology combining with hypofractionated electron-beam radiation to cure keloids. PATIENT CONCERNS AND DIAGNOSES From February 2013 to December 2016, 22 Asian patients (16 male, 6 female, age 19-46 years, mean age 28.14 ± 7.31 years) with keloids over half a year were enrolled in this study. INTERVENTIONS AND OUTCOMES All patients received a single MPR technology treatment by roller tip at 80-100 watt, and then hypofractionated electron-beam radiation of 6 MeV were performed twice, within 24 hours and one week after the operation with 9 Gy per time. Improvement were determined by the Vancouver Scar Scales (VSS) according to digital photographs. The results show that the volume of keloids reduced significantly among most patients. Only 3 patients encountered with mild to moderate hyperpigmentation, and none of malignance and worsening or recurrence of scars was observed. LESSONS MPR technology combined with post-operative hypofractionated electron-beam radiation therapy is an effective method for patients with multiple keloids distributed widely on the body with minimal complications, especially for patients with widely distributed keloids.
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Holcomb JD, Schucker A. Helium Plasma Skin Regeneration: Evaluation of Skin Tissue Effects in a Porcine Model and Comparison to Nitrogen Plasma Skin Regeneration. Lasers Surg Med 2019; 52:23-32. [PMID: 31587330 PMCID: PMC7004100 DOI: 10.1002/lsm.23167] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2019] [Indexed: 11/17/2022]
Abstract
Background and Objectives Helium plasma skin regeneration (PSR) is a novel skin rejuvenation technology with significant differences compared with nitrogen PSR technology but that may exert similar skin tissue effects. Study objectives included a comparison of acute and chronic skin tissue changes among the two plasmas in a porcine animal model. Study Design/Materials and Methods In this study, both helium and nitrogen gas plasmas were used to treat the dorsal skin of Yorkshire cross mini pigs with 20% (8.6 J/cm2) and 40% (17.8 J/cm2) power helium plasma single pass treatment (4 liter gas flow, continuous energy delivery, and linear non‐overlapping passes) compared with high energy nitrogen plasma double pass treatment (PSR3 @ 14.1 J/cm2: 4.0 J, 2.5 Hz pulse rate, overlapping horizontal, and vertical passes). Acute and chronic skin contraction, maximum acute depth of injury and chronic reparative healing depth were assessed along with representative histopathology in each treatment paradigm. Results High‐energy nitrogen plasma treatment exhibited greatest mean depth of acute tissue injury 4 hours post‐treatment whereas helium plasma treatment exhibited greater acute skin tissue contraction. Then, 20% and 40% power helium plasma treatment results were each very similar among animals as a percentage of nitrogen plasma treatment results for both depths of acute tissue injury and acute skin tissue contraction. Mean depths of reparative tissue healing were similar among treatment paradigms 30 days after treatment with significant intra‐ and inter‐animal variability observed within each treatment paradigm. Thirty‐day mean skin tissue contraction was greater for helium plasma treatment; however, the data varied significantly between animals in all paradigms. Histopathologic tissue evaluation after 30 days showed similar findings among the treatment paradigms with epidermal hyperplasia, flattening of rete ridges and with regenerative granulation tissue expanding the superficial and papillary dermis. Conclusions This study demonstrates modestly reduced depth of the thermal effect, greater skin tissue contraction and similarity of acute and chronic histopathological findings for helium plasma when compared with nitrogen plasma in a porcine animal model. © 2019 The Authors. Lasers in Surgery and Medicine published by Wiley Periodicals, Inc.
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Affiliation(s)
- J David Holcomb
- Division of Facial Plastic Surgery, Holcomb-Kreithen Plastic Surgery and MedSpa, Sarasota, Florida
| | - Adrienne Schucker
- Department of Pathology, American PreClinical Services, Minneapolis, Minnesota
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Giroux PA, Hersant B, SidAhmed-Mezi M, Pizza C, La Padula S, Meningaud JP. The Outcomes Assessment of the Plasma Blade Technology in Upper Blepharoplasties: A Prospective Study on a Series of 25 Patients. Aesthetic Plast Surg 2019; 43:948-955. [PMID: 30927022 DOI: 10.1007/s00266-019-01360-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Accepted: 02/21/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND The Dermo Ablation Surgery (DAS) Medical® (Technolux, Italy) device is a plasma blade which induces a plasma voltaic arc causing a retraction in the epidermis and superficial dermis. OBJECTIVE The aim of our study is to prove the efficacy and safety of the DAS Medical® device in dermatochalasis size reduction. METHODS Our prospective study included 25 adult patients presenting with upper eyelid dermatochalasis undergoing a two-session treatment protocol with the DAS Medical® device (with a month treatment-free interval). The primary end point was the reduction in the size of the dermatochalasis. The secondary end points were patient satisfaction, and a blinded assessment of the outcomes was carried out by 15 plastic surgery specialists on post-procedural pictures. RESULTS The mean reduction in the size of the dermatochalasis was estimated at 2.47 mm on a 6-month follow-up (13.5 mm at T0 vs. 11.03 mm at 6 months, p = 0.0002) and 1.97 mm on a 12-month follow-up ((13.5 mm at T0 vs. 11.53 mm at 12 months, p = 0.0055). Eighty per cent of the patients and 78% of the assessing clinicians were globally satisfied with the results on a 12-month follow-up. The mean visual analogue pain score reported during the treatment was 4.5/10; MEOPA® was used in 23% of cases. No irreversible post-procedural sequelae (complications) were observed. CONCLUSION Voltaic plasma arc treatment with DAS Medical® is an effective technique for non-invasive blepharoplasty on moderate dermatochalasis patients not suffering from palpebral lipoptosis and is very well tolerated. It can be usefully and successfully associated with surgery. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Fu X, Dong J, Wang S, Yan M, Yao M. Advances in the treatment of traumatic scars with laser, intense pulsed light, radiofrequency, and ultrasound. BURNS & TRAUMA 2019; 7:1. [PMID: 30723753 PMCID: PMC6350396 DOI: 10.1186/s41038-018-0141-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Accepted: 12/25/2018] [Indexed: 12/21/2022]
Abstract
Traumatic scarring is one of the most common complications after soft tissue injury caused by burns and trauma, which affects tens of millions of people worldwide every year. Traumatic scars diminish the quality of life due to disfigurement, symptoms of pain and itch, and restricted motion. The pathogenesis and pathophysiology of traumatic scar remain elusive. The management for traumatic scars is comprised of surgical and non-surgical interventions such as pressure therapy, silicone, corticosteroid, and radiotherapy, which are chosen by clinicians based on the physical examinations of scars. Recently, great progress in treating traumatic scars has been achieved by the development of novel technologies including laser, intense pulsed light (IPL), radiofrequency, and ultrasound. The aim of this review article was to summarize the advances of these technologies for traumatic scars intervention.
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Affiliation(s)
- Xiujun Fu
- Department of Plastic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011 China
| | - Jiying Dong
- Department of Plastic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011 China
| | - Shen Wang
- Department of Plastic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011 China
| | - Min Yan
- Department of Plastic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011 China
| | - Min Yao
- Department of Plastic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011 China
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Tian J, Lei XX, Xuan L, Tang JB, Cheng B. Application of plasma-combined regeneration technology in managing facial acne scars. J COSMET LASER THER 2018; 21:138-144. [PMID: 30110184 DOI: 10.1080/14764172.2018.1481512] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 05/20/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Plasma skin regeneration (PSR) and platelet-rich plasma（PRP） have gained popularity in the treatment of acne scars due to their efficacy and improved tolerability. The objective of this investigation was to evaluate the synergistic effect of PRP plus PSR (plasma-combined regeneration technology, PCRT) in managing facial acne scars. METHODS From March 2015 to June 2017，a total of 25 cases with facial atrophic acne scars were treated with PCRT treatment for three to five times. Treatments were repeated at an interval of 8 weeks．Treatment parameters were titrated to an immediate end point of moderate erythema. The clinical end point for cessation of treatment was the attainment of satisfactory clinical results. Results were monitored photographically up to 6 months after treatment. The efficacy and adverse effects were evaluated by using the following outcome parameters： the duration of edema,erythema and crusting; the degree of hyperpigmentation, hypopigmentation and scarformation; subjective effective rate was evaluated by patients and physicians. RESULTS 22 of 25 participants completed the study, and were followed up for 6-12 months. After three to five treatments, evaluation by patients showed that the total effective rate was 90.91%. Evaluation by two physicians showed that the total effective rate was 86.36%. Treatment was well tolerated by all participants. The total duration of side effects was 6.7 ± 1.7 days of edema, 8.1 ± 2.3 days of erythema,6.5 ± 1.8 days of crusting, respectively. No hyperpigmentation, depigmentation, and worsening of scarring were observed by the conclusion of the follow-up period． Conclusion: These results provide initial evidence for the safety and effectiveness of PCRT as a well-tolerated modality for the treatment of acne scars. PCRT is an ideal treatment for facial acne scars with minimal side effect．.
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Affiliation(s)
- Ju Tian
- a Department of Plastic Surgery, Guangzhou School of Clinical Medicine, Southern Medical University (Guangzhou General Hospital of Guangzhou Military Region) , Guangzhou , Guangdong , P.R. China
- b Department of Plastic Surgery , Guangzhou General Hospital of People's Liberation Army, the Key Laboratory of Trauma Treatment and Tissue Repair of Tropical Area, PLA , Guangzhou , Guangdong , P.R. China
- c Department of Plastic Surgery , ZhongShanCityPeople'Hospital , ZhongShan , Guangdong , P.R. China
| | - Xiao Xuan Lei
- a Department of Plastic Surgery, Guangzhou School of Clinical Medicine, Southern Medical University (Guangzhou General Hospital of Guangzhou Military Region) , Guangzhou , Guangdong , P.R. China
- b Department of Plastic Surgery , Guangzhou General Hospital of People's Liberation Army, the Key Laboratory of Trauma Treatment and Tissue Repair of Tropical Area, PLA , Guangzhou , Guangdong , P.R. China
| | - Li Xuan
- d Department of Human Resources , Guangzhou General Hospital of People's Liberation Army, the Key Laboratory of Trauma Treatment and Tissue Repair of Tropical Area, PLA , Guangzhou , Guangdong , P.R. China
| | - Jian Bing Tang
- b Department of Plastic Surgery , Guangzhou General Hospital of People's Liberation Army, the Key Laboratory of Trauma Treatment and Tissue Repair of Tropical Area, PLA , Guangzhou , Guangdong , P.R. China
| | - Biao Cheng
- a Department of Plastic Surgery, Guangzhou School of Clinical Medicine, Southern Medical University (Guangzhou General Hospital of Guangzhou Military Region) , Guangzhou , Guangdong , P.R. China
- b Department of Plastic Surgery , Guangzhou General Hospital of People's Liberation Army, the Key Laboratory of Trauma Treatment and Tissue Repair of Tropical Area, PLA , Guangzhou , Guangdong , P.R. China
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Wang LZ, Ding JP, Yang MY, Chen DW, Chen B. Treatment of facial post-burn hyperpigmentation using micro-plasma radiofrequency technology. Lasers Med Sci 2014; 30:241-5. [PMID: 25209007 DOI: 10.1007/s10103-014-1649-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 08/28/2014] [Indexed: 11/28/2022]
Abstract
Management of facial post-burn hyperpigmentation is a common and challenging problem for dermatologists and plastic surgeons. The recent development of micro-plasma radiofrequency technology, which allows precise and rapid treatment with controlled thermal injury, can be an effective treatment of post-burn hyperpigmentation. This study aimed to evaluate the effectiveness and complications of micro-plasma radiofrequency treatment of post-burn hyperpigmentation. The study included 35 patients with Fitzpatrick skin type III or IV and facial post-burn hyperpigmentation. Patients received three to five treatments at 8-week intervals. A roller tip was used with the power setting at 60-90 W, and 3-4 passes were made in different directions. The degree of improvement and complications were recorded. Improvement of hyperpigmentation was evaluated by patient self-assessment and by plastic surgeons who compared digital photographs taken before treatment and 2 months after the last treatment. The results showed that post-burn hyperpigmentation responded favorably to micro-plasma radiofrequency treatment with very few complications. The average pain score using a visual analog scale from 0 to 10 was 6.7 ± 0.7. After a series of treatments, 32 of the 35 patients had achieved a >51% improvement of their hyperpigmentation, and 3 patients had achieved a fair improvement. The mean score for improvement of hyperpigmentation was 4.28. Patient self-evaluations indicated good satisfaction with the cosmetic outcomes, and some softening of the scars. Micro-plasma radiofrequency technology is appropriate, effective, and safe for the treatment of facial post-burn hyperpigmentation, and provides a promising noninvasive treatment for superficial facial injuries.
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Affiliation(s)
- Lian-Zhao Wang
- Department of Plastic and Reconstructive Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 33 Ba-Da-Chu Road, Shi Jing Shan District, Beijing, 100144, People's Republic of China
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Loesch MM, Somani AK, Kingsley MM, Travers JB, Spandau DF. Skin resurfacing procedures: new and emerging options. Clin Cosmet Investig Dermatol 2014; 7:231-41. [PMID: 25210469 PMCID: PMC4155739 DOI: 10.2147/ccid.s50367] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The demand for skin resurfacing and rejuvenating procedures has progressively increased in the last decade and has sparked several advances within the skin resurfacing field that promote faster healing while minimizing downtime and side effects for patients. Several technological and procedural skin resurfacing developments are being integrated into clinical practices today allowing clinicians to treat a broader range of patients' skin types and pathologies than in years past, with noteworthy outcomes. This article will discuss some emerging and developing resurfacing therapies and treatments that are present today and soon to be available.
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Affiliation(s)
- Mathew M Loesch
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Ally-Khan Somani
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Melanie M Kingsley
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Jeffrey B Travers
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, IN, USA ; Department of Pharmacology and Toxicology, Indiana University School of Medicine, Indianapolis, IN, USA ; Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Dan F Spandau
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, IN, USA ; Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USA
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Sanderson AR, Wu EC, Liaw LHL, Garg R, Gangnes RA. The effect of topical anesthetic hydration on the depth of thermal injury from the plasma skin regeneration device. Lasers Surg Med 2013; 46:127-31. [DOI: 10.1002/lsm.22210] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2013] [Indexed: 11/06/2022]
Affiliation(s)
- Alicia R. Sanderson
- Department of Otolaryngology; University of California, Irvine; 101 The City Drive Orange California 92868
| | - Edward C. Wu
- Department of Head & Neck Surgery; University of California, Los Angeles Medical Center; 10833 Le Conte Ave., CHS 62-132 Los Angeles California 90095
| | - Lih-Huei L. Liaw
- Beckman Laser Institute and Medical Clinic; University of California, Irvine; 1002 Health Sciences Rd. East Irvine California 92612
| | - Rohit Garg
- Kaiser Permanente Orange County Anaheim Medical Center; 3440 East La Palma Ave Anaheim California
| | - Richard A. Gangnes
- Facial Aesthetic Concepts; 665 Camino De Los Mares #100A San Clemente California 92673
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Goodman G. Commentary on “Comparison of a Fractional Microplasma Radiofrequency Technology and Carbon Dioxide Fractional Laser for the Treatment of Atrophic Acne Scars: A Randomized Split-Face Clinical Study”. Dermatol Surg 2013; 39:567-70. [DOI: 10.1111/dsu.12161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Goodman GJ. Treating Scars: Addressing Surface, Volume, and Movement to Expedite Optimal Results. Part 2: More-Severe Grades of Scarring. Dermatol Surg 2012; 38:1310-21. [DOI: 10.1111/j.1524-4725.2012.02439.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Heinlin J, Isbary G, Stolz W, Morfill G, Landthaler M, Shimizu T, Steffes B, Nosenko T, Zimmermann J, Karrer S. Plasma applications in medicine with a special focus on dermatology. J Eur Acad Dermatol Venereol 2011; 25:1-11. [PMID: 20497290 DOI: 10.1111/j.1468-3083.2010.03702.x] [Citation(s) in RCA: 185] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The recent tremendous progress in understanding physical plasma phenomenon, together with the development of new plasma sources has put growing focus on the application of plasmas in health care. Active plasma components, such as molecules, atoms, ions, electrons and photons, reactive species, ultraviolet radiation, optical and infrared emission and heat have the ability of activating, controlling and catalysing reactions and complex biochemical procedures. Thermal and non-thermal (i.e. cold) plasmas - both already widely established in medicine - are used for various therapeutic applications. Particularly in dermatology, plasma applications hold big potential, for example, in wound healing, such as efficient disinfection or sterilization, therapy of various skin infections or tissue regeneration. This review gives an overview on potential plasma applications in medicine - including the recent research on skin diseases - and summarizes possible interactions between plasmas and living tissue.
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Affiliation(s)
- J Heinlin
- Department of Dermatology, University of Regensburg, Germany
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Treatment of keloids and hypertrophic scars with the triple-mode Er:YAG laser: A pilot study. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/j.mla.2010.10.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Treatment of mesh skin grafted scars using a plasma skin regeneration system. PLASTIC SURGERY INTERNATIONAL 2010; 2010:874348. [PMID: 22567232 PMCID: PMC3335560 DOI: 10.1155/2010/874348] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2009] [Accepted: 04/18/2010] [Indexed: 12/04/2022]
Abstract
Objectives. Several modalities have been advocated to treat traumatic scars, including surgical techniques and laser resurfacing. Recently, a plasma skin regeneration (PSR) system has been investigated. There are no reports on plasma treatment of mesh skin grafted scars. The objective of our study is to evaluate the effectiveness and complications of plasma treatment of mesh skin grafted scars in Asian patients. Materials and Methods. Four Asian patients with mesh skin grafted scars were enrolled in the study. The plasma treatments were performed at monthly intervals with PSR, using energy settings of 3 to 4 J. Improvement was determined by patient questionnaires and physician evaluation of digital photographs taken prior to treatment and at 3 months post treatment. The patients were also evaluated for any side effects from the treatment. Results. All patients showed more than 50% improvement. The average pain score on a 10-point scale was 6.9 +/− 1.2 SD and all patients tolerated the treatments. Temporary, localized hypopigmentation was observed in two patients. Hyperpigmentation and worsening of scarring were not observed. Conclusions. Plasma treatment is clinically effective and is associated with minimal complications when used to treat mesh skin grafted scars in Asian patients.
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