Terry L. Donat, M.D.1; Steve H. Mandell, M.D.2; Robin J. Hood, Ph.D.3;
and Peter A. Hilger, M.D.4
1 Clinical Assistant Professor, Department of Otolaryngology/Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan.
2 Assistant Professor FA, Department of Pathology, Wayne State University School of Medicine, Detroit, Michigan.
3 Director of the Central Analytical Instrumentation Facility, Department of Chemistry, Wayne State University, Detroit, Michigan.
4 Associate Professor, Division of Facial Plastic Surgery, Department of Otolaryngology, University of Minnesota Medical School, Minneapolis, Minnesota.
ABSTRACT
Objective: (1) To determine the single pulse fluence ablation effects of CO2 and Er:YAG laser energy on human dermal collagen, elastin, and other structural protein non-aqueous chromophores; (2) To determine the infrared absorption spectra of hydrated and anhydrous human dermal protein layers.
Design: Comparative histological determinations of CO2 and Er:YAG laser ablation and thermal injury characteristics, including the selective ablation of particular dermal protein chromophores, were performed using a unique dermal model (Alloderm). Incremental fluence treatments and protein histology under four conditions are examined: (a) desiccated acellular dermis, (b) rehydrated acellular dermis, (c) anhydrous (differentially infrared-absorptive) mineral oil-permeated acellular dermis, and (d) surface mineral oil-overlay on rehydrated acellular dermis. Comparative infrared spectrophotometry was performed on planar samples of Alloderm superficial papillary dermis, deep papillary dermis, superficial reticular dermis and deep reticular dermis under (a)-(c) conditions.
Subjects: Subject tissue is commercially available desiccated acellular human dermis.
Interventions: Full-thickness dermal sections, under each condition, were treated with comparable incremental single-pulse fluences using CO2 and Er:YAG lasers. Specially-stained histological samples were obtained for all treated and untreated sites. Surface infrared spectrophotometry was performed on (a)–(c) conditioned samples.
Results: Protein infrared absorption spectra throughout dermal layers are equivalent. Major protein absorption bands are proximate to Er:YAG and CO2 laser energy emissions. Significantly differing effects on dermal proteins are demonstrated as independent of laser-water interaction within 4-12J/cm2 clinical laser fluence ranges.
Conclusions: Significant differential effects of Er:YAG and CO2 emissions on dermal protein chromophores exist and must be considered in the resurfacing mechanism and ongoing development of effective laser treatments.
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