title: Histologic and clinical response to varying density settings with a fractionally scanned carbon dioxide laser.
abstract: OBJECTIVE
  An evaluation of the histological and clinical response to varying density settings (-10%, 0, and 10% overlap) with a fractionally scanned CO2 laser.
  
  
  METHODS
  Clinical and histological study evaluating abdominoplasty excised tissue for depth of penetration and width of tissue ablated with varying density and energy settings utilizing a scanned microsecond pulsed CO2 laser. These parameters were correlated clinically with patients treated with similar density settings.
  
  
  METHODS
  Fifteen patients were enrolled with 5 patients in each group: group 1 (density 1 settings), group 2 (density 2 settings) and group 3 (density 3 settings).
  
  
  RESULTS
  Histological differences of width and depth of tissue ablated with varying density settings and correlation with photodamage improvement clinically.
  
  
  METHODS
  Six samples of excised abdominoplasty tissue were treated with increased energy and density settings and were evaluated histologically. Clinically, 15 patients with photodamage to the face were randomized to receive a fractional CO2 laser treatment with density levels ranging from 1 to 3.
  
  
  RESULTS
  Microarrays of tissue injury were visualized with multiple areas of superficial to full-thickness epidermal thermal damage. As energy increased (90 W to 100 W), the width of basophilic coagulation of the subepidermal collagen increased. Increased density paralleled increased depth of penetration of subepidermal coagulation. Patient assessment of discomfort, erythema, edema, and satisfaction with the procedure was proportional to increasing densities.
  
  
  CONCLUSIONS
  A fractional CO2 laser produces photorejuvenation, erythema, edema and discomfort in proportion with the depth and extent of epidermal and subepidermal thermal damage.
authors.affiliation: American Academy of Cosmetic Surgery Fellow, Dermatology/Cosmetic Laser Surgery Associates of La Jolla, Inc., CA, USA. MGoldman@Spa-MD.com
authors.forename: Raminder
authors.initials: R
authors.lastname: Saluja
authors.forename: Jane
authors.initials: J
authors.lastname: Khoury
authors.forename: Susan P
authors.initials: SP
authors.lastname: Detwiler
authors.forename: Mitchel P
authors.initials: MP
authors.lastname: Goldman
mesh_terms: D000328:Adult; D000368:Aged; D062109:Dermatologic Surgical Procedures; D004487:Edema / Q000209:etiology; D004890:Erythema / Q000209:etiology; D005145:Face / Q000528:radiation effects / Q000601:surgery*; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D054020:Lasers, Gas / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D017060:Patient Satisfaction; D012060:Rejuvenation; D012867:Skin / Q000473:pathology* / Q000528:radiation effects; D015595:Skin Aging / Q000528:radiation effects*