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Abstract

Plasma skin regeneration (PSR) is a novel method of resurfacing that uses plasma energy to create a thermal effect on the skin. PSR is different from lasers, light sources, and ablative lasers in that it is not chromophore dependent and does not vaporize tissue, but leaves a layer of intact, desiccated epidermis that acts as a natural biologic dressing and promotes wound healing and rapid recovery. Histological studies performed on plasma resurfacing patients have confirmed continued collagen production, reduction of elastosis, and progressive skin rejuvenation beyond 1 year after treatment. PSR has received US Food and Drug Administration 510 (k) clearance for treatment of rhytides of the body, superficial skin lesions, actinic keratoses, viral papillomata, and seborrheic keratoses. PSR also has beneficial effects in the treatment of other conditions including dyschromias, photoaging, skin laxity, and acne scars. The safety profile of PSR is excellent, and there have been no reports of demarcation lines in perioral, periorbital, or jawline areas, as can sometimes be observed following CO2 resurfacing. PSR is effective in improving facial and periorbital rhytides and can be used on nonfacial sites, including the hands, neck, and chest. Numerous treatment protocols with variable energy settings allow for individualized treatments and provide the operator with fine control over the degree of injury and length of subsequent recovery time.

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... So, they can stimulate the cells to produce more collagen 28,29 . Unlike ablative technologies (ablative lasers), there is no evaporation in the epidermis and burns during treatment in PSR, which is one of the advantages of this device that attracts attention 30 . Plasma is not dependent on interacting with a chromophore. ...
... Plasma is not dependent on interacting with a chromophore. So, it is more uniform than ablative lasers 30 . Fibroblast activity increases during dermal layer rejuvenation 30 . ...
... So, it is more uniform than ablative lasers 30 . Fibroblast activity increases during dermal layer rejuvenation 30 . PSR works effectively and with minimal side effects and safely minimizes the risk of unpredictable hot spots and scar 18 . ...
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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.
... The system converts nitrogen gas into plasma energy within the tip of the handpiece which results in the expulsion of controlled pulses of energy to the tissue. The energy is not chromophore dependent and does not vaporize tissue [8,9]. The upper layers of the skin are desiccated during treatment and remain intact to serve as a biological dressing during the initial stages of healing [8,9]. ...
... The energy is not chromophore dependent and does not vaporize tissue [8,9]. The upper layers of the skin are desiccated during treatment and remain intact to serve as a biological dressing during the initial stages of healing [8,9]. The technology has demonstrated efficacy for the treatment of mild-to-moderate periorbital wrinkles and photodamaged facial skin with reported complications typical for resurfacing procedures such as postinflammatory hyperpigmentation, focal areas of delayed healing, and rare instances of hypertrophic scarring [8][9][10][11][12][13]. to the nitrogen plasma system in a porcine model [15]. ...
... The upper layers of the skin are desiccated during treatment and remain intact to serve as a biological dressing during the initial stages of healing [8,9]. The technology has demonstrated efficacy for the treatment of mild-to-moderate periorbital wrinkles and photodamaged facial skin with reported complications typical for resurfacing procedures such as postinflammatory hyperpigmentation, focal areas of delayed healing, and rare instances of hypertrophic scarring [8][9][10][11][12][13]. to the nitrogen plasma system in a porcine model [15]. The results of this pre-clinical study were then translated into a prospective, 55-patient FDA investigational device exemption (IDE) clinical study in which subjects treated with a single pass from the helium device achieved significant improvements in facial appearance with rapid recovery and relatively few unanticipated adverse events [16]. ...
... Micro-plasma radio-frequency (MPR) technology has been demonstrated as an effective therapy on rhytides, photo-aged skin, scars, and post-burn hyperpigmentation with rare complications and shorter recovery time. [8][9][10][11][12][13][14][15][16] Since 2013, we have been developing a novel treatment for keloids, which combines MPR with hypo-fractionated electron-beam radiation therapy. The purpose of the present study is to investigate the clinical outcome of the novel treatment for keloids. ...
... Unlike ablative lasers, MPR is nonchromophore dependent and the necrotic epidermis is not vaporized but retained as the natural "dressing," which can accelerate wound healing with less side effects and shorter recovery time. [8] Recent studies show that MPR is an effective therapy for moderate to deep rhytides, photo-aged skin, acne scars, mesh skin graft scars, traumatic scars, facial post-burn hyperpigmentation with rare complications, and shorter recovery time. [8][9][10][11][12][13][14][15][16] Kono et al [15] reported that the plasma treatment was a safe and effective method to treat traumatic scars with the mean re-epithelization time of 7.3 days, but did not recommended it for deep scars, such as abdominal surgery scars. ...
... [8] Recent studies show that MPR is an effective therapy for moderate to deep rhytides, photo-aged skin, acne scars, mesh skin graft scars, traumatic scars, facial post-burn hyperpigmentation with rare complications, and shorter recovery time. [8][9][10][11][12][13][14][15][16] Kono et al [15] reported that the plasma treatment was a safe and effective method to treat traumatic scars with the mean re-epithelization time of 7.3 days, but did not recommended it for deep scars, such as abdominal surgery scars. This is the first report on combining MPR technology with hypo-fractionated electron-beam radiation for keloid treatment. ...
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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.
... Skin applications of non-thermal atmospheric pressure plasma (NTAPP) have been studied for the last decades, for both medical or cosmetic purposes. Positive effects of plasma have been reported for blood coagulation [1,2], wound healing [3,4], tissue regeneration [5], cancer treatment [6,7], drug delivery [8,9] and cosmetic purposes such as acne treatment and anti-aging [10,11]. These positive effects are attributed to the various reactive oxygen and nitrogen species (RONS) occurring in the plasma. ...
... H2O2 + O → HO2 + OH (4) HO2 + H2O2 → OH + H2O + O2 (5) H2O2 + H → OH + H2O (6) NO + OH → HNO2 (7) HNO2 + OH → H2O + NO2 (8) NO + HO2 → OH + NO2 (9) NO2 + H → OH + NO (10) HNO3 + NH2 → NH3 + NO3 (11) NH3 + NO3 → HNO3 + NH2 (12) NO2 + OH → HNO3 (13) HNO3 + OH → H2O + NO3 (14) NO2 -+ O3 → NO3 -+ O2 ...
... As a result, the absorption reduction under the condition of the addition of the SC layer is due to the decrease in all three reactive species H2O2, NO2 − , and NO3 − . The detection of NO3 − can predict the reduction of the SC layer's penetration barrier by plasma treatment and hydrophilization by plasma treatment [5,48]. When using a real pig skin model, it is noteworthy that the overall absorbance decreases but the absorbance increases at 190 nm, 260 nm, and 280 nm. ...
Article
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Skin applications of non-thermal atmospheric pressure plasma (NTAPP) have been at-tracting attention from medical and cosmetic aspects. The reactive species generated from plasma sources have been known to play important roles in the skin. For proper applications, it is essential to know how they diffuse into the skin. In this study, the penetration of active species from NTAPP through a skin model was analyzed by UV absorption spectroscopy. The diffusions of hydrogen peroxide, nitrite, and nitrate were quantified through curve fitting. We utilized an agarose gel to mimic epidermis and dermis layers, and we used a lipid film or a pig skin sample to mimic the stratum corneum (SC). The diffusion characteristics of reactive species through this skin model and the limitations of this method were discussed
... LTP can be safely used in all Fitzpatrick skin types with favorable safety profiles. [4][5][6][7][8][9][10] Since 2006, the LTP device has been approved by the US Food and Drug Administration for treatment of rhytids, dyschromia, acne scars, and photoaged skin. 4,7,11 In Thailand, several trials with LTP were conducted by a nonthermal plasma device that can create a low-temperature plasma beam from dielectric electrodes. ...
... [4][5][6][7][8][9][10] Since 2006, the LTP device has been approved by the US Food and Drug Administration for treatment of rhytids, dyschromia, acne scars, and photoaged skin. 4,7,11 In Thailand, several trials with LTP were conducted by a nonthermal plasma device that can create a low-temperature plasma beam from dielectric electrodes. [12][13][14] LTP removes superficial layers of skin in a smooth, nonablative, and painless manner. ...
... 13 The gold standard for facial rhytids is carbon dioxide (CO 2 ) laser resurfacing, which has been decreasing in popularity due to its adverse effects and downtime. [1][2][3][4][5][6][7][8][9][10] Although several nonablative modalities had been developed over the years, none of them are equivalent to ablative methods. ...
Article
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Background: Plasma, the fourth state of matter, has been widely proposed in antiaging medicine. The usage of low-temperature plasma (LTP), which converts nitrogen gas into plasma, demonstrates releasing of several growth factors and promotion of tissue regeneration. The nonchromophore-dependent property and preservation of skin architecture after treatment make LTP an interesting tool for facial rejuvenation. This study aimed to investigate the efficacy of LTP for facial rejuvenation. Methods: A prospective cohort study involving 40 women who received full face LTP treatment once a week for 5 consecutive sessions. The melanin index, erythema index, and elasticity index were measured by Mexameter and Cutometer, respectively. The Fitzpatrick wrinkle scale and quartile grading scale were assessed by two plastic surgeons. Results: All patients were between 26 and 55 years old and had mild-to-moderate Fitzpatrick wrinkle scale scores. The Fitzpatrick wrinkle scale scores showed a mean improvement of 0.47 and 0.89 at 4 and 12 weeks posttreatment (P < 0.001). Statistically significant improvements in melanin index, erythema index, and elasticity index at periorbital and perioral areas were found at 4 and 12 weeks after treatment (P < 0.001). Most subjects had quartile grading scale improvement of 51%-75% at 4 and 12 weeks after treatment. Patients reported a greater than 75% improvement in dyspigmentation, wrinkles, and elasticity in 60%, 50%, and 57.5% of subjects, respectively. Conclusion: LTP is another choice for facial rejuvenation, wrinkles reduction, and dyspigmentation with significantly improved results.
... Nitrogen plasma skin regeneration (PSR) remains a viable option for skin rejuvenation. The unique heat signature and healing profile of nitrogen plasma results in a non-ablative (at time of treatment), non-chromophoredependent thermal wound with initial preservation of the upper layers of desiccated skin tissue that serve as a natural biological dressing during the skin's regenerative healing process [1,2]. The lack of an open wound, relatively rapid epidermal recovery (typically within 7 days after treatment), non-fractionated (effectively full field) energy delivery and suitability for diverse skin types are among the more significant clinical merits of this skin rejuvenation treatment [3,4]. ...
... Nitrogen PSR histological studies (porcine, human) showed significant neo-collagenesis and a corresponding reduction in elastosis in the upper dermis [4][5][6]. Clinical evaluation of nitrogen PSR treatment effectiveness demonstrated benefits in the appearance of treated skin with improvements in dyschromia, photodamage and skin texture including reduction of acne scarring and rhytidosis [1,2,4,[7][8][9]. Complications resulting from nitrogen PSR treatment include focally delayed healing, post-inflammatory hyperpigmentation, and rare hypertrophic scarring events [1,4,10]. ...
... Clinical evaluation of nitrogen PSR treatment effectiveness demonstrated benefits in the appearance of treated skin with improvements in dyschromia, photodamage and skin texture including reduction of acne scarring and rhytidosis [1,2,4,[7][8][9]. Complications resulting from nitrogen PSR treatment include focally delayed healing, post-inflammatory hyperpigmentation, and rare hypertrophic scarring events [1,4,10]. Despite treatment protocols that include darker skin types permanent hypopigmentation has not been reported. ...
Article
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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.
... It works by discharging a continuous electric chain able to stimulate the tissue and epithelium cells. Plasm jet also unleashes retracting on elastic fibers and vasodilation because of increase of local temperature [6,7]. A commonly used resource in clinical practice is the photodocumentation once by using photography it is possible to assure to professionals all characteristics pre-existing in a patient before starting the therapy as well as to compare before and after treatment aiming to see all obtained results. ...
... With regard to treatments developed to induce hair growth in cases of alopecia areata, photobiomodulation has been shown as the most efficient. Laser is a device composed of substances from liquid, solid or gas form that manufacture beams of light when stimulated by a source of energy usually called as "laser ray" [6]. Then, laser therapy of low-power takes place by exposing the scalp area to lighting energy and this energy has the capacity to change biomolecules through photochemical reactions acting directly over capillary matrix [13]. ...
... Then, laser therapy of low-power takes place by exposing the scalp area to lighting energy and this energy has the capacity to change biomolecules through photochemical reactions acting directly over capillary matrix [13]. Also, these lasers produce analgesic effects beyond biostimulation and anti inflammatory [6]. Photobiomodulation applies a bio-stimulating action in the tissue repair process inducing mitotic activity of epithelial cells and fibroblasts that will be encouraged to produce collagen. ...
... Plasma also showed an acceptable performance in skin regeneration in the field of cosmetic medicine. A treatment with a commercial RF N2 plasma jet (Portrait ® PSR) led to a controlled damage of the skin [224][225][226] and a complete regeneration of epidermis was reported after 10 days. Moreover, an ongoing collagen production, reduction of elastosis and progressive skin rejuvenation was confirmed over one year after the plasma treatment. ...
... It has been shown that reactive Plasma also showed an acceptable performance in skin regeneration in the field of cosmetic medicine. A treatment with a commercial RF N 2 plasma jet (Portrait ® PSR) led to a controlled damage of the skin [224][225][226] and a complete regeneration of epidermis was reported after 10 days. Moreover, an ongoing collagen production, reduction of elastosis and progressive skin rejuvenation was confirmed over one year after the plasma treatment. ...
Article
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Plasma-liquid systems have attracted increasing attention in recent years, owing to their high potential in material processing and nanoscience, environmental remediation, sterilization, biomedicine, and food applications. Due to the multidisciplinary character of this scientific field and due to its broad range of established and promising applications, an updated overview is required, addressing the various applications of plasma-liquid systems till now. In the present review, after a brief historical introduction on this important research field, the authors aimed to bring together a wide range of applications of plasma-liquid systems, including nanomaterial processing, water analytical chemistry, water purification, plasma sterilization, plasma medicine, food preservation and agricultural processing, power transformers for high voltage switching, and polymer solution treatment. Although the general understanding of plasma-liquid interactions and their applications has grown significantly in recent decades, it is aimed here to give an updated overview on the possible applications of plasma-liquid systems. This review can be used as a guide for researchers from different fields to gain insight in the history and state-of-the-art of plasma-liquid interactions and to obtain an overview on the acquired knowledge in this field up to now.
... Following experimental use of radiofrequency (RF) energy to create a superficial skin injury through a conductive gel plasma interface (coblation) [4], alternative skin rejuvenation treatments that have entered widespread clinical use include non-ablative fractional resurfacing (NFR) [5,6], ablative fractional resurfacing (AFR) [7], treatment with dual-wavelength NFR lasers (e.g., 1550 and 1927 nm) [8] as well as dual-modality AFR and NFR (e.g., micro-ablative 2940 nm and non-ablative 1470 nm) [9], variable depth RF microneedle treatments [10] and nitrogen plasma skin regeneration (PSR) [11,12]. Known as the fourth state of matter, plasmas are gases in temporary higher energy states wherein electrons have transitioned to higher orbits and where the higher energy states quickly dissipate without additional energy input. ...
... Skin healing after nitrogen PSR treatment involves a process of natural skin regeneration, wherein the upper/ outer layers of skin that are desiccated during treatment remain intact as a natural biological dressing during the early phase of healing; as the "old" skin desquamates, the newly regenerated and smoother pink skin appears [13]. Clinical benefits of nitrogen PSR treatment include a range of treatment protocols for diverse skin types and conditions, effective reversal of photodamage and dyschromia, preservation of natural skin tone, and modest reduction of acne scarring and rhytidosis [10,[12][13][14][15][16][17][18]. ...
Article
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Background and Objectives A novel helium plasma device was evaluated for efficacy and safety for dermal resurfacing (ClinicalTrials.gov Identifier: NCT03286283). The helium plasma device delivers energy in a controlled, bimodal fashion that when compared with the nitrogen plasma predicate device in a porcine animal model demonstrated a more limited depth of thermal effect but a greater skin tissue contraction. Study Design/Materials and Methods Fifty‐five eligible subjects seeking improvement in facial rhytids were enrolled for study at one of three investigational sites. Most subjects underwent full‐face treatment. Power levels were limited to 20% at peri‐oral and peri‐orbital areas—a level that correlates to an energy density 40% lower than the highest setting on the predicate device. Three‐month post‐treatment Fitzpatrick Wrinkle and Elastosis Scale (FWS) scores were compared with baseline scores as determined by blinded independent photographic reviewers (IPRs) and study investigators. Results Blinded IPRs observed a ≥1‐point FWS improvement in 63.64% of subjects whereas study investigators noted a ≥1‐point FWS improvement in 54 of 55 subjects (98.18%) of subjects. 90.9% of subjects indicated “improvement” in appearance utilizing the modified Global Aesthetic Improvement Scale. Subgroup analysis showed 1‐point (±0.05) FWS improvement by IPRs and study investigators for Fitzpatrick Skin Types II and III, age≥62, two of three study sites, and post‐treatment oral steroid use. Eighty Non‐Serious Adverse Events in 39 subjects were reported, most of which resolved within 14 days or less. There were no Serious Adverse Events or Unanticipated Device Effects reported. Conclusion At the modest power level studied, a significant improvement from a single pass helium plasma dermal resurfacing treatment was observable in most subjects by IPRs and investigators, and no serious adverse events were reported. The discrepancy between IPR and study investigator FWS improvement may be explained in part by the limitations of assessing two‐dimensional photographs versus live in‐person evaluation of subjects. Studies evaluating higher energy levels and/or multiple treatment passes are ongoing. Lasers Surg. Med. © 2020 The Authors. Lasers in Surgery and Medicine published by Wiley Periodicals, Inc.
... 6,8 Nevertheless some complications have been reported in the English literature like delayed neoepithelialization, skin infection, tissue scarring, and hyperpigmentation. 7,9 In this paper, we report two different cases of hyperpigmentation following, respectively, upper and lower blepharoplasty. ...
... 2,6,8 Few complications were reported such as delayed healing, skin bacterial infection, herpes simplex virus infection, tissue scarring, and postinflammatory hyperpigmentation. 7,9 Plasma can be used in Fitzpatrick skin types I-IV and there is no enough evidence that it can be used on skin types V and VI. 9 ...
Article
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Nitrogen plasma is considered nowadays one of the efficient treatment options for nonsurgical blepharoplasty. Although it is an overall safe treatment, it has some side effects. This short paper addresses the risk of hyperpigmentation following the use of plasma and list few suggestions on how to prevent it.
... Plasma is the fourth state of the matter, composed of ionized atoms. Electrons escape from their atoms to form plasma when adequate energy is applied to a gas such as nitrogen [3][4][5]. Thermal and non-thermal plasmas can be discerned; while thermal plasmas cannot be used on living tissues like the skin, non-thermal or cold atmospheric pressure plasmas may be applied to the skin. Plasma delivers energy to the target tissue independently of the skin chromophores and produces a controlled tissue ablation by passing ultra-high radio-frequency (RF) waves into nitrogen gas [1,4]. ...
... In this technology, various energy settings can be used for different depths of effect. Compared to ablative lasers, plasma resurfacing leaves a layer of necrotic epidermis serving as a biologic dressing and promotes a short recovery period [2][3][4]. ...
Article
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Nowadays, there is a great attention to the plasma applications in medicine. Not only does cold atmospheric pressure plasma provide a therapeutic opportunity to control redox-based processes, it is also an innovative method in rejuvenation. Given the current interest in new methods of rejuvenation, we aimed to introduce a novel pulsed nitrogen plasma torch with potential use in rejuvenation. We investigated production of reactive species at different pulse energy by spectroscopy and also measured nitric oxide and O 2 concentration and evaluated the flame temperature. Fifteen Wistar rats were divided into three groups based on the applied energy settings; the skin of the animals was processed with plasma. For quantitative evaluation of dermis, epidermis and hair follicles (to confirm the effects of this technique on rejuvenation), skin biopsies were taken from both unexposed and treated areas. The spectroscopy results showed the presence of nitric oxide in plasma and the concentration was suitable for dermatological applications. A significant increase was observed in epidermal thickness, fibroblast cell proliferation and collagenases (P < 0.05). Interestingly, plasma led to a temporary increase in the diameter of primary and secondary hair follicles compared to the controls. The results confirmed the positive effects of this pulsed nitrogen plasma torch on rejuvenation and also revealed a new possible aspect of cold plasma; its effect on hair follicles as a promising area in the treatment of alopecia that requires further clinical and molecular studies. Keywords Collagenesis · Epidermis · Hair follicle · Nitrogen · Plasma · Skin rejuvenation Abbreviations DP Dermal papilla H&E Hematoxylin and eosin NO Nitric oxide OES Optical emission spectroscopy PSR Plasma skin regeneration RF Radio-frequency RNS Reactive nitrogen species ROS Reactive oxygen species SLPM Standard liter per minute
... A small temporary water loss was observed in vivo in human stratum corneum after plasma exposure [221]. Epidermis desiccation is a desired effect in plasma skin resurfacing where the non-ablated dried epidermis protects the thermally damaged layers during the recovery process [222]. Paradoxically since CAPs can deposit charges on the treated surface, it is likely that after a plasma treatment skin could attract more water molecules. ...
Article
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The maintenance of skin integrity is crucial to ensure the physiological barrier against exogenous compounds, microorganisms and dehydration but also to fulfill social and aesthetic purposes. Besides the development of new actives intended to enter a formulation, innovative technologies based on physical principles have been proposed in the last years. Among them, Cold Atmospheric Plasma (CAP) technology, which already showed interesting results in dermatology, is currently being studied for its potential in skin treatments and cares. CAP bio-medical studies gather several different expertise ranging from physics to biology through chemistry and biochemistry, making this topic hard to pin. In this review we provide a broad survey of the interactions between CAP and skin. In the first section, we tried to give some fundamentals on skin structure and physiology, related to its essential functions, together with the main bases on cold plasma and its physicochemical properties. In the following parts we dissected and analyzed each CAP parameter to highlight the already known and the possible effects they can play on skin. This overview aims to get an idea of the potential of cold atmospheric plasma technology in skin biology for the future developments of dermo-cosmetic treatments, for example in aging prevention.
... Plasma skin regeneration (PSR), which uses nitrogen as the gaseous source, has been used successfully to treat photoaging and may also be considered for FRD. PSR leaves a layer of desiccated epidermis that acts as a biologic dressing and promotes rapid wound healing [37]. The treated areas have continued collagen production and reduction of elastosis beyond 1 year after treatment. ...
Article
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Favre−Racouchot disease (FRD) is an occupational disorder characterized by solar elastosis with open and cystically dilated comedones that tend to appear on the periorbital and temporal face of elderly light-complexioned men. It is a benign condition caused by chronic excessive ultraviolet exposure, as well as ionizing radiation and/or smoking. However, malignant skin neoplasms are uncommonly observed arising in FRD, which suggests a protective role of some element of FRD against carcinogenesis. We explore elastosis as a possibly beneficial tissue response. The clinical manifestations, pathogenesis, and recommended treatment options of this disorder are reviewed.
... Dr. Laroussi used glow discharge plasma at atmospheric pressure to sterilize instruments and food, proving that plasma can effectively inactivate bacteria [15]. In the past 20 years, due to the physical and chemical advantages of atmospheric pressure cold plasma, its applicability in biomedicine has increased, especially in the areas of sterilization, dental diseases, skin care, skin disease treatment, cancer treatment, wound healing, etc. [16][17][18][19][20][21][22][23][24][25][26][27][28]. Infection is a major factor that hinders wound healing, so CAP, a new technology that can sterilize and painlessly treat wounds, offers unique advantages in the field of wound healing. ...
Article
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Infection can hinder the process of wound healing, so it is important to begin antibacterial treatment quickly after a wound forms. Plasma activated water (PAW) can inactivate a variety of common wound infection bacteria. In this study, we compared the effects of PAW prepared with portable surface discharge plasma equipment and medical alcohol on wound healing in a mouse full-thickness skin wound model. The effectiveness of wound healing processes in mice was ranked accordingly: PAW treatment group > medical alcohol treatment group > control group. In order to further understand the mechanism of PAW in promoting wound healing, we tested the expression levels of the pro-inflammatory factors interleukin (IL)-1β and IL-6, the anti-inflammatory factor IL-10, and vascular endothelial growth factor (VEGF). The results showed that PAW promoted the release of pro-inflammatory factors and anti-inflammatory factors from the wounds in mice, which allowed the mice in the treatment group to transition out of the inflammatory period early and enter the next stage of wound healing. The expression level of VEGF in the wounds of mice in the PAW treatment group was higher, which indicates that the microvessels around the wound in the PAW treatment group proliferated faster, and thus the wound healed faster. PAW biosafety experiments showed that PAW did not significantly affect the appearance, morphology, or tissue structure of internal organs, or blood biochemical indicators in mice. In general, PAW prepared via portable devices is expected to become more widely used given its convenience, affordability, and lack of side effects in promoting wound healing.
... 36 In addition, the plasma-induced skin regeneration is a novel method of resurfacing that serves as a natural biological dressing and promotes wound healing and rapid recovery. 37 Furthermore, low-dose nonthermal plasma enhances endothelial cell proliferation due to reactive oxygen species-mediated fibroblast growth factor 2 release. 38 These processes may help explain our findings of fewer scleral defects in the LTP group. ...
Article
Purpose: Surgical excision is the standard treatment for pterygium. This study was conducted to evaluate the safety and efficacy of a novel technique using low-temperature plasma (LTP) for excision and hemostasis in pterygium surgery. Methods: A prospective, comparative, and randomized clinical trial was conducted on 60 patients (60 eyes) undergoing pterygium excision with conjunctival autografts using fibrin glue. Patients were equally divided into the following 2 groups: a control group and a LTP group. Postoperative follow-up visits were scheduled on day 1, week 1, and months 1 and 3, and recurrence was evaluated at 1 year. Patients were examined for operative time, best corrected visual acuity, conjunctival autograft inflammation (CAI), graft stability (GS), pain, recurrence, and final appearance. Factors related to pterygium recurrence and final appearance were analyzed. Results: Mean operative times were shorter in the LTP group (16.7 ± 3.4 min) than those in the control group (20.1 ± 4.7 min, P = 0.002). LTP eyes had milder CAI than control eyes at postoperative day 1 (P = 0.000) and week 1 (P = 0.000). Patients in the LTP group exhibited better GS (P = 0.01) and milder pain (P = 0.04) than those in the control group on day 1. Two control patients (6.7%) and no (0%) LTP patients experienced recurrence (P = 0.08). GS and CAI were the significant factors contributing to recurrence (GS: R = 0.425, P = 0.001; CAI: R = 0.309, P = 0.016). Conclusions: LTP to replace surgical blades and disposable cautery for ablation and hemostasis is safe and efficient for pterygium surgery, resulting in shorter operative time, milder inflammation, and better graft stability without increasing complication risk.
... Various studies have reported the use of cold plasma for treatment of malignant or dysplastic lesions, 6,7 for promoting wound healing, 8 for achieving haemostasis, 9 and for inducing cell regeneration. 10 Some of this research has already led to the development of medical devices such as the kIN-PenMED ® (Neoplas Tools GmbH) 11 and the PlasmaDerm ® (CINOGY System GmbH), 12 which are currently available on the market. ...
... PSR technology is a new method that uses the thermal effect of plasma energy on the skin surface to promote skin repair. 41 This method was first established in 2003 and has been approved by the US Food and Drug Administration for the treatment of skin wrinkles, actinic keratosis, superficial skin lesions, seborrheic keratosis, acne scars, and viral papilloma. 42 PSR was therefore used as another positive control in this study. ...
Article
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Objective To establish a nude mouse model of photoaging and study the therapeutic effect of a concentrated growth factor preparation (CGF) on skin photoaging. Methods CGF was prepared from blood from Sprague–Dawley rats. A skin photoaging nude mouse model was developed using UV irradiation combined with the photosensitizer, 8-methoxypsoralen. Mice were divided randomly into seven groups (n = 6 per group): normal control, photoaging, mock treatment, saline treatment, CGF treatment, Filoca 135HA treatment, and plasma skin regeneration system irradiation (the latter two were positive controls). Body weight and skin appearance were observed and pathological changes were determined by hematoxylin and eosin staining. Fiber elasticity was evaluated by Weigert staining. Expression levels of proliferating cell nuclear antigen (PCNA) and matrix metalloproteinase 1 (MMP1) were determined by immunohistochemistry. Results A mouse model with typical features of photoaging skin was successfully developed. CGF significantly improved the skin appearance, wrinkle scores, pathological changes, and fiber elasticity, and increased PCNA and decreased MMP1 expression levels in photoaging mice, comparable to the two positive controls. Conclusion CGF can improve the symptoms of skin photoaging in mice, suggesting that it may have applications in the treatment of skin aging in humans.
... According to Foster's study, no patient developed permanent hypopigmentation, a complication that is generally observed in 8-20% of CO 2 resurfacing patients, although a very small proportion (4%) of patients reported transient hyperpigmentation, which should be treated with hydroquinone creams or combination creams containing a mild topical corticosteroid, retinoid, and hydroquinone. 25 Fitzpatrick et al reported that the thermal damage by PSR for any energy level was at most equivalent to medium fluence of the carbon dioxide laser and that the damage was confined within 15 μm depth, in contrast to 33.4 μm thermal damage created by high fluence of the carbon dioxide laser. 26 In fact, not many risk factors other than ancestry, early age and skin injuries are known about keloid. ...
Article
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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.
... Such techniques, like argon plasma coagulation (APC), rely on precisely targeted thermal necrotization of tissue to achieve hemostasis (cauterization), or to cut or remove tissue (16,17). Furthermore, several plasma-based devices in cosmetics, e.g. for wrinkle removal and skin regeneration, also rely on thermal plasma effects (18,19). Since the 1990s, technologies for stable and reproducible plasma generation at low temperature under atmospheric conditions are available on a larger scale, facilitating the generation of so-called cold atmospheric plasmas (CAP). ...
Article
Plasma medicine comprises the application of physical plasma directly on or in the human body for therapeutic purposes. Three most important basic plasma effects are relevant for medical applications: i) inactivation of a broad spectrum of microorganisms, including multidrug-resistant pathogens, ii) stimulation of cell proliferation and angiogenesis with lower plasma treatment intensity, and iii) inactivation of cells by initialization of cell death with higher plasma treatment intensity, above all in cancer cells. Based on own published results as well as on monitoring of relevant literature the aim of this topical review is to summarize the state of the art in plasma medicine and connect it to redox biology. One of the most important results of basic research in plasma medicine is the insight that biological plasma effects are mainly mediated via reactive oxygen and nitrogen species influencing cellular redox-regulated processes. Plasma medicine can be considered a field of applied redox biology.
... Plasma also showed an acceptable performance in skin regeneration in the field of cosmetic medicine. A treatment with a commercial RF N2 plasma jet (Portrait ® PSR) led to a controlled damage of the skin [330][331][332] and a complete regeneration of epidermis was reported after 10 days. Moreover, an ongoing collagen production, reduction of elastosis and progressive skin rejuvenation was confirmed over one year after the plasma treatment. ...
... In recent years, plasma has been used to increase the speed of blood clotting without any thermal effect, or damage to the surrounding live tissues [9]. In 2005 the Food and Drug Administration (FDA) licensed the technology of Plasma Skin Rejuvenation (PSR) to renew the skin and treat wrinkles [10][11][12][13]. Cold plasma is complex mixtures of charged particles, reactive atoms, and molecules (e.g., atomic oxygen, ozone, hydroxyl group, oxides of nitrogen, etc.), electric fields, and ultraviolet (UV) radiation. ...
Conference Paper
Nowadays plasma has been used in many applications. This work was done to study the effect of cold plasma on the speed of wounds recovery for diabetic’s rats. The rats have been infected with diabetes using the Alloxan substance. Then these rats are divided into four groups. The first group included control animals. The second group was injured and treated with plasma in period of 2min and flow rate of 2.5 slm and 7.5slm. The third group was treated by the antibiotic (penicillin). The fourth group was treated with penicillin and plasma. The results of histological sections for the four groups show the use of plasma with penicillin for wound treatment gives better results for skin recovery for the same treatment period, as well as plasma treatment is better than treatment with penicillin for the same period of time.
... The demand for minimally invasive and safe technology for the treatment of scars has stimulated the search for more effective novel therapy with fewer collateral effects. Plasma radiofrequency (PRF) ablation is a new technique consisting of the generation of plasma energy through the production of ionized energy that thermally heats tissue in a uniform and controlled manner, through a plasma radiofrequency device, inducing a sublimation of the tissue [11]. In contrast to ablative treatments, such as lasers and traditional radiofrequency, plasma sublimation leaves a layer of intact and desiccated epidermis that acts as a natural biologic dressing, avoiding damaging the deeper layers of the skin and predisposing to better healing [10]. ...
Article
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Scars are a common disfiguring sequela of various events such as acne, hidradenitis suppurativa, surgery, trauma, and burns, which can lead to serious psychosocial problems with a negative effect on the quality of life. Many conventional approaches have been proposed for the treatment of scars, including surgical techniques, dermabrasion, chemical peels, topical silicone gel, 5-fluorouracile and dermal fillers injection or autologous fat transfer for atrophic scars, and corticosteroids injection for hypertrophic and keloid scars; however, they have sporadic effects. Ablative lasers, such as carbon dioxide laser or Erbium Yag laser, are associated with many collateral effects limiting their application. Non-ablative laser treatments have been shown to be safer and to have fewer side effects, but they have a reduction of clinical efficacy compared to ablative lasers and a minimal improvement of scars. The demand for minimal invasive and safe technology for the treatment of a scars has stimulated the search for more effective novel therapy with fewer collateral effects. Plasma radiofrequency ablation is a new technique consisting of the generation of plasma energy through the production of ionized energy, which thermally heats tissue in a uniform and controlled manner, through a plasma radiofrequency device, inducing a sublimation of the tissue. The aim of this study is to evaluate the effectiveness of P-RF ablation in the treatment of scars performed with D.A.S. Medical device (Technolux, Italia), which is a tool working with the long-wave plasma radiofrequency principle.
... The plasma therapy has several applications in aesthetics. The plasma "regeneration" of the skin, in filamentary regime, common in the "pens" of plasma jet, happens due to the production of heat, inducing the thermal "damage" in the superficial skin, also causing new collagen production, elastic fibres modification, and dermis restructuring [7][8][9][10]. It is also known that other atmospheric plasma chemical species, such as hydroxyl ion (OH) and ozone (O 3 ) may act as bactericide for repairing ulcers, wounds, postoperative, disinfecting the skin, among other actions. ...
... Each pulse of plasma energy is released to the treated area in a Gaussian distribution creating an inner zone of thermal damage and an outer zone of thermal modification. [10][11][12][13][14][15] Owing to the relatively low thickness of eyelid skin, the low energy of nitrogen plasma may be suitable for eyelid area. The low energy of nitrogen plasma is also safer and has less adverse effects for Thais who have high Fitzpatrick skin type due to the PSR's properties of nonchromophore dependence. ...
Article
Background Nitrogen plasma skin regeneration is a novel device that produces heat to the skin, resulting in the production of new collagen. Because of lower energy with safer skin damage and lesser adverse effects who have high Fitzpatrick's skin type especially Thais, this technique is very interesting for clinical application for skin esthetic treatment. However, this treatment has yet been empirically studied as the treatment for mild‐to‐moderate periorbital wrinkles. Objectives This study aimed to evaluate clinical efficacy of nitrogen plasma for the treatment of mild‐to‐moderate periorbital wrinkles. Methods Eighteen volunteers were enrolled. Each volunteer was randomized to receive nitrogen plasma treatment on one side of periorbital wrinkles with three sessions at a three‐week interval and compared with contralateral side without treatment. Photographic examination, skin wrinkle (SEw) score, melanin index, patients' satisfaction score, side effect, and pain score were reported. Results At over fourteen weeks, all volunteers completed the study. Treatment with nitrogen plasma group had significantly better improvement for periorbital wrinkles score by Lemperle scale, skin wrinkle (SEw) score by Visioscan® VC 98, and the melanin index by Mexameter® than the control groups (P = 0.004, P < 0.001, P < 0.001, respectively). This study also showed significantly greater satisfaction score to favor the nitrogen plasma treatment group than the control group (P < 0.001). The short‐term adverse effects included erythema, scaling, temporary hyperpigmentation, pruritus, and dryness. Conclusion Nitrogen plasma skin regeneration is effective and safe for the treatment of mild‐to‐moderate periorbital wrinkles and darkening.
... CAP has also been applied for skin regeneration by promoting the formation of a layer of intact desiccated epidermis that acts as a natural biologic dressing to promote rapid healing. [29] These studies further demonstrated that CAP is a safe technology that is not chromophore dependent and does not result in significant damage to the epidermis. Multiple reviews cover CAP applications and safety considerations for animal/human living tissue sterilization, dermatology, blood coagulation, wound healing, tissue regeneration, cancers, and other diseases. ...
Article
The coronavirus disease 2019 (COVID‐19) pandemic has greatly stressed the global community, exposing vulnerabilities in the supply chains for disinfection materials, personal protective equipment, and medical resources worldwide. Disinfection methods based on cold atmospheric plasma (CAP) technologies offer an intriguing solution to many of these challenges because they are easily deployable and do not require resource‐constrained consumables or reagents needed for conventional decontamination practices. CAP technologies have shown great promise for a wide range of medical applications from wound healing and cancer treatment to sterilization methods to mitigate airborne and fomite transfer of viruses. This review engages the broader community of scientists and engineers that wish to help the medical community with the ongoing COVID‐19 pandemic by establishing methods to utilize broadly applicable CAP technologies. Pandemics such as coronavirus disease 2019 (COVID‐19) can benefit from disinfection methods based on cold atmospheric plasma (CAP) technologies that are easily deployable, easily accessed, and sustainable. CAP technologies have shown great promise for a wide range of medical applications from wound healing and cancer treatment to sterilization methods to mitigate airborne and fomite transfer of viruses. Therefore, CAP is an attractive resource for the future of controlling viruses such as those causing the COVID‐19 pandemic.
... Besides the effectiveness in skin decontamination and the healing of skin wounds, mild NTP treatments have shown to enhance the expression of collagen I, fibronectin, and vascular endothelial growth factor (VEGF) in fibroblasts significantly to boost angiogenesis and repair of connective tissues, hence application in dermatology as rejuvenation (Choi et al., 2013;Foster et al., 2008). ...
Thesis
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Electrochemotherapy (ECT) – an established method for the local eradication of cutaneous tumours based on electroporation technology – is widely used in Europe in human and veterinary medicine with very few systemic side effects. Non-thermal plasmas (NTP) are recently gaining momentum for application in cancerology based on their rich content of short-lived reactive species as well of long-lived reactive oxygen and nitrogen species (RONS) which can be transferred to liquids being treated with NTP. We sought to combine those technologies in order to enhance the ECT capabilities and to better understand the contribution of RONS in those anticancer strategies. As a multidisciplinary study at the crossroads of physics, chemistry, biotechnologies and medicine, this thesis aimed at emphasising the potent beneficial outcome of the combination of ECT and NTP medicine. A novel, stable source of helium plasma multi-jet (PMJ) has been utilised for in vitro investigations on three different cell lines (the DC-3F, B16-F10 and LPB cells), and for in vivo studies on nude and C57Bl/6 mice bearing sub-cutaneous tumours. We demonstrated that the pH of the plasma-treated PBS (pPBS) and the stability of the three main RONS (H₂O₂, NO₂- and NO₃-) under various storage conditions were crucial for the storage of plasma-treated liquids while maintaining their anti-cancer capabilities. In combination with ECT at an electric field amplitude lower than the one usually applied, those stable pPBS partially restored the ECT efficacy, delaying tumour growth and hence prolonging mice survival.
... 32 Plasma resurfacing has been used safely in skin types I-IV and may have a better safety profile than ablative laser. 33 This modality has been used with good results in full-facial resurfacing. 34 In a recent study, the use of this technology has shown good response to treat periorbital area for dermatochalasis and wrinkles. ...
Article
Background: The periorbital region is among the first areas to be affected by the process of aging, which is influenced by genetic and constitutional factors. As the region plays an important role in overall facial appearance, rejuvenation of the area has immense cosmetic benefit and various treatment modalities have been used to achieve the same. Aims: This article reviews commonly used non-surgical and minimally invasive modalities for periorbital rejuvenation. Methods: The literature research considered published journal articles (clinical trials or scientific reviews). Studies were identified by searching electronic databases (MEDLINE and PubMed) and reference lists of respective articles. Only articles available in English were considered for this review. Results: Autologous platelet rich plasma (PRP) is increasingly used in dermatology for skin and hair conditions. The use of PRP is rapidly growing in popularity as a modality to achieve skin rejuvenation. The mechanism by which PRP leads to skin rejuvenation is by increasing the dermal fibroblast proliferation, expression of matrix metalloproteinase and collagen synthesis. Conclusion: The evidence discussed in this article indicates the increasing importance of minimally invasive modalities in periorbital rejuvenation and a promising role for PRP as solo therapy or in multimodality regimens.
Article
Nitrogen plasma skin regeneration (PSR) initiated the use of cold atmospheric plasma (CAP) in skin rejuvenation over a decade ago. Helium gas CAP is already in widespread use worldwide for many surgical applications, whereas its use in skin rejuvenation is now emerging as a viable tool for treatment of facial rhytidosis. Animal studies comparing these CAPs suggest that observed differences in skin tissue interaction result from differences in plasma generation and in energy deposition wherein greater skin tissue contraction observed with helium PSR may result from its unique bimodal energy deposition and more complete full field treatment of the tissue.
Article
Background: Surgical blepharoplasty is one of the most common plastic surgical procedures performed worldwide. It is carried out for treating both aesthetic and functional indications. As with any surgical procedures, the technique is not free from complications. The growing request for non-invasive, effective procedures, and safe technology for aesthetic treatments of eyelids has implied the research for novel treatment strategies marked by a good efficacy and less collateral effects when compared to surgical procedures. The choice fell on the relatively recent plasma skin regeneration technique. Aims: The aim of this study is to evaluate the effectiveness of plasma radiofrequency ablation in non-surgical blepharoplasty performed with DAS Medical device (Technolux), a tool working with long-wave plasma radiofrequency principles. Patients/methods: Ten patients affected by aesthetically unpleasant dermatochalasis, excess of tissue and fine wrinkles of the eyelids, were enrolled for non-surgical blepharoplasty with long-wave plasma radiofrequency ablation device. The treatment consisted of two sessions carried out at interval of 30 days. Results: Treatments were well tolerated by all patients with no adverse effects and optimal aesthetic results. Conclusions: The technique consists of a modeling of the eyelids that must be sculpted reducing excess of skin, improving the appearance of eyelids, rejuvenating the eyes, and reducing eyelid heaviness. Long-wave plasma radiofrequency ablation could be an effective treatment for non-surgical blepharoplasty, and could offer an alternative choice to surgical procedures for aesthetic treatments of eyelids.
Article
Background In the latest few years, plasma radiofrequency ablation has turned out a good option for treatment of several benign skin lesions. The technique can be easily performed to treat skin lesions with limited tissue invasion and no residual scars or hypo/hyperpigmentation areas. Objective The aim of this study was to assess the effects of plasma radiofrequency ablation in treatment of benign skin lesions, through clinical and reflectance confocal microscopy outcomes. Methods Six patients who presented benign skin lesions underwent long‐wave plasma radiofrequency ablation treatment with DAS medical device (Technolux, Italia). Reflectance confocal microscopy analysis was performed at baseline and after 1 month. Results The treatment was well tolerated; only a slight erythema and a thin crust on the treated area were referred for 3‐7 days after treatment. After one month from treatments, we observed the complete disappearance of the lesions and no significant signs of inflammation, redness, hypo/hyperpigmentation, or scars on the site of the treated areas; these clinical data were also confirmed by reflectance confocal microscopy analysis. Conclusions Long‐wave plasma radiofrequency ablation actually can be considered a well‐tolerated, painless, safe, effective, and low‐cost procedure for skin treatments.
Article
In aesthetic medicine, plasma can successfully treat scarring, stretch marks, acne, dyskeratosis, xanthelasma, warts, verrucae, naevi, fibromas, seborrhoeic keratosis and a host of other skin lesions. For most patients, the most exciting revolution in plasma technology is non-surgical blepharoplasty. There are so many plasma or fibroblast devices on the market that vary in price and are marketed at both medics and non-medics, but what exactly is plasma? This article will discuss what plasma is, as well as exploring the indications for use, complications that come with this device and how to treat the upper eyelid.
Article
Hybrid dielectric barrier discharges are investigated for plasma generated on the surface of a dielectric layer, where two conducting electrodes of high voltage and ground are formulated on the upper and bottom surfaces. Using a flexible thin polyimide-film of a thickness ranging from 25 to 125 μm, a plasma is generated with a voltage of about 1 kV and a frequency of 40 kHz. However, the surface of the dielectric layer was etched through a chemical reaction involving plasma oxygen radical species, and thus the polyimide films failed readily, resulting in dielectric breakdown within short operating time ranging from a few minutes to several tens of minutes, based on the film thicknesses of 25 μm and 125 μm, respectively. These plasma erosions were prevented by coating the polyimide surface with a 25 μm thick silicone paste. The silicone-coated film surface was then reinforced remarkably against plasma erosion as the organic polymer was vulnerable to chemical reaction of the plasma species, while the inorganic silicone exhibited a high chemical resistance against plasma erosion. © 2018 Hefei Institutes of Physical Science, Chinese Academy of Sciences and IOP Publishing.
Article
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..
Article
The biomedical applications of cold atmospheric plasma (CAP) involve diverse multidisciplinary approaches and are based on the plasma interactions with tissues/cells and other biomaterials. Recently, we have implemented experiments for plasma-tissue interactions and first observe CAP-induced skin wrinkling behavior. The plasma-induced wrinkling behavior during the CAP interaction with a mouse's skin is explored through theoretical modeling and numerical simulation. It is found that the critical strain decreases with the increase of the elastic modulus ratio of the equivalent film-substrate model. The change of the elastic modulus ratio will lead to different surface morphology, which infers a suitable way to diagnose skin diseases. In addition, surface morphologies with similar wavelength but larger amplitude can be observed for a larger radius of curvature. These results might help the plasma community to understand the CAP-induced wrinkling phenomenon and stimulate extensive discussions on studies on plasma-tissue/biomaterials interactions.
Article
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Fungal diseases seriously affect agricultural production and the food industry. Crop protection is usually achieved by synthetic fungicides, therefore more sustainable and innovative technologies are increasingly required. The atmospheric pressure low-temperature plasma is a novel suitable measure. We report on the effect of plasma treatment on phytopathogenic fungi causing quantitative and qualitative losses of products both in the field and postharvest. We focus our attention on the in vitro direct inhibitory effect of non-contact Surface Dielectric Barrier Discharge on conidia germination of Botrytis cinerea, Monilinia fructicola, Aspergillus carbonarius and Alternaria alternata. A few minutes of treatment was required to completely inactivate the fungi on an artificial medium. Morphological analysis of spores by Scanning Electron Microscopy suggests that the main mechanism is plasma etching due to Reactive Oxygen Species or UV radiation. Spectroscopic analysis of plasma generated in humid air gives the hint that the rotational temperature of gas should not play a relevant role being very close to room temperature. In vivo experiments on artificially inoculated cherry fruits demonstrated that inactivation of fungal spores by the direct inhibitory effect of plasma extend their shelf life. Pre-treatment of fruits before inoculation improve the resistance to infections maybe by activating defense responses in plant tissues.
Article
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Introduction Nine experienced physician users of a novel helium plasma dermal resurfacing device for heating the skin at a controlled depth to achieve collagen coagulation, tissue contraction, and neocollagenesis convened to discuss their experiences and keys to success with their off‐label use of this device with collectively more than 800 cases performed for facial skin renewal procedures. Methods A round table discussion format was used to address a variety of topics including pretreatment considerations, optimum treatment parameters, posttreatment healing regimen, and avoidance and management of side effects and complications. All panelists consented to data collection, analysis, compilation, and publication. Results Ideal candidates for the procedure were identified along with optimum treatment parameters and posttreatment care. Strategies for avoidance and management of complications and side effects were discussed. Conclusions Consensus guidelines were developed for patient selection, pretreatment considerations, treatment parameters, posttreatment healing regimen, and avoidance and management of complications and side effects.
Article
Plasma medicine is an innovative research field combining plasma physics, life science, and clinical medicine. It is mainly focused on the application cold atmospheric plasma (CAP) in therapeutic settings. Based on its ability to inactivate microorganisms but also to stimulate tissue regeneration, current medical applications are focused on the treatment of wounds and skin diseases. Since CAP is also able to inactivate cancer cells, its use in cancer therapy is expected to be the next field of clinical plasma application. Other promising applications are expected in oral medicine and ophthalmology. It is the current state of knowledge that biological CAP effects are mainly based on the action of reactive oxygen and nitrogen species supported by electrical fields and UV radiation. However, continuing basic research is not only essential to improve, optimize, and enlarge the spectrum of medical CAP applications and their safety, but it is also the basis for identification and definition of a single parameter or set of parameters to monitor and control plasma treatment and its effects. In the field of CAP plasma devices, research and application are currently dominated by two basic types: dielectric barrier discharges and plasma jets. Its individual adaptation to specific medical needs, including its combination with technical units for continuous and real-time monitoring of both plasma performance and the target that is treated, will lead to a new generation of CAP-based therapeutic systems.
Article
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Background Helium plasma dermal resurfacing (HPDR) is an emerging off-label use for an existing FDA-approved device. Objectives Retrospective evaluation of patient satisfaction and adverse events (AEs) following facial skin resurfacing with HPDR technology. Methods Single-site, retrospective review of 301 patient charts following HPDR treatment of the face. Patient satisfaction data were collected during review of medical records. AE data were analyzed to determine the effects of demographic, procedural, and posttreatment variables on the presence or absence of AEs. Results HPDR was performed concurrently with other facial/non-facial surgical procedures in 193 of 301 patients (64.1%) including over undermined facial skin in 58 patients (19.3%) during rhytidectomy. No serious AEs were observed. Nonserious AEs were noted, however, in 20 patients (7.3%) and included erythema/prolonged erythema, hyperpigmentation, milia, slow healing, and upper lip hypertrophic scar. Among the 288 patients returning for follow-up (mean 2 months postprocedure), satisfaction with HPDR treatment results was documented in 275 patients (95.5%); the remaining 13 patients’ charts did not reference satisfaction or dissatisfaction, and no AEs were recorded for this patient subgroup. Conclusions This retrospective study supports the use and safety of HPDR technology for facial skin rejuvenation; no serious AEs and relatively few nonserious AEs were observed following either sole modality HPDR or HPDR with concurrent treatment of undermined skin tissue during rhytidectomy procedures. Patient satisfaction and observed results are comparable to full-field laser skin resurfacing treatments. Level of Evidence: 3
Chapter
The periorbital region is a difficult area to treat because of its delicate nature, thinnest part in the body and important function. Careful treatment of the anatomic eyelid structure is crucial in order to avoid any complications. Proper patient selection and assessment of aging severity is important in order to determine the best therapeutic option. With advances in cosmetic medicine, minimally invasive techniques in aesthetic rejuvenation have become increasingly popular. Topical therapy, chemical peels, laser resurfacing, plasma resurfacing, radiofrequency and surgery, along with neuromodulators and fillers, can be used to enhance the appearance of the periorbital region. The objective of this chapter is to review common applications of lasers and energy-based devices for the treatment of periorbital concerns.
Article
Background The field of aesthetic dermatology continues to evolve rapidly, and aesthetic procedures for facial skin play a key role in it. During recent years, patients have been demanding more non‐invasive and safe technology characterized by satisfactory results and minimal downtime as compared to traditional surgical procedures. In the panorama of facial skin treatments, the many options have different indications and limitations. Aims The aim of this study is to report the effectiveness of plasma radiofrequency ablation in facial skin aesthetic treatments, performed with D.A.S. Medical device (Technolux, Italia). Methods Once the dermatologist has diagnosed the unsightly facial skin disorder and ascertained that PRF ablation could be an appropriate approach, contraindications to treatment must be excluded. After the patient has signed the informed consent for treatment, it will be possible to proceed with the PRF ablation sessions. According to the aesthetic disorder and the area of the face to be treated, PRF ablation is performed at energy and frequency values chosen depending on the case. Results Treatments are generally well tolerated by patients, and excellent aesthetic results and no side effects are observed. Conclusions Even today, plasma radiofrequency ablation is perhaps one of the most versatile minimal invasive techniques, regarding both for variety of indications as well as effectiveness and fast downtime. Its applications are many, ranging from the removal of unsightly skin lesions, to the correction of scars, treatment of blepharochalasis, periocular and perioral wrinkles, active acne, that distort the homogeneity and the youthful appearance of the face. PRF ablation has shown to be an effective option demonstrating its value in this field.
Chapter
In the past two decades, usage of non-thermal, cold atmospheric pressure (CAP) plasmas for medical application are widely studied as it can be used at room temperature and pressures without damaging the human skin. There are a lot of prospective applications of CAP plasma in various health-related applications like wound healing, cancer treatment, disinfection, dental, and many others. Cold atmospheric plasma has been explored for its use in dermatology, particularly for wound disinfection and as a curative remedy for skin diseases caused by pathogens, due to its antimicrobial properties. The cellular mechanisms involved in CAP plasma for wound healing have been well studied. Various plasma-based sources for wound healing have been developed. In this chapter, in the beginning, a brief overview of plasma and plasma sources along with its interaction with living cells is presented. In vitro and in vivo investigations for wound disinfection by various researchers along with clinical trials for wound healing have also been summarized. As this technology is novel, a lot of research and clearances are yet to be obtained for the medical community to be convinced of its safety and efficiency compared to the traditional and conventional therapeutic methods for wound healing.
Article
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Non-thermal plasma activated water (PAW) has recently emerged as a powerful antimicrobial agent. Despite numerous potential bio-medical applications, studies concerning toxicity in live animals, especially after long-term exposure, are scarce. Our study aimed to assess the effects of long-term watering with PAW on the health of CD1 mice. PAW was prepared from distilled water with a GlidArc reactor according to a previously published protocol. The pH was 2.78. The mice received PAW (experimental group) or tap water (control group) daily for 90 days as the sole water source. After 90 days, the following investigations were performed on the euthanatized animals: gross necropsy, teeth mineral composition, histopathology, immunohistochemistry, hematology, blood biochemistry, methemoglobin level and cytokine profile. Mice tolerated PAW very well and no adverse effects were observed during the entire period of the experiment. Histopathological examination of the organs and tissues did not reveal any structural changes. Moreover, the expression of proliferation markers PCNA and Ki67 has not been identified in the epithelium of the upper digestive tract, indicating the absence of any pre- or neoplastic transformations. The results of our study demonstrated that long-term exposure to PAW caused no toxic effects and could be used as oral antiseptic solution in dental medicine.
Article
Introduction: Plasma IQ™, the first FDA-cleared hand-held plasma energy device, is indicated for removal and destruction of skin lesions and coagulation of tissue. Treatment involves use of an electrostatic plasma spark to heat the skin and create discrete microthermal wounds. Methods: Microthermal wounds on preauricular and upper eyelid skin from two individual subjects were created using multiple treatment parameters to assess the impacts of power, pulse duration and needle electrode type on wound depth, width and thermal spread, and analyzed using histology to characterize treatment effects. Results: Device power had a statistically significant impact on upper eyelid skin microthermal wound depth and width (2-sided t-test p < 0.0001 for both) but not on thermal spread (p = 0.1171). No meaningful differences in wound width, depth, or thermal spread were observed based on pulse duration or electrode type. All microthermal wounds demonstrated dual zones of tissue injury and extended to the superficial reticular dermis. Conclusion: Treatment with the Plasma IQ™ device creates focal microthermal wounds of reproducible depth and width that are comprised of dual thermal injury zones similar to other plasma energy skin rejuvenation devices. Device power is the most important factor determining microthermal wound depth and width.
Article
As the fourth state of matter, plasma’s unique properties and interactions with other states of matter offer many promising opportunities for investigation and discovery. In particular, cold atmospheric plasma (CAP), operating at atmospheric pressure and room temperature, has remarkable potential for biomedical applications through various delivery methods. These biomedical applications include sterilization, wound healing, blood coagulation, oral/dental diseases treatment, cancer therapy, and immunotherapy. Effective delivery of plasma constituents is critical to its efficacy for these applications. Therefore, this review presents the key research activities related to CAP delivery (including direct CAP delivery, delivery of plasma-activated media, biomedical device-assisted plasma delivery, and CAP delivery with other therapeutics) and needs for future research. This review will be of great interest for understanding the current state-of-the-art of biomedical applications of plasma medicine while also giving researchers from a broad range of communities insight into research efforts that would benefit from their contributions. Such communities include biomedicine, physics, biochemistry, material science, nanotechnology, and medical device manufacturing.
Article
Plasma medicine means the application of non-equilibrium plasmas at temperatures around body temperature, for therapeutic purposes. Non-equilibrium plasmas are weakly ionized gases, which contain charged and neutral species and electric fields and emit radiation particularly in the visible and ultraviolet range. Medically relevant cold atmospheric pressure plasma (CAP) sources and devices are usually dielectric barrier discharges (DBDs) and non-equilibrium atmospheric pressure plasma jets (N-APPJs). Plasma diagnostic methods and modelling approaches are used to characterize the densities and fluxes of active plasma species and its interaction with surrounding matter. Distinguished from direct application of plasma on living tissue, treatment of liquids like water or physiological saline by a CAP source is realized to acquire specific biological activities. Basic understanding of plasma interaction with liquids and bio-interfaces is essential to follow biological plasma effects. Charged species, metastable species, and other atomic and molecular reactive species first produced in the main plasma ignition are transported to the discharge afterglow to finally be exposed to the biological targets. By contact with these liquid-dominated bio-interfaces, other secondary reactive oxygen and nitrogen species (ROS, RNS) are generated. Both ROS and RNS possess strong oxidative properties and can trigger redox-related signalling pathways in cells and tissue leading to various impacts of therapeutic relevance. Dependent on the intensity of plasma exposure, redox balance in cells can be influenced in a way that oxidative eustress leads to stimulation of cellular processes or oxidative distress leads to cell death. Currently, clinical CAP application is realized mainly in wound healing. Plasma in cancer treatment (i.e. plasma oncology) is the currently emerging field of research. Future perspectives and challenges in plasma medicine are mainly directed to control and optimize CAP devices, to broaden and establish its medical applications, and to open new plasma-based therapies in medicine.
Article
Cold atmospheric plasma induces various dose-dependent effects on living cells, from proliferation to necrosis. These effects are of interest in the field of therapeutic flexible endoscopy, although implementing an effective plasma delivery system represents a technical challenge. This work studies the impact of critical parameters on plume intensity, delivered reactive species, and current administered to the target for the use of plasma in endoscopy. A two-meter-long dielectric barrier discharge plasma jet was studied upon nano-pulsed high voltage excitation to increase plasma reactivity. The peak voltage, gas gap, pulse repetition frequency, and pulse width were varied while the power dissipated by the system and the optical emissions (with imaging and spectrometry) were measured. Two configurations were compared: the first one with the plume exiting freely in air, and the second one with the plume impinging an electrical equivalent of the human body. Finally, the current flowing through the capillary was measured at regular intervals along the tube with a Rogowski coil. Results show that i) a conductive target increases the ratio of reactive species produced over the dissipated power, ii) increasing the pulse repetition frequency does not improve the reactive species production per pulse (e.g., through a synergetic, memory effect), iii) increasing the pulse width does not influence reactive species production but increases the dissipated power, and iv) current linearly leaks through the tube walls, and leaks are lower with nano-pulsed compared to sinusoidal excitation. Reactance and capacitance values of the system are analyzed based on the electrical equivalent circuit approach. Finally, displacement and discharge currents are discussed to bring power dissipation mechanisms to light and compare them between configurations.The conclusions drawn are important for the future design of safe and effective endoscopic plasma devices.
Article
When rejuvenating the hands, the most aesthetically pleasing results are achieved when the effects of both intrinsic and extrinsic ageing are addressed, which often involves using a number of approaches. Extrinsic ageing affects both the epidermis and dermis, manifesting as dermatoheliosis (wrinkling, skin laxity, crepiness, rough texture and pigmentary changes). The skin of the dorsal hand can be effectively treated with a range of modalities, although their use must be adapted to account for the anatomical differences between facial skin and that on the hand. This second article in a two-part series will look at the various options for skin rejuvenation of the ageing hand.
Article
Plasma skin regeneration (PSR) technology uses energy delivered from plasma rather than light or radiofrequency. Plasma is the fourth state of matter in which electrons are stripped from atoms to form an ionized gas. The plasma is emitted in a millisecond pulse to deliver energy to target tissue upon contact without reliance on skin chromophores. The technology can be used at varying energies for different depths of effect, from superficial epidermal sloughing to deeper dermal heating. With the Portrait PSR device (Rhytec, Inc.) there are three treatment guidelines termed PSR1, PSR2, and PSR3. The PSR1 protocol uses a series of low-energy treatments (1.0,1.2 Joules) spaced 3 weeks apart. The PSR2 protocol uses one high-energy pass (3.0, 4.0 Joules) performed in a single treatment, and the PSR3 protocol uses two high-energy passes (3.0 4.0 Joules) performed in a single treatment. All protocols improve fine lines, textural irregularities, and dyspigmentation; however, skin tightening is probably more pronounced with the high-energy treatments.
Article
We attempt to characterize the degree of skin thermal damage by using multiphoton microscopy to characterize dermal thermal damage. Our results show that dermal collagen and elastic fibers display different susceptibility to thermal injury. Morphologically, dermal collagen starts to denature at 60 degrees C while fracture and aggregation of elastic fibers do not occur until 65 degrees C. With increasing temperatures, the structures of both elastic and collagen fibers deteriorate. While second-harmonic-generation (SHG) imaging is helpful in identifying the denaturation temperature of collagen, autofluorescence (AF) imaging can help to identify the structural alternations of tissue at higher temperatures when SHG signals have decayed. We also employ a ratiometric approach based on the AF-to-SHG index of dermis (ASID) to characterize the degree of dermal thermal damage. Use of the ASID index can bypass the difficulty in analyzing inhomogeneous dermal fibers and show that dermal collagen starts to denature at 60 degrees C. Our results suggest that with additional developments, multiphoton microscopy has potential to be developed into an effective in vivo imaging technique to monitor and characterize dermal thermal damage.
Article
A new modality, the Portrait plasma skin regeneration (PSR(3)) system, allows precise and rapid treatment of photo-damaged skin, with controlled thermal injury and modification. Radio frequency (RF) energy converts nitrogen gas into plasma within the handpiece. Rapid heating of the skin occurs as the plasma rapidly gives up energy to the skin. This energy transfer is not chromophore dependent. The gold standard, carbon dioxide (CO(2)) laser resurfacing, has decreased in popularity due to high morbidity and downtime. There is demand for a technology that can provide the degree of improvement obtained with resurfacing without the complications associated with its use. This study evaluated the PSR(3) technology in full facial procedures. A two-site prospective study evaluated safety and efficacy for a single pass treatment of the full face using the Portrait PSR(3) system. Improvement in skin texture, tone, fine lines, dyschromia, and rhytides were assessed. Two-millimeter punch biopsy specimens were taken pre- and 90 days post-treatment. Follow-up was performed at days 2, 5, 7, 30, and 90 post-treatment to monitor recovery, improvement, and any subsequent sequelae. Patients developed erythema and edema shortly after treatment, with no immediate epidermal loss or charring. Epidermal loss occurred in the subsequent 24-48 h followed by epidermal recovery in approximately 7 days. Histological investigation showed regenerative epidermal and dermal architecture. The Rhytec Portrait PSR(3) system provides an attractive alternative to standard lasers that is well tolerated by patients, stimulates collagen remodeling, and provides excellent clinical outcomes.
Article
A novel device for skin rejuvenation has been developed and tested. The device converts a stream of nitrogen into a plasma of ionized gas, which ablates surface tissue in a controlled manner. Eleven patients were followed up for 6 months. The results were assessed objectively using skin molds to measure skin irregularity, as well subjectively using patient- and doctor-assessed parameters. Plasma skin regeneration was shown to reduce fine line wrinkles by an average of 24% at 6 months (P = 0.005, Mann-Whitney rank sum test) and to improve acne scarring by 23% at 6 months (P = 0.001, Mann-Whitney rank sum test). The main benefit of this system was that the patients had minimal erythema lasting only 1-6 days and no pigmentary changes. This is therefore a device with proven efficacy and limited morbidity.
Article
Background: Tonsillectomy is one of the most commonly performed surgical procedures. There are several operative methods currently in use, but the superiority of one over another has not been clearly demonstrated. Objectives: To assess the effectiveness of coblation tonsillectomy compared with other surgical techniques in reducing morbidity. Search strategy: We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 4, 2006), MEDLINE (1966 to 2006) and EMBASE (1974 to 2006). The date of the last search was December 2006. Selection criteria: Randomised controlled trials of children and adults undergoing tonsillectomy by means of coblation compared with any other surgical technique for removal of the tonsils. Trials were assessed for methodological quality according to the method outlined in the Cochrane Handbook for Systematic Reviews of Interventions 4.2.6. Data collection and analysis: Data were extracted using standardised data extraction forms. Authors were contacted where additional data were required. Main results: Nineteen studies were identified with sufficient data for further assessment. Four of these were excluded because intra-capsular tonsillectomy (i.e. tonsillotomy) rather than sub-capsular tonsillectomy was performed, and a further five studies because tonsils rather than participants were randomised. One further study was excluded because, although describing itself as a randomised trial, its participants turned out not to have been randomised to their intervention groups. Nine trials met the inclusion criteria, comparing coblation to other tonsillectomy techniques. All but two studies were of low quality and therefore a meta-analytical approach was not appropriate. In most studies, when considering most outcomes, there was no significant difference between coblation and other tonsillectomy techniques. Authors' conclusions: In terms of postoperative pain and speed and safety of recovery, there is inadequate evidence to determine whether coblation tonsillectomy is better or worse than other methods of tonsillectomy. Evidence from a large prospective audit suggests that it has been associated with a higher level of morbidity, in terms of postoperative bleeding. Large, well-designed randomised controlled trials supplemented by data from large prospective audits are needed to produce information on effectiveness and morbidity respectively.
Article
Many noninvasive treatments to rejuvenate photodamaged skin are characterized by an unattainable balance between effectiveness and morbidity. The demand for safe, effective procedures has fueled the emergence of plasma skin regeneration (PSR). Preliminary studies have elaborated on the safety and efficacy of PSR for facial skin; however, no evaluation in nonfacial areas has been made. This study was conducted to evaluate the efficacy and safety of PSR in the treatment of moderately photodamaged skin on the neck, chest, and dorsal hands. Thirty skin areas in 10 patients were selected. Each area received one of three discrete energy settings using a commercially available PSR system. Clinical evaluations of skin texture, pigmentation, wrinkle severity, and side effects were conducted immediately and at 4, 7, 14, 30, and 90 days after treatment. Mean clinical improvements of 57, 48, and 41% were observed in chest, hands, and neck sites, respectively. Significant reduction in wrinkle severity, hyperpigmentation, and increased skin smoothness were achieved. Higher-energy settings yielded greater benefit but also prolonged tissue healing. PSR offers improvement of moderately photodamaged skin of the neck, chest, and dorsal hands with limited side effects. Further studies are needed to determine the effect of multiple treatment sessions, optimal treatment parameters, and intervals for each site and longevity of clinical results.
Article
Plasma skin regeneration is a novel type of skin rejuvenation technology developed over the last 3 years. Plasma is the fourth state of matter in which electrons are stripped from atoms to form an ionized gas. Although high temperature plasmas have been used in surgery for over a decade, plasma had previously been used as a conduction medium for electric current. Unlike lasers which rely on the principle of selective photothermolysis to deliver heat to specific targets in the skin, plasma technology delivers heat energy directly to tissue upon contact without reliance on skin chromophores. The plasma itself produces controlled thermal damage to the skin surface to elicit changes such as new collagen formation and improvement in photodamaged skin. The technology can be used at varying energies for different depths of effect, from superficial epidermal effects to deeper dermal heating.
Plasma/CO 2 complication comparison, advanced treatment approach
  • R Fitzpatrick
Fitzpatrick R. Plasma/CO 2 complication comparison, advanced treatment approach, latest Portrait PSR3 research.