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. 2017 Sep 30;26(3):211-222.
doi: 10.5978/islsm.17-OR-17.

Treatment of Chronic Lower Extremity Ulcers with A New Er:Yag Laser Technology

J M Alcolea  1   2 , E Hernández  3 , P A Martínez-Carpio  4   2 , M Vélez  5   2 , V Khomchenko  6 , A Sola  7 , M A Trelles  2
Affiliations

Treatment of Chronic Lower Extremity Ulcers with A New Er:Yag Laser Technology

J M Alcolea et al. Laser Ther. .

Abstract

Chronic lower extremity ulcers (CLEUs) have a high prevalence and are difficult to treat due to their various aetiologies. The aim of this study is to evaluate the results achieved in treating CLEUs using an Erbium: YAG (Er:YAG) laser with RecoSMA technology. This laser emits thousands of microbeams of energy causing superficial epidermal ablation and a separation of dermal fibres due to a mechanical-acoustic and resonance effect. The evaluation of the results achieved was carried out by questionnaires completed by 18 patients enrolled in the study. Histological studies and photographs taken before each session (16 sessions in total) were analysed to visually monitor the clinical progress. The analyses were carried out with the help of computer software. The results after 16 treatment sessions showed the complete healing of ulcers or a decrease in their initial area of at least 55% in over 65% of the patients treated. The Student's t-test and Fisher's exact test were used for statistical analysis. The Er:YAG laser and RecoSMA technology ablates few epidermal cell layers, producing a mechanical-acoustic effect with resonance action leading to tissue regeneration mechanisms. This technology offers an effective and safe alternative for treating CLEUs.

Keywords: Chronic lower extremity ulcers; Er:YAG; RecoSMA technology; Ulcers; laser; mechanical-acoustic effect.

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Figures

Fig. 1:
Fig. 1:
73-year-old male, case patient No. 2 of the study. Ulcers have been present for 4 years. A) Observe the treated area which surpasses the ulcer. The white labels allow the software to recognise the colour in order to match the tone from the photographs, and to help to define the size of the lesion. B), C) and D) Are related to the various treatments carried out. The progressive improvement of the ulcer until its closure can be observed.
Fig. 2:
Fig. 2:
The RecoSMA® system has several lenses that allow the laser beam to be divided into 10,000 microbeams/cm2, with each one of them retaining high power. RecoSMA® is attached to the hand piece of the Er:YAG laser.
Fig. 3:
Fig. 3:
A 61-year-old female, patient No. 9 of the study shows multiple ulcers with a slow progress of more than 8 years. A), B) and C) show the progressive improvement relating to the various treatments.
Fig. 4:
Fig. 4:
72-year-old male, patient No. 8 of the study. A) and B) show the progress of the ulcer until its final condition C) at the end of the scheduled series of treatments. The closure of the ulcer was not achieved, but its condition was improved, preparing the patient to receive a skin graft. The graphic below quantifies the reduction of the ulcer according to calculations made by the software.
Fig. 5:
Fig. 5:
76-year-old female, patient No. 13 of the study. A) and B) represent various conditions until the final healing of the ulcer in C). The graphic below shows the significant progress of the ulcer as quantified by the software.
Fig. 6:
Fig. 6:
Histology samples corresponding to A) before starting the treatment sessions; B) six weeks after, and C) three months after beginning the treatment.
See this image and copyright information in PMC

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