Use of Biobrane after laser resurfacing.
BACKGROUND
Laser skin resurfacing has become an ever more popular and effective technique for the treatment of photoaged skin. Often a prolonged postoperative healing period adversely affects patients and physician satisfaction. Erythema and a certain degree of patient discomfort are often believed to be inevitable as they are thought to reflect depth of wounding and consequently the efficacy of wrinkle removal. In addition, a high incidence of irritant contact dermatitis has been observed, complicating recovery.


OBJECTIVE
To develop a simplified wound dressing protocol aimed at achieving mild, short-term erythema and minimal side effects following effective rhytidectomy performed by laser resurfacing.


METHODS
In a retrospective study from September 1995 to May 1997, 85 patients undergoing laser resurfacing for rhytid removal were placed on a postoperative wound care protocol consisting of immediate postsurgical once-only application, for 6 days, of Biobrane, a biosynthetic semipermeable dressing followed by the topical use of only a 10% cartilage extract in ointment.


RESULTS
Thirty-eight full-face/three-quarter face, 26 supralabial, 13 perioral, and eight lower eyelid/crow's feet cosmetic units were treated. The fine and course wrinkles were improved in most patients, comparing favorably with other reported series. In 94% of patients erythema was absent to light pink at 4 weeks. Mild pain necessitating a medication was used in only five patients. Twenty-six patients developed transient hyperpigmentation and three patients developed focal hypopigmentation. Delayed irritant contact dermatitis presented in three patients. No infections developed and no scarring was observed.


CONCLUSIONS
With this wound healing protocol, carbon dioxide laser skin resurfacing can effectively improved facial rhytids with minimal to insignificant erythema or discomfort.
Department of Dermatology, Hôpital Cantonal Genèva, Switzerland.
P M
PM
Levy
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Salomon
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use; D001672:Biocompatible Materials / Q000627:therapeutic use*; D002245:Carbon Dioxide; D020099:Coated Materials, Biocompatible; D017453:Dermatitis, Irritant / Q000517:prevention & control; D004890:Erythema / Q000517:prevention & control; D005260:Female; D006025:Glycosaminoglycans / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D017495:Hyperpigmentation / Q000209:etiology; D017496:Hypopigmentation / Q000209:etiology; D053685:Laser Therapy; D008875:Middle Aged; D009779:Occlusive Dressings; D009824:Ointments; D010149:Postoperative Pain / Q000517:prevention & control; D017060:Patient Satisfaction; D012189:Retrospective Studies; D015361:Rhytidoplasty / Q000379:methods*; D015595:Skin Aging; D017592:Skin Care; D014945:Wound Healing
D000700:Analgesics; C042816:Biobrane; D001672:Biocompatible Materials; D020099:Coated Materials, Biocompatible; D006025:Glycosaminoglycans; D009824:Ointments; D002245:Carbon Dioxide