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Lasers, Lights and New Technologies in Medicine and Surgery

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A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Dermatology".

Deadline for manuscript submissions: closed (25 May 2022) | Viewed by 18333

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Special Issue Editor

Dr. Luigi Bennardo

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Guest Editor

Mariano Santo Hospital, Cosenza, Italy
Interests: clinical dermatology; psoriasis; melanoma

Special Issue Information

Dear Colleagues,

Laser and lights sources are becoming a more and more relevant topic in Medicine and Surgery. Laser ablative devices, such as CO₂ or Erbium lasers, may be used in surgical operations in various specialties, such as dermatology, gynecology, dentistry and plastic surgery, and many others. Single wavelength lasers have been used in medicine to manage various conditions, such as vascular lesions, hyperpigmentations, hair removal, scar management. Also, lights at different wavelengths have been proposed in the management of various diseases, such as psoriasis, hypopigmentations, vitiligo, dermatitis, rosacea. The field of application of these devices is quickly expanding, with the invention of new techniques such as laser-assisted drug delivery or novel applications in cosmetic dermatology.

This Special Issue aims to explore new possible applications of laser and light sources in medicine, both in vivo and in vitro. Also, original studies and reports providing new information to the scientific literature and interesting reviews and commentary adding new perspectives from a clinicians' point of view will be considered eligible for publication.

Dr. Luigi Bennardo
Guest Editor

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

lasers
lights
dermatology
phototherapy
photodynamic therapy
intense pulsed light
ablative lasers
fractional lasers
single-wavelength lasers

Published Papers (6 papers)

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Research

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12 pages, 2791 KiB

Open AccessArticle

Synergistic Sequential Emission of Fractional 10.600 and 1540 nm Lasers for Skin Resurfacing: An Ex Vivo Histological Evaluation

by Steven Paul Nisticò, Luigi Bennardo, Tiziano Zingoni, Laura Pieri, Irene Fusco, Francesca Rossi, Giada Magni and Giovanni Cannarozzo

Medicina 2022, 58(9), 1308; https://doi.org/10.3390/medicina58091308 - 19 Sep 2022

Cited by 12 | Viewed by 2055

Abstract

Background: Fractional ablative and non-ablative lasers are useful treatments for skin rejuvenation. A procedure that provides the sequential application of fractional ablative followed by non-ablative laser treatment may reduce patients’ downtime and deliver better cosmetic results than with either laser alone. Objective: The purpose of the current study was to demonstrate the ameliorative and therapeutic effects in skin remodeling of the synergistic use of the two laser wavelengths (fractional ablative CO₂ and non-ablative 1540 nm) with three different types of pulse shapes, S-Pulse (SP), D-Pulse (DP) and H-Pulse (HP), through which the CO₂ laser can emit, performing an ex vivo histological evaluation. Methods: In this prospective study, ex vivo sheep inner thigh skin was chosen due to its similarity to human skin tissue, and a histological evaluation was performed. Three irradiation conditions, using all of the three CO₂ pulse shapes (alone or averaged), were investigated: (1) 10.600 nm alone, the sequential irradiation of the two wavelengths in the same perfectly controlled energy pulses (DOT) for the entire scan area; ((2) 10.600 nm followed immediately by 1540 nm; and (3) 1540 nm followed immediately by 10.600 nm). Results: When comparing ablative to sequential irradiations, the synergy of the two wavelengths did not alter the typical ablative pulse shape of the 10.600 nm laser alone. With the same CO₂ pulse shape, the lesion depth did not vary with the synergy of the two wavelengths, while thermal lesion width increased compared to CO₂ alone. The ablation rate was achieved, while the total thermal lesion coverage in the scanning area of CO₂ − 1540 lasers was greater than when using CO₂ alone and then the other sequential irradiation. Conclusions: This study provides important preclinical data for new and early uses of the novel 10.600/1540 nm dual-wavelength non-ablative fractional laser. The synergy of the two wavelengths enhanced all the benefits already available when using CO₂ laser systems both in terms of tone strengthening, thanks to a greater shrinking effect, and in terms of stimulation and collagen remodeling thanks to a greater volumetric thermal effect. Full article

(This article belongs to the Special Issue Lasers, Lights and New Technologies in Medicine and Surgery)

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5 pages, 2702 KiB

Open AccessArticle

Comparing Traditional and in Motion Nd:YAG Laser in Hair Removal: A Prospective Study

by Steven Paul Nistico, Luigi Bennardo, Stefano Bennardo, Miriam Marigliano, Elena Zappia, Martina Silvestri and Giovanni Cannarozzo

Medicina 2022, 58(9), 1205; https://doi.org/10.3390/medicina58091205 - 02 Sep 2022

Cited by 3 | Viewed by 2178

Abstract

Background and Objectives: Hair removal is a common cosmetic problem interesting more and more patients nowadays. Various laser treatments are currently available. Alexandrite and Nd:YAG laser are the most effective procedures in lighter and darker skin phototypes, respectively. Materials and Methods: A total of 40 patients seeking hair removal in one or more body areas with skin phototypes 2–6 was recruited to perform this study. Patients were divided into two groups. One group was treated with the standard Nd:YAG hair removal procedure, while the other group was treated with a new “in motion” Nd:YAG technology. Results and hair removal rates were evaluated six months after the last treatment. Results: Out of 40 patients treated, all patients experienced hair reduction. No statistically significant difference in hair removal was noted between the two groups; however, a statistically significant reduction in pain during the procedure was observed in the group treated with the “in motion” technique. Conclusions: While traditional and “in motion” Nd:YAG techniques have similar result outcomes in hair removal, the “in motion” technology seems to guarantee a better safety profile compared with the traditional technique. A more extensive clinical study will be necessary to confirm our study’s results. Full article

(This article belongs to the Special Issue Lasers, Lights and New Technologies in Medicine and Surgery)

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14 pages, 2281 KiB

Open AccessFeature PaperArticle

Scanning Super/Ultrapulsed CO₂ Laser Efficacy in Laryngeal Malignant Lesions

by Stefano Dallari, Luca Giannoni and Alessandra Filosa

Medicina 2022, 58(2), 200; https://doi.org/10.3390/medicina58020200 - 28 Jan 2022

Cited by 1 | Viewed by 2250

Abstract

Introduction: The authors review their experience in transoral laryngeal microsurgery (TLM) that they performed with two different CO₂ laser devices from the same company, which were both equipped with a micromanipulator and digital scanner. Material and Methods: A total of 91 glottic and glotto-supraglottic cancers were treated during the years 2009–2016 and then analyzed in relation to the laser performances and the long-term oncologic results. Results: Laser devices proved to be very efficient and the UP mode was confirmed to be the best in terms of cutting precision and lowest thermal damage. Conclusions: CO₂ laser TLM is the preferred option for the majority of small–medium size glottic and supraglottic cancers and may also be used for bigger tumors, especially in older patients. Full article

(This article belongs to the Special Issue Lasers, Lights and New Technologies in Medicine and Surgery)

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10 pages, 2302 KiB

Open AccessArticle

Vaginal Bipolar Radiofrequency Treatment of Mild SUI: A Pilot Retrospective Study

by Paolo Mezzana, Ignacio Garibay and Irene Fusco

Medicina 2022, 58(2), 181; https://doi.org/10.3390/medicina58020181 - 25 Jan 2022

Cited by 5 | Viewed by 3883

Abstract

Background and Objectives: This retrospective study investigates the action of a bipolar, temperature controlled, endovaginal RF handpiece for the treatment of mild, moderate, and severe stress urinary incontinence with a minimally invasive approach. Stress urinary incontinence (SUI) is a common condition resulting in involuntary urine leakage, with an associated social and psychological impact. SUI is the most common type of urinary incontinence in women. Materials and Methods: We retrospectively studied 54 patients for this study. The bipolar radiofrequency energy used in all patients was 50 W, with temperatures maintained between 41 °C and 44 °C. Two sessions were performed four weeks apart. In order to monitor all patients before the first treatment and 4 months after the second treatment, the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) was used. Paired Student’s t test was used to elaborate the statistical data. Results: The average frequency of urine leak improved from “2–3 times a week” (2.1 ± 1.3 points before the treatment) to “once a week” (0.8 ± 1.3 points 4 MFU post-treatment). The average volume improved from “small/moderate quantity” (3.2 ± 1.6 points before the treatment) to “none” (0.9 ± 1.4 points 4 MFU post-treatment). No adverse events or side effects were found. Conclusion: Our preliminary results represent a good starting point to check the effectiveness and validity of the bipolar radiofrequency temperature-controlled method in the treatment of SUI. Full article

(This article belongs to the Special Issue Lasers, Lights and New Technologies in Medicine and Surgery)

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12 pages, 3560 KiB

Open AccessArticle

Sequential Use of CO₂ Laser Prior to Nd:YAG and Dye Laser in the Management of Non-Facial Warts: A Retrospective Study

by Luigi Bennardo, Gaia Fasano, Federica Tamburi, Elena Zappia, Francesco Rizzuto, Steven Paul Nisticò and Giovanni Cannarozzo

Medicina 2022, 58(1), 115; https://doi.org/10.3390/medicina58010115 - 12 Jan 2022

Cited by 6 | Viewed by 2744

Abstract

Background and Objectives: Warts are benign lesions of viral etiology characterized by a hyperkeratotic appearance tending to spread across the skin surface. Various treatments have been proposed to manage this condition, such as acids, imiquimod, photodynamic therapy, cryotherapy, and various lasers. Materials and Methods: In this paper, we describe a combination protocol using CO₂ laser prior to Nd:YAG laser for lesions interesting the palmoplantar areas or dye laser for lesions on other skin surfaces in the management of non-facial warts resistant to traditional therapies. In total, 34 patients with 103 warts suffering from wart infection resistant to traditional therapies treated from 1 January 2019 to 1 June 2020 were retrospectively enrolled at the Dermatological Unit of Magna Graecia University (Catanzaro, Italy). Two dermatologists measured clinical results, classifying lesions with complete resolution, partial resolution, or non-responding. Patients at four months follow-up were asked to evaluate their degree of satisfaction with a visual analog scale (VAS). Results: Almost all patients reported the complete resolution of lesions, with no patient reporting scarring. Five patients reported hypopigmentation in the treated areas. The mean satisfaction level was high. Only three patients experienced a relapse of the condition. Conclusions: Using a vascular laser following a CO₂ superficial ablation of warts may help reduce the risk of scarring and decrease the incidence of relapses for lesions resistant to traditional therapies. Therefore, more extensive studies will be necessary to confirm the obtained results. Full article

(This article belongs to the Special Issue Lasers, Lights and New Technologies in Medicine and Surgery)

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34 pages, 918 KiB

Open AccessSystematic Review

The Low-Fluence Q-Switched Nd:YAG Laser Treatment for Melasma: A Systematic Review

by Yeon Seok Lee, Yu Jin Lee, Jung Min Lee, Tae Young Han, June Hyunkyung Lee and Jae Eun Choi

Medicina 2022, 58(7), 936; https://doi.org/10.3390/medicina58070936 - 14 Jul 2022

Cited by 5 | Viewed by 4700

Abstract

Melasma is a common pigmentary disorder with a complex pathogenesis, of which the treatment is challenging. Conventional treatment often leads to inconsistent results with unexpected pigmentary side effects and high recurrence rates. Recently, the low-fluence Q-switched Nd:YAG laser (LFQSNY) has been widely used for treating melasma, especially in Asia. We reviewed literatures on the LFQSNY treatment of melasma published between 2009 and May 2022 to evaluate the efficacy and adverse events, including its combination therapy. A systematic PubMed search was conducted and a total of 42 articles were included in this study. It was hard to summarize the heterogenous studies, but LFQSNY appeared to be a generally effective and safe treatment for melasma considering the results of previous conventional therapies. However, mottled hypopigmentation has been occasionally reported to develop and persist as an adverse event of LFQSNY, which may be associated with the high accumulated laser energy. When used aggressively, even LFQSNY can induce hyperpigmentation via unwanted inflammation, especially in darker skin. Although few studies have reported considerable recurrence rates three months after treatment, unfortunately, there is a lack of the long-term follow-up results of LFQSNY in melasma. To enhance the effectiveness and reduce the adverse events, LFQSNY has been used in combination with other treatment modalities in melasma, including topical bleaching agents, oral tranexamic acid, chemical peeling, or diverse energy-based devices, which generally reduced side effects with or without significant superior efficacy compared to LFQSNY alone. Full article

(This article belongs to the Special Issue Lasers, Lights and New Technologies in Medicine and Surgery)

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