{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,9,15]],"date-time":"2024-09-15T13:11:34Z","timestamp":1726405894450},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,5,19]],"date-time":"2016-05-19T00:00:00Z","timestamp":1463616000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Lasers Surg Med"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Non\u2010invasive laser skin treatment modalities are generally designed to protect the epidermis by cooling and limiting the laser energy deposition in accordance with skin type. We explore a treatment modality that uses a 2,940\u2009nm Er:YAG laser with high tissue absorption to ablate an array of channels through the epidermis and upper dermis, and then deliver laser energy from a 1,320\u2009nm Nd:YAG laser with lower tissue absorption through the ablated channels. Treatment through ablated conduits offers a unique capability to deliver laser radiation to a deeper level in the dermis or beyond the dermis and the delivered energy to be deposited in a nearly uniform distribution. The ablated channels represent a relatively small surface and volume fraction of the epidermis and upper dermis, and heal very fast. A pilot study was performed to explore the benefits of treatments through ablated conduits for skin tightening, cellulite, and acne scarring.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>A custom\u2010built laser from Cynosure Inc. was designed to deliver to the epidermis up to 3\u2009J\/cm<jats:sup>2<\/jats:sup> at 2,940\u2009nm from an Er:YAG laser followed in less than 10\u2009ms by up to 20\u2009J\/cm<jats:sup>2<\/jats:sup> at 1,320\u2009nm from a Nd:YAG laser. Both laser sources were delivered to the skin through a diffractive lens array. The spatial intensity modulation created by the diffractive lens array on the skin surface consisted of a low energy density background that did not damage the epidermis and a superimposed array of much higher energy density regions where the Er:YAG laser ablated the channels, and most of the 1,320\u2009nm laser energy was delivered through the channels. Various fluence combinations of the ablative and non\u2010ablative lasers were tested on <jats:italic>ex vivo<\/jats:italic> human skin samples to evaluate tissue effects and parameters for a clinical test. A limited clinical study was performed to evaluate tissue response and healing effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Histology confirmed the presence of ablative channels through the epidermis and upper dermis as well as the absence of epidermal damage apart from the channels. Three days posttreatment there was complete skin healing with no evidence of channel ablation or coagulation in the skin biopsies. Limited clinical testing for facial treatments showed mild improvement for acne scarring and skin laxity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Laser skin treatment through ablated conduits can be performed safely with fast subsequent healing of the channels ablated through the skin. Further refinement of the treatment parameters and variation of the wavelength of the non\u2010ablative laser source may bring improved treatment efficacy. Lasers Surg. Med. 49:69\u201377, 2017. \u00a9 2016 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lsm.22533","type":"journal-article","created":{"date-parts":[[2016,5,21]],"date-time":"2016-05-21T14:00:24Z","timestamp":1463839224000},"page":"69-77","source":"Crossref","is-referenced-by-count":4,"title":["Delivery of light to the skin through ablated conduits"],"prefix":"10.1002","volume":"49","author":[{"given":"Emil","family":"Tanghetti","sequence":"first","affiliation":[{"name":"Center for Dermatology and Laser Surgery Sacramento California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirko","family":"Mirkov","sequence":"additional","affiliation":[{"name":"Cynosure Inc. Westford Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael A.","family":"Sierra","sequence":"additional","affiliation":[{"name":"Cynosure Inc. Westford Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,5,19]]},"reference":[{"issue":"25","key":"e_1_2_7_2_1","first-page":"137","article-title":"Fractional CO2 laser associated with Q\u2010switched YAG laser for the removal of treatment\u2013resistant tattoos","volume":"45","author":"Chacur R","year":"2013","journal-title":"Laser Surg Med"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.20048"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.20860"},{"key":"e_1_2_7_5_1","unstructured":"MansteinD. 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