title: The effect of pre-operative topical anaesthetic cream on the ablative width and coagulative depth of ablative fractional resurfacing laser.
abstract: Topical anaesthetic cream (TAC) is commonly used as a pre-treatment of ablative fractional resurfacing (AFR) laser. Most of anaesthetic cream contains distilled water as major component. Therefore, pre-operative TAC may interfere the photothermal reaction in the skin treated with fractional carbon-dioxide (FCO2) laser and fractional erbium-doped yttrium aluminium garnet (FEr:YAG) laser. The objective of the study was to compare the ablative width (AW) and coagulative depth (CD) of AFR laser with and without pre-treatment with TAC. Four Thai females who underwent abdominoplasty were included in the study. The excised skin of each subject was divided into four areas. TAC (eutectic mixture of local anaesthesia; EMLA) with 1-h occlusion was applied only on the first and second areas. The first and third areas were treated with FCO2at 15 mj and 5% density. The second and fourth areas were treated with FEr:YAG at 28 J/cm2and 5% density. Six biopsied specimens were obtained from each area. A total of 96 specimens (24 specimens from each area) were collected from four patients and examined randomly by two dermatopathologists. The ablative width and coagulative depth from each specimen were determined. In FCO2-treated specimens, the mean AW of the specimens that were pre-treated with TAC and control was 174.86 ± 24.57 and 188.52 ± 41.32 μm. The mean CD of the specimens that were pre-treated with TAC and control was 594.96 ± 111.72 and 520.03 ± 147.40 μm. There were no significant differences in AW and CD between both groups (p = 0.53 and p = 0.15). In FEr:YAG-treated specimens, the mean AW of the specimens that were pre-treated with TAC and control was 381.11 ± 48.02 and 423.65 ± 60.16 μm. The mean CD of the specimens that were pre-treated with TAC and control was 86.03 ± 29.44 and 71.59 ± 18.99 μm. There were no significant differences in AW and CD between both groups (p = 0.16 and p = 0.24). The pre-treatment with TAC provided no statistically difference from the control group on AW and CD of both FCO2and FEr:YAG laser irradiation. However, there was a tendency to have narrower AW and deeper CD of the areas that were pre-treated with TAC when comparing to that of the control.
authors.affiliation: Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Pran-nok Road, Bangkok, 10700, Thailand.
authors.forename: Preawphan
authors.initials: P
authors.lastname: Punyaratabandhu
authors.affiliation: Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Pran-nok Road, Bangkok, 10700, Thailand. rungsima.wan@mahidol.ac.th.
authors.forename: Rungsima
authors.identifier: http://orcid.org/0000-0002-3926-2193
authors.initials: R
authors.lastname: Wanitphakdeedecha
authors.affiliation: Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Pran-nok Road, Bangkok, 10700, Thailand.
authors.forename: Penvadee
authors.initials: P
authors.lastname: Pattanaprichakul
authors.affiliation: Department of Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Panitta
authors.initials: P
authors.lastname: Sitthinamsuwan
authors.affiliation: Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Pran-nok Road, Bangkok, 10700, Thailand.
authors.forename: Weeranut
authors.initials: W
authors.lastname: Phothong
authors.affiliation: Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Pran-nok Road, Bangkok, 10700, Thailand.
authors.forename: Sasima
authors.initials: S
authors.lastname: Eimpunth
authors.affiliation: Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Visnu
authors.initials: V
authors.lastname: Lohsiriwat
authors.affiliation: Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Pran-nok Road, Bangkok, 10700, Thailand.
authors.forename: Woraphong
authors.initials: W
authors.lastname: Manuskiatti
mesh_terms: D000287:Administration, Topical; D000777:Anesthetics / Q000008:administration & dosage* / Q000494:pharmacology*; D005260:Female; D006801:Humans; D017075:Laser Coagulation; D053844:Lasers, Solid-State / Q000627:therapeutic use; D011300:Preoperative Care; D012867:Skin / Q000187:drug effects / Q000473:pathology / Q000528:radiation effects
chemical_list: D000777:Anesthetics
keywords: Ablative fractional resurfacing laser; Ablative width; Coagulative depth; Topical anaesthetic cream