Protocols for the treatment of complications of hardware procedures

The frequency of complications after the use of hardware laser techniques today is quite high and affects the patient’s quality of life:

• redness, swelling - 100%. They are more often referred to not as side effects, but as a manifestation of the rehabilitation period;
• hyperpigmentation - 50%;
• bruises - 15%;
• depigmentation - 10%.
• superficial skin burns followed by the appearance of a scar - 2%.

Let us consider in Table 1 what side effects and complications are possible after laser procedures:

Table 1. Side effects and complications after laser procedures

I would like to note the importance of early diagnosis of complications and immediate treatment.

In our clinical practice, we use the method of administering the patient’s autologous plasma by injection and application, as well as acupuncture to the affected areas and adjacent tissues.

Algorithm for rehabilitation and prevention of complications

Treatment of complications after CO2 “resurfacing” by fractional photothermolysis are given in Table 2:

Table 2. Treatment of complications after fractional photothermolysis

Telangiectasia and reticular veins of the lower extremities are observed in 70-80% of women and are a problem of both an aesthetic and psychological nature. Currently, laser coagulation is used in the treatment of vascular pathology. The method has gained immense popularity due to its uniqueness and effectiveness. The only negative factor is the difficulty of predicting the occurrence of side effects. This is due to the individual characteristics of each patient’s skin. In our work, we tried to analyze the method of combining PRP and laser correction to reduce the number of side effects and obtain a shorter rehabilitation period.

To correctly select operating parameters, it is necessary to understand the mechanism of action of laser coagulation, which is based on slow, uniform heating of the vessel over the entire cross-section to achieve its thermal damage. Thermal degranulation of the endothelium and thermal effects on perivascular structures lead to the launch of an inflammatory reaction and the replacement of vessels with fibrous tissue.

1. The first step is laser treatment of the pathologically altered vessel (after correctly selecting the parameters according to the caliber of the vessel).
2. The second stage is the use of autologous PRP of the vascular zone (injection-papular around the treated vessel, as well as application to the entire laser treatment area).

This method is effective for the treatment of both large and small telangiectasias. Concurrent use of autologous PRP may improve healing of laser-damaged tissue. Since it is known that 5 main growth factors such as TGF, ICF, PDGF, EGF and VEGF are associated with the process of tissue regeneration.

Treatment of complications using PRP

In patients with the combined use of laser and PRP therapy for the treatment of vascular pathology, the following is noted (photo 9-11):

• reduction in the average duration of erythema after the procedure;
• the zone of residual thermal damage is smaller;
• acceleration of the rehabilitation period;
• pronounced aesthetic effect.

The PRP method can also be used for rehabilitation after laser hair removal: burns, hypopigmentation ( photo 1-4 ).

Photo 1-4. Complications after laser procedures: burns, hyperpigmentation, erythema, ecchymosis

Photo 9-11. Treatment of complications using the PRP method: before and after 3 procedures

Conclusion

PRP therapy, due to its pronounced anti-inflammatory effect, as well as accelerating tissue regeneration, is one of the most effective and safe methods of rehabilitation and prevention of complications after invasive and hardware cosmetic procedures.