In-vivo study of epidermal protection by cryogen spray cooling during pulsed-laser irradiation at high radiant exposures
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Cryogen spray cooling (CSC) offers a means to selectively cool the epidermis during laser therapy and has been used in conjunction with pulsed laser irradiation to treat light skin patients (Fitzpatrick Type I-TV) at moderate radiant exposures (<15 J/cm2). The purpose of this study was to determine the effectiveness of CSC in protecting the human skin epidermis in vivo from thermal injury during high radiant exposures (>15 J/cm2). Normal abdominal skin on twenty anesthetized individuals undergoing transverse rectus abdominis myocutaneous (TRAM) flap procedures with various skin types (Fitzpatrick type I-VT) were irradiated using incident radiant exposures of 8-30 J/cm2 without and with CSC. Assessment of tissue damage was based on histologic analysis. Epidermal damage was observed as basal epidermal cell vacuolization, epidermal basal layer separation, and epithelial cell spindling. For lighter skin patients (Fitzpatrick type IIV) the epidermal damage threshold was increased to as much as 30 J/cm2 when using CSC. However, complete epidermal protection in the darkest skin patients (Fitzpatrick type V-VT) could not be achieved with cryogen spurt durations as long as 300 ms using cunent CSC protocols.
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Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems XII, Proceedings of SPIE
James William Tunnell, .., David Chang, .., Carol Johnston, .., Jorge H. Torres M.D., .., Charles W. Patrick, .., Michael J. Miller, .., Sharon L. Thomsen M.D., .., & Bahman Anvari.
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8
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Bartels, K. E., Bass, L. S., de Riese, W. T., Gregory, K. W., Katzir, A., Kollias, N., ... Woodward, T. A.
