Laboratory evaluation of skin refrigerants used in dermabrasion

Dermabrasion in dermatology

Dermabrasion has been used for a number of years to treat a variety of dermatologic conditions, including facial skin resurfacing and scar revision. The popularity of this procedure has diminished with the advent of newer procedures including chemical exfoliation, laser resurfacing, non-ablative laser resurfacing, and microdermabrasion. Dermabrasion found its niche in treating acne and traumatic facial scars, and in cosmetic facial resurfacing. Small, portable hand-held dermabraders are the most popular units available today and are able to generate rotation speeds of 18,000-35,000 revolutions per minute. End pieces, including wire brushes, diamond fraises and serrated wheels, attach to the end of the dermabrader to allow precise resurfacing and treatment. As with all cosmetic surgical procedures, appropriate patient selection and room preparation (with appropriate lighting and monitoring equipment) are essential to assure optimal outcomes with the dermabrasion procedure. Patients must understand all of the potential risks, benefits and limitations associated with the procedure. Patients must also be aware of alternative therapies that are available. Dermabrasion is technique-dependent and the surgeon should be well versed on the technique prior to performing this therapy. Gentian violet solution is used to delineate the areas to be treated. Refrigerant topical anesthesia is used to freeze the skin prior to the procedure. Holding the skin taut, the dermabrasion procedure occurs in a routine manner, treating one anatomic unit at a time. Postoperatively, patients may have an open or closed dressing system. Postoperative medical treatment is also recommended, including the use of antiviral agents, antibacterials and corticosteroids. The re-epithelialization process is usually complete in 5-7 days and residual erythema is common for up to 4 weeks. Adequate sun protection is essential following dermabrasion. Dermabrasion has also been used in combination with other dermatologic procedures, including chemical exfoliation, soft tissue augmentation and laser procedures, to enhance the results of dermabrasion. Dermabrasion remains a useful facial skin resurfacing and scar revision technique, particularly when performed by a trained and skilled surgeon. Most dermatologic surgeons argue that pure dermabrasion is a useful modality in skilled surgical hands and should be considered when appropriate.

Dermabrasion: state of the art 2002

Dermabrasion is a resurfacing procedure that has been part of dermatology for almost 100 years. With the advent of laser resurfacing in the 1990s, the art of dermabrasion has temporarily been partially eclipsed. This review article covers the history of dermabrasion, (pre-operative selection of patient equipment, the techniques and the post-operative care of dermabrasion patients. Many clinical examples are illustrated. The combination of dermabrasion with other resurfacing techniques, such as laser (CO(2 )and Erbium) and chemical peels (trichloracetic acid (TCA)) are illustrated.

Dermabrasion

This article provides an overview of the resurfacing technique of dermabrasion. Preoperative consultation, perioperative medications, postoperative management, common complications, and reasonable outcome expectations are all described in detail. A description of proper technique, intraoperative equipment, and an approach to full-face procedures is also described.

Cutaneous resurfacing

Cutaneous resurfacing can be accomplished with application of acids, abrasive modalities, or the new generation of carbon dioxide lasers. Ultimately, the universal goal is removal and replacement of the epidermis and dermal collagen remodeling. The indications range from therapeutic and reconstruction to the treatment of the stigmata associated with senescence. The indications are not technique-specific, and the art of cutaneous resurfacing is identifying the cutaneous defect and selecting the appropriate tool or tools to realize the optimal clinical results.

Dermabrasion

Dermabrasion is a mechanical, "cold steel" method of removing the epidermis and creating an upper to mid-dermal wound. The subsequent restructuring of collagen and a freshly resurfaced epidermis yields excellent results in actinically damaged, aged, and scarred skin. Preoperative and postoperative management to optimize wound healing are well established and predictable, and morbidity and complications are infrequently encountered.

[Cryoanesthesia by freon spray for venepuncture in children]

This prospective study was designed to assess the quality of skin analgesia provided by cryoanesthesia induced by a spray of freon (dichloro-tetrafluoro-ethane) for venous cannulation (22 or 24 Gauge cannulas). Eighty children between the ages of 5 and 15 years were allocated to two groups: 40 children had a conventional venepuncture, 40 others had a venepuncture under cryoanesthesia. The spray of freon was applied for ten seconds on the area of skin to be anaesthetised. The venous cannulation was carried out by an anaesthetist of the paediatric surgical unit. The intensity of pain at venepuncture was quantified with a visual analogic scale (range 0 to 100). The median values of the pain scores were 11.5 (0 to 50) in the cryoanesthesia group and 48 (11 to 75) in the control group respectively. It is concluded that freon spray provides a convenient analgesia for venepuncture in children aged 5-15 years.

Cryosurgical treatment of nodular neurodermatitis with Refrigerant 12

Neurodermatitis is a relatively common skin condition characterized by patches of scaly, pruritic skin in one or more of several classic locations. It can be treated with cryosurgery using Refrigerant 12 with successful clinical and aesthetic results.

A histologic evaluation of the effects of skin refrigerants in an animal model

The effects of a number of commonly used skin refrigerants were studied in controlled freezing experiments on guinea pig skin. Frigiderm and Fluro Ethyl produced very little effect on the skin compared to colder preparations such as Cryosthesia -30 degrees C and Cryosthesia -60 degrees C.

Dermabrasion of the scalp as a treatment for actinic damage

Dermabrasion of the scalp was safely and effectively performed on five patients as a treatment for actinic damage. This surgical modality can be an important part of the management of solar keratoses of the scalp in patients with alopecia.

Complications of dermabrasion resulting from excessively cold skin refrigeration

Three patients developed complications following dermabrasion with a new potent skin refrigerant mixture. Freezing can usually be performed more rapidly with such mixtures, but the risk of complications may be greater.