Application
182099015-V01-10.Juni2013-GA-MCL31-THAI 43
6.2.1.3 Pre-Therapy Action
The area to undergo treatment must be carefully cleaned.
Depending on the size and/or depth of a lesion to be dealt with, it must be decided if anesthesia
is required and what type of anesthesia is appropriate.
Therapeutic treatment performed with an Er:YAG laser causes a distinct amount of fume for-
mation resulting from photo ablation. Released particles and aerosols are extracted by the hand-
piece close to their point of origin during laser operation. A built-in extraction device contains
special filters that are capable of retaining particles and releasing the air in a cleaned state.
If there is no exhaust facility to support the process, the optical performance of the handpiece will
quickly deteriorate as a consequence of particle sedimentation, which, in turn may result in burn
effects and damage.
6.2.1.4 Treatment Techniques
Planar skin disorder (age spots, etc.) can be ablated by applying a uniform series of continuously
overlapping laser spots.
The degree of overlapping that appears to be the best match to the beam profile ranges from
10% to 20% of the beam’s spot diameter. Although it is possible to work with a greater overlap,
one should consider that energy densities will add up in the areas where overlapping occurs.
Spot energy settings must be reduced in such cases! An overlap degree below 10% is not advis-
able, because ablation will not occur with uniform depth in this case.
Skin unevenness (wrinkles, acne scars, etc.) can be effectively smoothed out. For example, fol-
lowing an area-related ablation, single treatment steps are performed for individual lesion pock-
ets, i.e. moving along the shoulders of a wrinkle or similar irregular patterns.
Point lesions (syringomas, etc.) can be treated using single-shot technique. This should be done
with a frequency setting as small as possible (repetition rate), in order to prevent overheating of
the lesion.
Trial treatment:
One trial treatment session (1-2 cm²) appears reasonable in all cases to be able to gauge the fi-
nal result of therapeutic procedures (after 6 to 10 weeks).
CAUTION
FLUENCE settings must be such that the ablation threshold is actually reached. Below this
threshold, the laser will have a thermal impact on tissue! This may also occur if the hand-
piece is held at too great a distance from the skin surface (spacer pin does not contact
skin, skin area enlarged due to beam divergence – identifiable at pilot laser beam)
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