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CORRESPONDENCE
Year : 2020  |  Volume : 65  |  Issue : 2  |  Page : 166-167
Preliminary assessment for postsurgical scar treatment with the novel low-energy plasma skin regeneration technique


Dermatology Unit, University of Campania “Luigi Vanvitelli”, Naples, Italy

Date of Web Publication25-Feb-2020

Correspondence Address:
Adone Baroni
Dermatology Unit, University of Campania “Luigi Vanvitelli”, Naples
Italy
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijd.IJD_166_18

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How to cite this article:
Baroni A. Preliminary assessment for postsurgical scar treatment with the novel low-energy plasma skin regeneration technique. Indian J Dermatol 2020;65:166-7

How to cite this URL:
Baroni A. Preliminary assessment for postsurgical scar treatment with the novel low-energy plasma skin regeneration technique. Indian J Dermatol [serial online] 2020 [cited 2020 Apr 1];65:166-7. Available from: http://www.e-ijd.org/text.asp?2020/65/2/166/279186




Sir,

Postsurgical soft-tissue injuries, as a result of common cutaneous surgical procedures such as biopsies or excisions, can result in permanent normal or complicated scars, with unpleasant esthetic appearance. To improve the scar appearance, many pharmacologic measures are performed, such as silicone gel, 5-fluorouracil or corticosteroids injections, with good clinical results.[1] For unresponsive scar or as alternative therapy, laser treatment may be very effective.[1] Ablative laser treatment, in particular, carbon dioxide and erbium lasers, has been used for the treatment of scar, often with significant collateral effect arising during the reepithelization process.[2] In contrast, nonablative laser treatment using infrared wavelengths, such as 1320-nm Nd:YAG or 1450-nm diode, creating a controlled dermal wound without epidermal disruption results in more safe treatment of the scar.[2],[3] Posttreatment collateral effect can also occur in patients receiving fractional laser therapy.[2],[3]

The demand for noninvasive and safe technology for the treatment of scar paved the way for the research of novel therapy with less collateral effect and more efficacy. Plasma skin regeneration (PSR) is a new technique consisting of generation of plasma energy through the production of ionized energy that thermally heats tissue, through a plasma radiofrequency (P-RF) device.[4],[5]

A 45-year-old woman with a 5-month history of normal scar of the upper lip, with focal hypertrophy at the peaks caused by the emerging sutures, following surgical excision of a skin cancer [Figure 1]a was treated with P-RF device (D. A. S. Medical, Technolux, Italia), a tool that work with long-wave P-RF principle. Before starting treatment, she signed an informed consent form. No contraindications to treatment, such as Fitzpatrick skin Types V-VI, concomitant bacterial or viral infection, collagen vascular disorders, diabetes, malignancy, pregnancy, and ablative skin procedures carried out within the previous 3 months, were present. After careful disinfection of the skin with antiseptic solution, long-wave plasma- RF (LWP-RF) ablation was performed without anesthesia. The margins of the scar were superficially ablated with one pass at 0.6 J energy and 3 Hz frequency, delivered in a paintbrush fashion, with detached spots of sublimation, leaving columns of intact epidermis, and without touching the central linear fibrous part of the scar. Focal hypertrophy at the peaks of the scar was fully ablated with two passes of the same values of energy and frequency, with no columns of sparing tissue. Treatment consisted of two sessions, carried out at 30-day interval. After LWP-RF procedure, she applied an antibiotic ointment for a few days, avoiding sun exposure during the sessions and for 5 months after the last session. The treatment was well tolerated, and no adverse effects were observed. The patient was followed up at 3 and at 6 months from the last treatment. Significant clinical improvement of the scar was already observed after only a single LWP-RF session [Figure 1]b.
Figure 1: (a) Postsurgical scar on the upper lip, with focal hypertrophy at the peaks of the scar. (b) Complete healing after long wave plasma radiofrequency ablation treatment

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P-RF device utilizes plasma energy created from the ionization of atmospheric gas between the device and the skin. Contrary to ablative treatments (lasers or traditional radiofrequency), plasma sublimation leaves a layer of intact and desiccated epidermis that acts as a natural biologic dressing and promotes a more rapid recovery, avoiding to damage the deeper layers of the skin and predisposing to better healing with best esthetic results. Treatment can be made without anesthesia because of its quickness, and low and tolerable pain stimulation. In conclusion, PSR with a low-energy setting, combined with the absence of anesthesia, quickness and low cost, could represent an effective option for the treatment of scars. Further studies with larger samples are needed to determine the efficacy of this technique in the treatment of scars.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Del Toro D, Dedhia R, Tollefson TT. Advances in scar management: Prevention and management of hypertrophic scars and keloids. Curr Opin Otolaryngol Head Neck Surg 2016;24:322-9.  Back to cited text no. 1
    
2.
Kim KH, Bernstein LJ, Chapas A, Geronemus RG. Use of the PSR technology at low fluence for full facial rejuvenation. Lasers Surg Med Suppl 2006;18:20.  Back to cited text no. 2
    
3.
Baroni A. Long-wave plasma radiofrequency ablation for treatment of xanthelasma palpebrarum. J Cosmet Dermatol 2019;18:121-3. doi: 10.1111/jocd.12509.  Back to cited text no. 3
    
4.
Avram MM, Tope WD, Yu T, Szachowicz E, Nelson JS. Hypertrophic scarring of the neck following ablative fractional carbon dioxide laser resurfacing. Lasers Surg Med 2009;41:185-8.  Back to cited text no. 4
    
5.
Foster KW, Moy RL, Fincher EF. Advances in plasma skin regeneration. J Cosmet Dermatol 2008;7:169-79.  Back to cited text no. 5
    


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