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"VASCULAR" LASER IN DERMATOLOGY

Дата публикации: 30 сентября 2021
Автор(ы): Marina MALYGINA
Публикатор: Научная библиотека Порталус
Рубрика: МЕДИЦИНА
Источник: (c) Science in Russia, №1, 2012, C.40-43
Номер публикации: №1633008902


Marina MALYGINA, (c)

by Marina MALYGINA, journalist

 

Specialists of the RAS Lebedev Physical Institute (FIAN) suggested a new technology for selective removal of vascular and pigmented defects of the skin without impairing the adjacent tissues. The method is realized by Yakhroma-Med laser. The basic device integrates the original technological designs protected by patents and authors' certificates, its working resources and safety are unique according to the world standards. It is the first and up to the present time the only device of this kind for the treatment of benign skin abnormalities, completely certified by the Ministry of Health and Social Development of the Russian Federation.

 

Optical quantum generators have been used in medicine for more than 50 years. As soon as the first ruby laser* was created in 1960, the dermatologists made the first attempts at using it. However, skin exposure was painful, caused burns, and was therefore seldom resorted to. In 1964, carbon dioxide laser was suggested for medical use, later on other

 

Pulsed laser yellow light.

 

* See: M. Khalizeva, "Lasers in Science, Technology, Medicine", Science in Russia, No. 3, 2011--Ed.

 
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devices differing by the type of active media--semiconductor, liquid (inorganic or organic stains), metal (mainly copper or gold) vapor-based lasers were introduced. Gradually exposure to a highly coherent monochromatic light beam became a common procedure in dermatology and cosmetology, one of the most often used ones. Even low selective activity (the adjacent intact tissues were warmed together with the pathological focus) of the first medical lasers did not prevent wide use of the method, and the physicians had to balance between efficiency and safety.

 

However, the brave and promising concept of selective photothermolysis (selective absorption of light waves of certain length by different tissues), put forward at the beginning of the 1980s by Rox Anderson and George Parrish, American dermatologists, crucially changed the picture. These authors have experimentally proved that some colored biological substances (melanin, hemoglobin) absorb photoenergy very well, causing cell destruction, while others do not. This promoted creation of new systems--"vascular" lasers with selective effects on the skin microzones. These systems were intended to help control highly prevalent vascular and pigmented abnormalities, such as teleangiectasia (dilatation of skin capillaries of the face and legs), capillary angiodysplasias ("wine spots"), hemangiomas (hyperplasias), and other kinds of the surface layer involvement, found (according to different estimations) in up to 30 percent of Russian population with light skin. Selective photothermolysis offered a unique possibility to repair these abnormalities without impairing vital functioning of the adjacent normal structures.

 

The yellow pulsed lasers, for example, copper vapor lasers working at a wavelength of 578 nm, gave the best results with minimum side effects. The light beams emitted by these lasers heated the forming "wine spot" or capillary hemangioma or vessels to the clotting temperature without involving the adjacent structures. The Yakhroma-Med device, created at the beginning of the 21st century at the Physical Institute by a team of scientists headed by Igor Ponomaryov, Cand. Sc. (Phys. & Math.), belongs to this very cluster. By its technological, exploitation, and ergonomic characteristics it is superior to the closest analogs and largely determines trends of development of Russian medical engineering for selective photodestruction.

 

Yakhroma-Med generates pulses in two bands, green and yellow, reports the Agency of Scientific Information FlAN-Inform. Green laser exposure removes surface defects of skin pigmentation (for example, freckles, nevuses), while yellow laser is used for treatment of deeper vascular formations. The matter is that the green wavelength (511 nm) is well absorbed by melatonin, while the yellow wavelength (578 nm) coincides with the local maximum of hemoglobin absorption. Due to this factor and the possibility to focus the radiation to the size of a visually discernible vessel, the device works selectively--the light absorbs only changed skin sites, while normal sites are not affected by it.

 

It is noteworthy that green lasers are not a rare thing at the technological market. Yellow light generators, working in the short pulse mode with pulses of tens or hundreds of kW (which leads to the therapeutic effect) are unique. This is explained by the difficulties of creating these systems. "Exposure to usual yellow light", explains to the Agency FIAN-lnform Alexander Nasibov, Dr. Sc. (Tech.), head of the laboratory of semiconductor lasers with electron inflation (FIAN), "is useless: while the vessel becomes cool, normal tissues

 
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are exposed and heated. Our device generates powerful pulses 10 ns (10-8 s) long. And as the process of cooling is longer (app. 10 µs or 10-5 s), the pulses have time to clot the blood in small vessels and capillaries, thus destroying them." Selectivity, accuracy of dosing, unique spectrum of exposure, small size of the focus spot--all these factors provide excellent clinical and cosmetic results.

 

The device made of Russian parts has a very long service period: over 1,500 h. The laser tube requiring no regular service provides its reliable work. The tube should be replaced once a year, the procedure in fact resembling replacement of an ordinary electric lamp.

 

The new device is convenient and simple in use. The microcontroller system allows the physician easily set up the required program, while a liquid crystal monitor shows the state of the device. The device is autonomous and can therefore be used at a medical institution of any kind, from research institute to a factory health center. However, it should be handled only by a highly qualified physician. Igor Ponomaryov asserts, "Not every doctor can handle this device properly. One and the same beauty-spot can be removed at a low energy and at 10 times higher energy. In the former case the skin will remain smooth, in the other-there will be a wound or a crater..." It is clear why physicists work in close cooperation with physicians, developing and improving the technology of selective removal of vascular and pigmented defects. The clinicists are trained to work with the device at well-known medical centers: I. Mechnikov State Medical Academy (St. Petersburg) and Russian State Medical University (Moscow). Moreover, the head of the project created an Internet community for Yakhroma-Med device users. Exchange of opinions, methods, parameters through the Internet helps even the newcomers adapt rapidly to and enjoy working on this modern high technology device, noted Sergei Larin, phlebologist from Volgograd.

 

The device has been certified in Russia and Ukraine, the treatment technology has been registered at the Ministry of Health and Social Development of the Russian Federation. The best physicians of the country, participating in clinical trials, have highly appreciated the device. "Due to Yakhroma-Med we have cured more than 2,000 children", commented Nikolai Pos-pelov, Head of Laser Center of the Russian Pediatric Clinical Hospital in Moscow, "and consider that copper vapor laser is an ideal instrument for the treatment of vascular diseases of the skin, particularly 'wine spots' and teleangiectasias. Its use is less painful. It is more effective and safe than other lasers, which is particularly important in the treatment of children." Svetlana Klyuchareva, dermatologist from I. Mechnikov State Medical Academy in St. Petersburg, shares this opinion: "The advantage of this method is a minimum risk of cicatrices and the adjacent tissue involvement, while the healing period is much shorter. The procedure is short, involves no blood loss, requires no anesthesia. The treatment efficiency is 96 percent." Her colleague Pavel Vlasov, a surgeon at the Phlebo-

 
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center in Perm, used Yakhroma-Med for selective coagulation of the lower limb vessels and noted, "The laser proved to be an excellent supplement to sclerotherapy, used previously at our Center. More than 500 patients from the Ural region have been treated with good results." Igor Yefimchuk, a plastic surgeon from the Baltic Institute of Cosmetology in Kaliningrad agreed with him: "Due to this device I can offer my patients a rapid and effective method for removal of vascular and pigmented defects of the skin, leaving no traces and requiring in fact no care after the treatment. We started its wide use and at present, after 300 procedures, presumably have the greatest experience in using the 'vascular' laser in the Baltic region."

 

One more thing: the price of Yakhroma-Med is several times lower than of its Western analogs. This, together with its high reliability and unique working resource, makes it a competitive product at the domestic and world markets, which is confirmed by practice: more than 100 Russian and foreign clinics and medical centers have purchased it and highly appreciate its efficiency and economy.

Опубликовано на Порталусе 30 сентября 2021 года

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