UltraPulse. UltraPulse. Physician Recommended Treatment Parameters. ActiveFX DeepFX TotalFX SCAAR FX

Transcription

1 UltraPulse UltraPulse TotalFX Physician Recommended Treatment Parameters Updated JUNE

2 Treatment Depths Treatment Depths The depth of ablation is directly correlated to the energy levels. The following depths are an average of based on energy levels various histology and OCT studies, since the actual Note: The following diagrams use different scales depth levels will vary based on various factors such as intracellular and intercellular water content. mj µm mm spot size 100 µm Depth (microns) Energy (mj) mj µm ! Use with caution Not suitable for conventional skin resurfacing.! Use with caution Not suitable for conventional skin resurfacing µm Depth (microns) Energy (mj) mj µm µm Depth (microns) Energy (mj) NOTE: The above charts use different scales

3 Treatment Density / square pattern / square pattern SETTING SCAN PATTERN DENSITY SETTING SCAN AREA SPOTS PER SCAN 5% 10% 15% 20% 25% 1 55% 2 2x % 3 3x % 4 4x % 5 5x >100% 6 6x >100% 7 7x >100% 8 8x >100% 9 9x >100% 10 10x The densities indicated on the control screen are averages. The actual densities are listed here and vary based on scan pattern and scan pattern size. / square pattern SETTING SCAN AREA SPOTS PER SCAN 1% 3% 5% 10% 5 5x x Synergistic Coagulation and Ablation for Advanced Resurfacing Improve structure of deep contracted skin lesions Treat conspicuous, complex and deep skin lesions 7 7x x x x

4 Pre-Treatment Guidelines Treatment Parameters Physicians may want to consider a skin care regimen prior to treatment including broad spectrum sun block SPF 50+. Topical analgesic may be used according to manufacturer s guidelines and shall be removed prior to treatment. Skin surface shall be thoroughly clean and dry prior to and during treatment. Do not conduct UltraPulse treatment if active herpes simplex virus or bacterial infections are present. Prescription medications which may be considered: - Anti-viral - Anti-anxiety - Narcotic analgesic - Treatments may consider: - Antibiotic - Antifungal - Facial blocks Eye shields shall be worn by the patient. - Metallic intraocular eye shields should always be used when treating within the orbital rim. NOTE: When Using parameters may be suitable for treating deep skin lesions and conditions that require synergistic coagulation and ablation for advanced resurfacing. Notes: Appropriate prophylactic antibiotic, antiviral and antifungal should be prescribed before the treatment The thickness of the lesion should be determined using Ultrasound or palpation Impact of chosen treatment parameters should not exceed the thickness of the lesion. Please note that the thickness of the lesion may vary within the lesion Nerve blocks or intralesional anesthetic may be required during treatments Skin surface should be cleaned thoroughly using antiseptic agent and then dried completely before the treatment 1.3 mm UltraScan CPG spot size spot pattern scan patterns 1.3 mm spot size Energy (mj) Scan Size Density Hz Repeat Delay Cool Scan No. of Passes Always start at the lowest energy in the recommended range mm sec. On 1 pigmentfx facial mm sec. On 1 moderate photoaging* / facial mm sec. On 1 2 severe photoaging* / facial mm sec. On 1 skin types IV VI / facial mm sec. On 1 neck, décolletage mm sec. On 1 hands, forearms * Per Glogau classification

5 Treatment Parameters 0.12 mm scan patterns microscanner spot size spot pattern Energy (mj) Scan Size Density Hz Repeat Delay No. of Pulses No. of Passes * deep wrinkles / facial periorbital* perioral surgical scars Always start at the lowest energy in the recommended range mm 5-10% sec mm 5-10% sec mm 5-15% sec mm 10-15% sec NOTE: Use of high density settings with high energy may produce undesired sequalae. Do not feather or brush with. One pass is recommended. *Pre-tarsal / upper eyelid treatment with is not recommended. Use low fluence with double pulse when depth is needed. Do not defocus. Multiple passes with are not needed or recommended. TotalFX + UltraScan CPG microscanner spot sizes spot pattern Energy (mj) Scan Size Density Hertz** Repeat Delay No. of Pulses No. of Passes*** acne scars rhinophyma surgical scars* Always start at the lowest energy in the recommended range mm 10-15% sec mm 10-15% sec mm 5-15% sec Energy (mj) Scan Size Density Hz Repeat Delay No. of Pulses No. of Passes acne scars rhinophyma surgical scars* mm sec. N/A mm sec. N/A mm sec. N/A 1 NOTE: Do not feather or brush with. Do not defocus. *Settings depend on thickness of scar tissue and body area treated; ** Using higher hertz may not allow tissue to cool, thus heat builds and may result in undesirable over treatment; ***When using high-density, lower energy, one pass is recommended.

6 Treatment Parameters Post Treatment Guidelines 0.12 mm spot size spot pattern microscanner scan patterns No. of Passes No. of Pulses Energy (mj) Scan Size Density Hz Repeat Delay Always start at the lowest energy and density in the recommended range Lesion related 1-10% sec Lesion related 1-5% sec Lesion related 1-3% sec. 1 1 Patients should apply a bland occlusive ointment to prevent direct contact between the treated tissue and the air during the healing process. The use of an occlusive ointment improves patient comfort, and reduces the sensation of pain and burning by preventing air from contacting the treated region. After healing is completed an intense moisturizer may be used. Patient may apply cool compresses immediately after treatment. Some patients report a hot feeling which lasts a few hours to a few days. Patient can gently wash area with tepid water and a gentle cleanser 3 times a day starting the morning after your treatment. Then immediately re-apply occlusive ointment for at least 4 days. Patient may shower, but avoid hot water/steam on treated area. Avoid picking at and aggressive scrubbing of the exfoliating skin allow it to gently exfoliate with the washing process. If possible, sleeping with the treated body part elevated on a pillow in the first few nights post treatment can help minimize swelling. Avoid direct sun exposure for 4-5 days or until complete re-epithelialization. After the fifth day, apply sun block SPF 50+ UVA and UVB. Wear a protective hat for the first month while outdoors. Avoid dirty, dusty environments, hairsprays, perfumes etc. while skin is healing. Patient may use mineral make-up usually 5 6 days after treatment, only once skin is healed. Additional days for healing, sometimes 10 or more, may be required depending on treatments. Shallow skin lesion (1-2 mm) Medium skin lesion (2-3mm) Deep skin lesion (>3mm) NOTE: When Using Immediately after the treatment, the treated area should be cleaned with sterilized saline A day after the treatment patients can gently wash the treated area and then apply occlusive ointment again

7 References & Tina Alster, MD, Washington, DC Jean Carruthers, MD Vancouver, Canada Matteo Tretti Clementoni, MD, Milano, Italy Kimberly Cockerham, MD, Los Altos, CA Mitchel Goldman, MD, San Diego, CA Emmy Graber, MD, Chestnut Hill, MA E.V. Ross, MD, San Diego, CA Gordon Sasaki, MD, Pasadena, CA Elizabeth Tanzi, MD, Washington, DC Jill Waibel, MD, West Palm Beach, FL Matteo Tretti Clementoni, MD, Milano, Italy Chad Hivnor, MD, San Antonio, TX Peter Shumaker, MD, San Diego, CA Nathan Uebelhoer, MD, San Diego, CA AMERICAS Lumenis Inc. Santa Clara, CA, USA Tel Fax JAPAN Lumenis (JAPAN) Co. Ltd. Tokyo, Japan Tel Fax UltraPulse Lumenis does not make recommedations regarding the practice of medicine. Laser treatment parameters are provided as a guide. Individual treatment should be based on clinical training, clinical observation of laser-tissue interaction, and appropriate clinical endpoints. For complete device usage instructions, please refer to the Operator s Manual. EUROPE / MIDDLE EAST / AFRICA Lumenis (GERMANY) GmbH Dreieich-Dreieichenhain, Germany Tel Fax ASIA / PACIFIC Lumenis (CHINA) Ltd. Beijing, China Tel Fax DANGER VISIBLE AND INVISIBLE LASER RADIATIION Avoid eye or skin exposure to direct or scattered radiation. LASER SURGERY IN PROGRESS SAFETY EYEWEAR REQUIRED CO2 LASER: 1060 nm 40 Watts continuous CLASS 4 / IV LASER Diode LASER: 635 nm 5 mwatts continuous CLASS 3A / IIIa LASER PB rev D