Casnigo, April, the 21 st, 2010 Operative Protocols for PRISMA 1440 Nd: YAG laser source @ 1440 Platform Manufacturer: Elettronica Valseriana Srl EVLASER Italy Medical reference: Dr. Alberto Bazzoni, Darfo, Italy 1. The Nd:YAG laser sources, general information 2. The Nd:YAG 1440 Fractional non ablative 1. The Nd:YAG Laser Introduction and technical specifications The object of the following documentation is to provide the laser operators with a protocol to correctly use the laser for the different applications. It based on about 3000 patients successfully treated in some of the laser clinics of the EVLaser network worldwide and constantly improved. Please consider that patients are different each other so use the protocols as reference and not as the must to follow in spite of skin reaction or patient s discomfort. Nd:YAG belongs to the fourth generation system of lasers. Its high power may cause retinal lesions in cases of direct or indirect (specular reflection) accidental visual exposition and also presents an increased ignition risk. Introduction and general applications Prisma is the newest laser using fractional technology. Nd:YAG fourth wavelength, 1440, is for skin treatments revolutionary since still allows a penetration in the tissues until 1,5 mm but, at the same time, a very high water affinity. This means unthinkable results with standard fractional lasers and no side effects at all. Prisma delivers the laser beam thru a new hand-piece able to fraction it in 500 different dots, very near each other, so to have an immediate pump-up effect on the tissues. The thousands micro-lesions into the skin, 150μ each, allow the stimulation of collagen that facilitates the elimination of denatured tissues in about 30 to 45 days. Derma and epidermis pigments and the skin to eliminate are then expelled in about a week: results are is a perfect skin without any downtime and side effects. Prisma is very effective on face, neck, chest and hand photo-damages skin, face wrinkles, acne scars and pigmentation issues in general. Results improve also after months since the stimulation continues for long time even after the latest application. Results are usually expected after 3 to 4 sessions, every 30 to 45 days.
EVLaser unique technology allows to get high energy even at 1440 nm so to have sufficient fluence equal to 600 mj/cm2 for each of the 500 dots, so to divide the total energy and create a stimulation without damaging the surrounding tissues, burning only small fractions of tissue in depth leaving the skin undamaged. Prisma means very effective, quick but safe skin treatments: - mouth and eyes contour wrinkles - pigmentation (sun and age spots) issues - non ablative cutaneous rejuvenation, face, neck, chest, hands - melasma, chloasma - solar lentigo - post acne scars Operative mode Prisma allows to operate thru the following screen: Parameters to set according to the kind of application are: - fluence; means the quantity of energy with spot 7 mm. Adjustable from to 30 J/cm 2 - frequency; mean number of pulses in one second. Adjustable from 1 to 2,5 Hz - diameter is spot size, not adjustable - F/D; means the fluence for each of the 500 dots. Adjustable according to the fluence setting up to 600 mj/cm 2 To enable or disable the aiming beam press aiming beam on or off. Thru the screen info acoustic notification of the pulse can be enabled or disabled.
Applications 1. mouth contour wrinkles 22 28 440-560 1 2. eyes contour wrinkles 12 19 240-380 1 3. sun spots 10 16 200-320 1 4. age spots 11 20 220-400 1 5. melasma, chloasma 15 22 300-440 2 6. solar lentigo 22 26 440-520 1 7. post acne scars 24 28 480-560 2 8. non-ablative resurfacing 24 30 480-600 2
Prisma technical specifications - laser source: Nd:YAG - wavelength: 1440 nm - energy per single pulse: 25J - max fluence: 30J/cm2 @ 2,5 Hz - max fluence per dot: 600 mj - emission mode: single to 2,5 Hz - spot: 500 dots @ 7 mm size - dots spot: 150μ - cooling: water sailed circuit - delivery: optic fibre.6 - interface: colour touch screen - life span of the lamp: 1.000.000 pulses System information screen
LIMITATIONS AND WARNINGS The 1440 Nd:Yag laser allows the operator to treat any skin types without relevant side effects; it is however suggested, in case of skin types V and VI, to reduce the fluence of the 30%; furthermore, for treatments on children, it is suggested to reduce the fluence of the 25% in comparison with the charts. Laser sessions should be done every 30 to 45 days. A patch test in on the area to treat is warmly suggested; the evaluation of any unexpected side effect shall be done 36 48 h after the test. DISEASES AND MEDICINES If the patient is suffering for any of the following diseases, or/and using any of the following medicines, or any medicine involved in the skin photosensitivity, before starting any kinds of treatment may we suggest to speak with the laser operator, who will decide if or if not carry out the treatment, or may not assure the usually expected result. May we suggest to refer to the following consultation card. APPLICATION... Laser Therapist. PATIENT Name. Address..postcode. Date of birth. Telephone home..work. E-mail address
MEDICAL HISTORY 1. Are you receiving treatments from a Doctor, Hospital Clinic or Specialist yes no 2. Are you or have you been taking any medication from your Doctor in the last six month? yes no 3. Do you suffer from any of the following Allergies Heart condition Acne Diabetes Epilepsy Depression Hypertension Herpes Simplex Asthma Skin Cancer Lupus Hyperthyroid Vitiligo Psoriasis Arthritis Autoimmune Disease Any other relevant condition?... 4. Is there any possibility of pregnancy. 5. Do you suffer from any acute or chronic skin disease in or near the area you require treatment?.. 6. Are you on any medication which is not in prescription e.g. Ibuprofen and St. Johns Wort? THERAPIST CHECK LIST 1. Describe the theory of the treatment. 2. Explain the sensation of the treatment. 3. Explain that the result often is dependent on: stress, hormonal changes, medication and regularity of treatments. 4. Emphasise the importance of client commitment. 5. Price quoted according to the length of treatment required: per treatment or per package of treatments. 6. Homecare products purchased? 7. Emphasise that any changes in health, medicines, injections or tablets MUST be reported to the Specialist.
PATIENT CONSENT I accept to undergo a hair removal treatment or course. I have been informed about contraindications and possible complications. I can confirm that I am not pregnant and that the information I have provided is correct. I understand that the result of the treatment is not guaranteed. Patients signature:.date. MEDICAL CONSENT (only if applicable) I have read the above consultation and in my professional opinion this patient is suitable for advanced hair removal treatments. Doctors signature:.date.. PRE-TREATMENT CHECK / CUSTOMER COMMENTS DATE MEDICATION GENERAL HEALTH COMMENTS
TREATMENT DETAILS DATE AREA TIME SHOTS THERAPIST SETTINGS/OBSERVATIONS
TREATMENT AREA NOTES: INFO AND DETAILS Should you need any further information or details, please do not hesitate to contact our staff at info@evlaser.com Or any local staff if available.