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Laser energy has been shown to be effective in skin resurfacing and other dermatologic surgery procedures, but it operates at relatively high temperatures (200-600°C). Lasers produce mid-to far-infrared energy that is absorbed primarily by tissue water and peptide bonds. The resulting localized tissue heating and vaporization produces tissue ablation with a residual thermal injury to the lower dermis. Traditional radiofrequency (RF) devices also use extreme heat (400-600 °C) to abruptly vaporize intracellular and extracellular fluids and cause tissue desiccation. In contrast, a new technology, Coblation®, utilizes a unique method of delivering RF energy for soft tissue removal applications in medicine, including dermatological surgery. Coblation uses bipolar wands to energize the particles in a conductive saline solution surrounding the target tissue to form a plasma field. The plasma has enough energy to break the tissue’s molecular bonds, creating an ablative path with minimal thermal effects (45-90 °C). Collateral tissue damage and tissue healing were investigated in several clinical studies, and compared to those observed with conventional electrosurgery. There was significantly less collateral tissue damage, less inflammation, and faster wound healing in Coblation-treated tissues. In a multicenter clinical study, Coblation was used for skin resurfacing for the treatment of facial wrinkles and provided statistically significant wrinkle improvement. When compared to CO2 laser, the decreased thermal effects of Coblation has led to less pain and faster recovery for most patients, yet the effect was enough to both stimulate new collagen production and to shrink collagen fibers. Coblation has the potential to be applied in most procedures where lasers have been used in the past in cosmetic and dermatological applications.
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