Micro-Mechanical Fractional Skin Rejuvenation

Fernandes, Justin R.; Samayoa, Juan C.; Broelsch, G. Felix; McCormack, Michael C.; Nicholls, Alexa M.; Randolph, Mark A.; Mihm, Martín C.; Austen, William G.

doi:10.1097/prs.0b013e3182789afa

Cited by 20 publications

(37 citation statements)

References 39 publications

(41 reference statements)

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“…Fernandes et al studied needle coring in swine and found, as in our study, the absence of scarring and evidence of rapid healing similar to that reported after fractional laser treatment. However, they did not attempt to close the array of wounds, created by needle coring . After coring holes in a similar manner without immediate wound closure they found a small, non‐significant amount of shrinkage, 3.6 %, comparable to our study.…”

Section: Discussionsupporting

confidence: 80%

Micro‐fractional, directional skin tightening: A porcine model

et al. 2015

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Section: Discussionsupporting

confidence: 80%

Micro‐fractional, directional skin tightening: A porcine model

et al. 2015

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“…Another limitation is the short 28-day duration of follow-up. In a previous study [10], closure of coring needle holes in swine with a longer follow-up of 3 months showed similar quantitative and qualitative results to those of the coring needles in this study, which suggests that the results of laser and hole closure are also likely to be stable for at least 3 months. Other limitations are lack of testing a wide range of treatment densities, lack of testing the optimum time for removal of compressive dressings after treatment, lack of comparing various types of ablative fractional lasers with each other, and lack of comparing a single treatment with multiple treatments.…”

Section: Discussionsupporting

confidence: 85%

Significant skin‐tightening by closure of fractional ablative laser holes

et al. 2017

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Background and Objective Ablative fractional laser treatment uses thousands of very small laser beam wounds to damage a fraction of the skin, which stimulates tissue remodeling. Each open micro‐wound heals without scarring, but the amount of skin tightening achieved is limited. This animal study was performed to test the hypothesis that immediate temporary closure of fractional laser wounds could increase skin tightening after fractional ablative laser treatment. Materials and Methods Four adult swine were used for the study; 98 square test sites (3 × 3 cm) were tattooed on the abdomen and flanks of each pig. An ablative fractional Erbium:YAG laser (Sciton Profile, Sciton Inc, Palo Alto, CA) was used to treat the test areas. A laser micro‐spot fluence of 375 J/cm2 was delivered in 150–250 microseconds pulses, resulting in an array of ablation channels extending 1.5 mm deep into the skin, with a spot size of 250 µm, with 10% treatment density. Immediately following laser exposure the resulting holes were closed using a stretched elastic adhesive dressing, which, when applied, recoiled and compressed the diameter of the ablation holes. The compressive dressings were removed after 7 days. This procedure was compared to removing the same amount of skin (10%) mechanically by specially designed 19 gauge coring needles, as well as to the same laser and coring methods without compression closure. Area and shape of test sites were measured by digital photography before and 28 days after treatment. Data analysis included compensation for animal growth, as measured by increase in the area of the untreated control sites. Results All treated and control sites healed within a week, without scarring evident at 28 days. Laser treatment combined with compressive wound closure caused significant shrinkage at 28 days compared with untreated control sites. The treated skin area was reduced by 11.5% (P = 0.0001). Needle coring with wound closure produced similar, significant shrinkage (8%, P < 0.0021), whereas laser and needle coring treatment without closure did not result in significant area reduction (P = 0.1289) compared with untreated control sites. Conclusion Significant skin tightening can be achieved by immediate temporary non‐invasive wound closure after short pulse Er:YAG fractional ablative laser treatment, as well as after mechanically removing skin with a coring needle. This approach may improve skin tightening after ablative laser treatments. Further clinical studies are necessary to confirm successful application in humans. Lasers Surg. Med. 50:64–69, 2018. © 2017 Wiley Periodicals, Inc.

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“…Unlike classical skin grafts, the skin microcolumns used in this study are within the small size range that can heal quickly and without scarring. This has been previously demonstrated in porcine models by us (Tam et al , ) and others (Fernandes et al , ), and also by the extensive non‐scarring clinical experience with fractional laser treatments (Manstein et al , ; Saedi et al , ).…”

Section: Discussionsupporting

confidence: 67%

Reconstitution of full-thickness skin by microcolumn grafting

Tam

Wang

Vuong

et al. 2016

J Tissue Eng Regen Med

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In addition to providing a physical barrier, skin also serves a diverse range of physiological functions through different specialized resident cell types/structures, including melanocytes (pigmentation and protection against ultraviolet radiation), Langerhans cells (adaptive immunity), fibroblasts (maintaining extracellular matrix, paracrine regulation of keratinocytes), sweat glands (thermoregulation) and hair follicles (hair growth, sensation and a stem cell reservoir). Restoration of these functional elements has been a long‐standing challenge in efforts to engineer skin tissue, while autologous skin grafting is limited by the scarcity of donor site skin and morbidity caused by skin harvesting. We demonstrate an alternative approach of harvesting and then implanting μm‐scale, full‐thickness columns of human skin tissue, which can be removed from a donor site with minimal morbidity and no scarring. Fresh human skin microcolumns were used to reconstitute skin in wounds on immunodeficient mice. The restored skin recapitulated many key features of normal human skin tissue, including epidermal architecture, diverse skin cell populations, adnexal structures and sweat production in response to cholinergic stimulation. These promising preclinical results suggest that harvesting and grafting of microcolumns may be useful for reconstituting fully functional skin in human wounds, without donor site morbidity. © 2016 The Authors Journal of Tissue Engineering and Regenerative Medicine Published by John Wiley & Sons Ltd.

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Micro-Mechanical Fractional Skin Rejuvenation

Abstract: This novel approach to skin rejuvenation was found to effectively induce the microscopic and biological endpoints of skin rejuvenation. This may provide a new modality for the safe and cost-effective treatment of age-related rhytides, skin laxity, photodamage, scarring, and striae.

Cited by 20 publications

References 39 publications

Micro‐fractional, directional skin tightening: A porcine model

Micro‐fractional, directional skin tightening: A porcine model

Significant skin‐tightening by closure of fractional ablative laser holes

Reconstitution of full-thickness skin by microcolumn grafting

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