980nm +1064nm Laser for Podiatry Applications - Warts

980nm +1064nm Laser for Podiatry Applications - Warts

l   Treatment Classification
- Non contact
        - Contact
l   Carbonization
l   Coagulation
l   Excision Treatment Basics

Warts Overview
Common methods of removing warts are: Cutting, Freezing, Drying, Burning and even Injecting with a cancer drug Bleomycin.
The DIMED Diode Laser is perfectly capable to treat warts by Coagulation method, as well as by Excision. Local anesthetic is always required, as well as post treatment care according to the clinician practice.

Verruca vulgaris; Verruca plantaris; Verruca senilis
Caused by Human Papilloma virus (HPV). HPV attacks the skin forcing the skin cells to overgrow. The infection results due to rapid multiplying of this virus.
Plantar warts generally develop in the bottom of the foot, where the plantar region is.



Treatment Classification
Non contact
• Carbonization
• Coagulation
Contact
• Excision
Non Contact – Coagulation
The DIMED laser can effectively coagulate small blood vessels without noticeably affecting the epidermis;
Two factors contribute to this ability:
1. Laser radiation between 800nm- 1200nm wavelengths absorbs very little in water, meaning the laser beam can pass through the tissue without loosing much energy and not heating up its surrounding.

2. Laser radiation between 980nm-1064nm absorbs very well in Hemoglobin and Oxyhemoglobin.

Pulsed laser radiation target the blood vessels sustaining the wart; upon intense laser irradiation, a wart should dry out and its entire capillaries chains fully coagulated. This will appear as a color transformation from pink to light grey.
Same amount of energy delivered in different ways, can lead to completely different results:












      Increased vaporization               Increased coagulation

PATIENT ASSESSMENT
• Obtain a medical history and signed consent.
• Contraindications for this treatment are Pregnancy and Skin Cancer.

Non Contact – Coagulation
PREPPING THE PATIENT TREATMENT
1. Mark the superior horny layer.
2. Hold the handpiece perpendicular to skin’s surface with slightly touching the skin.
3. Irradiate the entire wart area, using a spiral motion.
4. Pulses can be overlapped slightly by 10-20%
5. Do not treat outside the wart marked border.
6. The wart may become ashen or dusky immediately after treating.
7. Use cooling (frozen gel pack, etc.) periodically to help with patient comfort.

POST TREATMENT
• Warts usually have a grey crusty appearance within 24 hours after treatment and usually slough off in 1-2 weeks.
• Use ointment of choice and non-stick dressing for patient comfort.
• If a blister develops, treat as a wound.
• More than 1 treatment may be necessary (3-4 weeks apart).

1. Clean skin.
2. Take pre-treatment photographs for future reference.
3. Warts may need to be debrided prior to treatment.
4. Target area should be clearly marked with a medical marker pen.
5. Topical anesthetic is often required (refrigerant such as Gebauer’s “Pain Ease”);
* ALL people in the treatment room must wear safety goggles. *

Non Contact – Carbonization
Carbonization is ablative treatment, achieved by applying laser radiation that result in burnt tissue (carbonized). The burned tissue will separate from the healthy tissue underneath and fall off during the following days. In this method, the continuous laser radiation removes the whole wart as well as some of the surrounding tissue to make sure the wart, its roots and blood supply are completely eradicated. The ablative treatment is comparable with electric cauter.

PREPPING THE PATIENT TREATMENT GUIDELINES
Warts are burned out on the surface, resulting in a carbonized surface. The burned tissue will separate from the healthy tissue underneath and fall off during the following days. Use a medical marker pen, to fully cover the target surface. This will increase laser absorption and will both shorten the treatment time as well as minimize unnecessary deep tissue over heating. Always start with lowest laser settings and gradually increase when necessary. Smoke evacuator and laser plume masks (filters to 0.1microns) are recommended.
1. Clean skin.
2. Take pre-treatment photographs for future reference.
3. Warts may need to be debrided prior to treatment.
4. Target area should be clearly marked with a medical marker pen.
5. Local anesthetic is usually required; - Superficial targets can be done with topical anesthetic skin refrigerant (such as Gebauer’s “Pain Ease”); - Deeper targets may require Lidocaine injections.
* ALL people in the treatment room must wear safety goggles. *

Non Contact – Coagulation / Carbonization
Carbonization Treatment Guidelines TAMED INC. ©2013 For internal use only
Applying cooling post treatment (e.g. frozen gel pack), may help with patient comfort.
Within a few days the area will transform to eschar neoplasm.
Tissue will slough off in 1-2 weeks post treatment.
Clinician may prescribe ointment of choice and non-stick dressing.
If a blister develops, it should be treated as a wound.
More then 1 treatment may be necessary (3-4 weeks apart).

Contact – Excision
Surgical Handpiece
Allow a direct fiber – tissue contact, which maximize energy transfer.
Laser setting is always cw, and output should be adjusted based on the conditions.

3 mm distance must be kept between the fibre end and the cannula end.
Use bare fiber 200um or 300um.
Use SS cannula (several options available: bent and straight, with several lengths).
Continuous mode causes more haemostasis and more extended collateral damage (higher effective power, faster, more efficient cutting)

The innovation using the Jazz knife is that the knife has a link to the DIMED laser via fiber cable which transports laser energy to the knife.



The laser radiation is transmitted through the sapphire blade and exits the blade at the tip and coagulate in addition to the cutting process.
Common use is with laser power of 6- 8W and CW-mode (continuous) for the desired coagulation level.

Specifications:
Laser Name
HARLAS
Laser Type
GaAlAs Diode Laser
Wavelength
650nm+810nm+980nm+1064nm
Maximum Power
2mW+15W+15W+15W
Operation Mode
CW, Single Or Repeat Pulse
Pulse Duration
10us- 3s
Repetition Rate
0.2Hz- 50KHz
Pilot Beam
Red Diode Laser Of 650nm, Power<5mW
Control Mode
True Color Touch Screen (7 inches, resolution 1024*600)
Transmission System
Medical Fibers With SMA905 Connector
Dimensions
230(W)*180(L)*135(H) mm
Weight
3.5Kg



Wuhan Dimed Laser Technology Co., Ltd
Tel: +86 15827593150
Email: marketing@dimedlaser.com
Skype: 244067255@qq.com

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