<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03809416</url>
  </required_header>
  <id_info>
    <org_study_id>AY001</org_study_id>
    <nct_id>NCT03809416</nct_id>
  </id_info>
  <brief_title>Combined LASERs and PRP for Postacne Scars</brief_title>
  <official_title>Combined Fractional LASERs Resurfacing With Platelets Rich Plasma (PRP) for Treating Post Acne Atrophic Scarring</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>DEKA S.r.l.</agency>
      <agency_class>Industry</agency_class>
    </lead_sponsor>
    <collaborator>
      <agency>Universitat Autonoma de Barcelona</agency>
      <agency_class>Other</agency_class>
    </collaborator>
  </sponsors>
  <source>DEKA S.r.l.</source>
  <oversight_info>
    <has_dmc>Yes</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
    <is_us_export>No</is_us_export>
  </oversight_info>
  <brief_summary>
    <textblock>
      This study evaluates a new combined technique using two different laser wavelengths and&#xD;
      Platelets Rich Plasma (PRP) to treat post-atrophic acne scars. Within the available knowledge&#xD;
      of laser-tissue interactions and effects of PRP on wound healing, we will explore the&#xD;
      clinical effects of our new combination procedure on a histopathological and&#xD;
      immunohistochemical basis for guiding future post acne scars clinical research.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      The carbon dioxide and erbium lasers have been the gold and silver standards for acne scars&#xD;
      treatment. As with selective photothermolysis, a major advance in the field is the&#xD;
      incorporation of grids of MicroThermal Zones (MTZ) that spares islands of skin with an&#xD;
      attractive treatment efficacy to downtime healing (5-7 days) ratio. Application of these&#xD;
      fractionated resurfacing to carbon dioxide and erbium lasers allows deeper penetration into&#xD;
      the skin.&#xD;
&#xD;
      Fractional photothermolysis was first described by as a new method for delivery of laser&#xD;
      energy with the potential of laser safety and efficacy. Through the delivery of microscopic,&#xD;
      non-contagious zones of thermal damage using a 1550 nm, mid-infra-red laser source, it was&#xD;
      observed that surrounding islands of dermal and epidermal cells facilitated post-treatment&#xD;
      collagen remodeling and rapid healing. Despite the success of minimally ablative and&#xD;
      fractional technologies, there remained a need for more aggressive tissue ablation for the&#xD;
      purposes of tissue rejuvenation of severely photodamaged skin and deeper rhytides. This might&#xD;
      be due to the variability of architecture, depth, and width; thus, each type of scar has an&#xD;
      optimal method by which it can be improved.&#xD;
&#xD;
      The idea of combining both carbon dioxide and erbium lasers appeared even before the era of&#xD;
      fractional lasers. McDaniel et al, combined both non-fractional lasers for resurfacing of&#xD;
      perioral rhytides comparing it to using carbon dioxide lasers alone and concluded that carbon&#xD;
      dioxide laser resurfacing followed by 3 passes of erbium laser reduces the duration of&#xD;
      crusting, swelling and itching when compared to carbon dioxide laser resurfacing alone with&#xD;
      no significant difference in the outcome.&#xD;
&#xD;
      Later in 2010, the combination of fractional lasers carbon dioxide and erbium-doped laser was&#xD;
      tried out for treating mild acne scars by a group of researchers. They reported a longer post&#xD;
      laser erythema and hyperpigmentation, without precise pathogenesis. However, they suggested&#xD;
      that these unexpected outcomes may have resulted from bulk heat damage to the surrounding&#xD;
      tissues by heat stacking and recommended further studies to determine the optimal treatment&#xD;
      parameters and reduce unexpected adverse reactions.&#xD;
&#xD;
      Platelet-rich plasma (PRP) is a high concentration of platelets in a small volume of plasma.&#xD;
      PRP contains various growth factors and cytokines released by platelets, and those substances&#xD;
      play a critical role in all aspects of the wound healing process. Among the stored mitogenic&#xD;
      factors essential for wound repair are platelet-derived growth factor (PDGF) with the -AB and&#xD;
      -C isoforms predominating, transforming growth factor β (TGF-β), vascular endothelial growth&#xD;
      factor (VEGF), basic fibroblast growth factor (bFGF), platelet-derived epidermal growth&#xD;
      factor (PDEGF) and insulin-like growth factor-1 (IGF-1). These are variously involved in&#xD;
      stimulating chemotaxis, cell proliferation, and maturation. PDGF is a powerful&#xD;
      chemoattractant and stimulator of cell proliferation. All of them are potent angiogenic&#xD;
      factors and endothelial cell mitogens. The wound healing effect of PRP is relatively well&#xD;
      known, and PRP has been used in bone surgery, tendon and ligament repair, and chronic leg&#xD;
      ulcer treatment.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Completed</overall_status>
  <start_date type="Actual">October 1, 2018</start_date>
  <completion_date type="Actual">October 30, 2019</completion_date>
  <primary_completion_date type="Actual">June 30, 2019</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Non-Randomized</allocation>
    <intervention_model>Factorial Assignment</intervention_model>
    <primary_purpose>Treatment</primary_purpose>
    <masking>Double (Investigator, Outcomes Assessor)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Change in Patients' response denoting early Clinical improvement</measure>
    <time_frame>4 weeks after the 1st session</time_frame>
    <description>calculating the change in 17 questions' responses of a new Patient Oriented Tool questionnaire for assessing Atrophic Acne Scarring through two parts; a) assessment of Acne Scar Appearance and b) Acne Scar Quality of Life questionnaire. Patients will record their responses before the 1st session and on the date of 2nd session.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Final Clinical improvement assessed using (0-10) scoring scale by blind assessors</measure>
    <time_frame>12 weeks after the 4th session</time_frame>
    <description>The change in scores comparing 2 sets of digital photographs for each patient evaluated by 3 blind assessors, before and after 12 weeks of the 4th session. This blind assessment score will be compared to patients' score in their previous questionnaire.</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Higher new collagen formation in scars treated using lasers plus PRP technique</measure>
    <time_frame>Immediately after the 1st session</time_frame>
    <description>Picrosirus Red stained specimens under circularly polarized microscopy will be segmented into two color threshold bands (Green/Yellow G/Y and Red/Orange R/O) in the color HSB space. This will be numerically evaluated using ImageJ computer program</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Immunohistochemical evaluation of Collagen I, Collagen III, and MMP-2</measure>
    <time_frame>Immediately after the 1st session</time_frame>
    <description>Using a 4 grade scale (0, +, ++, +++), the 288 slides (i.e. 3 slides prepared from 96 specimens obtained from 32 patients) will be arranged for comparison among control, sham comparator and, active comparator. Also, results will be correlated to previous numerical ImageJ computerized assessment and patients' clinical improvement.</description>
  </secondary_outcome>
  <number_of_arms>3</number_of_arms>
  <enrollment type="Actual">32</enrollment>
  <condition>Atrophic Acne Scar</condition>
  <arm_group>
    <arm_group_label>Control</arm_group_label>
    <arm_group_type>No Intervention</arm_group_type>
    <description>32 biopsy specimens from acne scars will be excised without any treatment.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Lasers plus Normal Saline Solution</arm_group_label>
    <arm_group_type>Sham Comparator</arm_group_type>
    <description>32 biopsy specimens will be excised immediately after being treated with lasers and subsequent injection of normal saline solution.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Lasers plus Platelets Rich Plasma (PRP)</arm_group_label>
    <arm_group_type>Active Comparator</arm_group_type>
    <description>32 biopsy specimens will be excised immediately after being treated with lasers and subsequent injection of platelets Rich Plasma (PRP).</description>
  </arm_group>
  <intervention>
    <intervention_type>Device</intervention_type>
    <intervention_name>Lasers</intervention_name>
    <description>Fractional carbon dioxide laser will be applied only over spots of deep post-acne scars, while Erbium: Glass will be applied all over face except to the two predetermined spots, i.e. control and another spot where NSS will be injected.</description>
    <arm_group_label>Lasers plus Normal Saline Solution</arm_group_label>
    <arm_group_label>Lasers plus Platelets Rich Plasma (PRP)</arm_group_label>
    <other_name>Fractional CO2 and Erbium Glass Lasers</other_name>
  </intervention>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>Platelets Rich Plasma</intervention_name>
    <description>Platelet Rich Plasma (PRP) will be prepared from autologous blood collection in a syringe prefilled with anticoagulant solution followed by centrifugation then adding calcium gluconate 10% for induction of platelet activation. Activated PRP will be injected for all carbon dioxide laser spots in each patient immediately after each laser session except for two predetermined spots, i.e. control and sham comparator, which will be injected by normal saline solution (NSS).</description>
    <arm_group_label>Lasers plus Platelets Rich Plasma (PRP)</arm_group_label>
    <other_name>PRP</other_name>
  </intervention>
  <intervention>
    <intervention_type>Combination Product</intervention_type>
    <intervention_name>Lasers plus Normal Saline Solution</intervention_name>
    <description>Normal Saline Solution will be injected only in one spot after combined lasers resufacing to act as sham comparator compared to the other spot of Lasers plus PRP injection</description>
    <arm_group_label>Lasers plus Normal Saline Solution</arm_group_label>
    <other_name>NSS</other_name>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          1. Patients with atrophic post-acne scars.&#xD;
&#xD;
          2. Patients without surgical &amp;/or LASER resurfacing treatment for acne scars within the&#xD;
             last 6 months.&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          1. Pregnancy&#xD;
&#xD;
          2. Present or past history of hypertrophic scars or keloids&#xD;
&#xD;
          3. Present or past history of photosensitivity dermatoses including Connective Tissue&#xD;
             Diseases.&#xD;
&#xD;
          4. Present history of herpes infection&#xD;
&#xD;
          5. Present history of Anemia (HGB &lt; 10 g/dl), Thrombocytopenia &amp;/or Platelets&#xD;
             dysfunction.&#xD;
&#xD;
          6. Patients receiving isotretinoin within the last 3 months, NSAIDs within 72 hours of&#xD;
             the procedure, anticoagulants &amp;/or systemic use of corticosteroids within 2 weeks.&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>Accepts Healthy Volunteers</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Lluis Puig, MD, PhD</last_name>
    <role>Study Director</role>
    <affiliation>Universitat Autonoma de Barcelona (UAB)</affiliation>
  </overall_official>
  <overall_official>
    <last_name>Alberto Calligaro, MD, PhD</last_name>
    <role>Principal Investigator</role>
    <affiliation>University of Pavia</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>DEKA M.E.L.A. S.r.l.</name>
      <address>
        <city>Firenze</city>
        <state>Calenzano</state>
        <zip>50041</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Cosmetic Surgery Clinic</name>
      <address>
        <city>Al Qādisīyah</city>
        <zip>35858</zip>
        <country>Kuwait</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>Italy</country>
    <country>Kuwait</country>
  </location_countries>
  <results_reference>
    <citation>Layton A, Dreno B, Finlay AY, Thiboutot D, Kang S, Lozada VT, Bourdes V, Bettoli V, Petit L, Tan J. Erratum to: New Patient-Oriented Tools for Assessing Atrophic Acne Scarring. Dermatol Ther (Heidelb). 2016 Jun;6(2):235-6. doi: 10.1007/s13555-016-0107-8. No abstract available.</citation>
    <PMID>27008237</PMID>
  </results_reference>
  <results_reference>
    <citation>Manstein D, Herron GS, Sink RK, Tanner H, Anderson RR. Fractional photothermolysis: a new concept for cutaneous remodeling using microscopic patterns of thermal injury. Lasers Surg Med. 2004;34(5):426-38. doi: 10.1002/lsm.20048.</citation>
    <PMID>15216537</PMID>
  </results_reference>
  <results_reference>
    <citation>Cho SB, Lee SJ, Kang JM, Kim YK, Oh SH. Combined fractional laser treatment with 1550-nm erbium glass and 10 600-nm carbon dioxide lasers. J Dermatolog Treat. 2010 Jul;21(4):221-8. doi: 10.1080/09546630903089650. No abstract available.</citation>
    <PMID>19603309</PMID>
  </results_reference>
  <results_reference>
    <citation>Lee JW, Kim BJ, Kim MN, Mun SK. The efficacy of autologous platelet rich plasma combined with ablative carbon dioxide fractional resurfacing for acne scars: a simultaneous split-face trial. Dermatol Surg. 2011 Jul;37(7):931-8. doi: 10.1111/j.1524-4725.2011.01999.x. Epub 2011 Jun 2.</citation>
    <PMID>21635618</PMID>
  </results_reference>
  <results_reference>
    <citation>Prignano F, Campolmi P, Bonan P, Ricceri F, Cannarozzo G, Troiano M, Lotti T. Fractional CO2 laser: a novel therapeutic device upon photobiomodulation of tissue remodeling and cytokine pathway of tissue repair. Dermatol Ther. 2009 Nov;22 Suppl 1:S8-15. doi: 10.1111/j.1529-8019.2009.01265.x.</citation>
    <PMID>19891690</PMID>
  </results_reference>
  <verification_date>November 2019</verification_date>
  <study_first_submitted>January 14, 2019</study_first_submitted>
  <study_first_submitted_qc>January 15, 2019</study_first_submitted_qc>
  <study_first_posted type="Actual">January 18, 2019</study_first_posted>
  <last_update_submitted>November 26, 2019</last_update_submitted>
  <last_update_submitted_qc>November 26, 2019</last_update_submitted_qc>
  <last_update_posted type="Actual">November 29, 2019</last_update_posted>
  <responsible_party>
    <responsible_party_type>Sponsor</responsible_party_type>
  </responsible_party>
  <keyword>Acne scars</keyword>
  <keyword>fractional lasers</keyword>
  <keyword>PRP</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Atrophy</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03809416
org study id: AY001
nct id: NCT03809416
lead sponsor: 
collaborator: 
has dmc: Yes
is fda regulated drug: No
is fda regulated device: No
is us export: No
This study evaluates a new combined technique using two different laser wavelengths and
      Platelets Rich Plasma (PRP) to treat post-atrophic acne scars. Within the available knowledge
      of laser-tissue interactions and effects of PRP on wound healing, we will explore the
      clinical effects of our new combination procedure on a histopathological and
      immunohistochemical basis for guiding future post acne scars clinical research.
The carbon dioxide and erbium lasers have been the gold and silver standards for acne scars
      treatment. As with selective photothermolysis, a major advance in the field is the
      incorporation of grids of MicroThermal Zones (MTZ) that spares islands of skin with an
      attractive treatment efficacy to downtime healing (5-7 days) ratio. Application of these
      fractionated resurfacing to carbon dioxide and erbium lasers allows deeper penetration into
      the skin.

      Fractional photothermolysis was first described by as a new method for delivery of laser
      energy with the potential of laser safety and efficacy. Through the delivery of microscopic,
      non-contagious zones of thermal damage using a 1550 nm, mid-infra-red laser source, it was
      observed that surrounding islands of dermal and epidermal cells facilitated post-treatment
      collagen remodeling and rapid healing. Despite the success of minimally ablative and
      fractional technologies, there remained a need for more aggressive tissue ablation for the
      purposes of tissue rejuvenation of severely photodamaged skin and deeper rhytides. This might
      be due to the variability of architecture, depth, and width; thus, each type of scar has an
      optimal method by which it can be improved.

      The idea of combining both carbon dioxide and erbium lasers appeared even before the era of
      fractional lasers. McDaniel et al, combined both non-fractional lasers for resurfacing of
      perioral rhytides comparing it to using carbon dioxide lasers alone and concluded that carbon
      dioxide laser resurfacing followed by 3 passes of erbium laser reduces the duration of
      crusting, swelling and itching when compared to carbon dioxide laser resurfacing alone with
      no significant difference in the outcome.

      Later in 2010, the combination of fractional lasers carbon dioxide and erbium-doped laser was
      tried out for treating mild acne scars by a group of researchers. They reported a longer post
      laser erythema and hyperpigmentation, without precise pathogenesis. However, they suggested
      that these unexpected outcomes may have resulted from bulk heat damage to the surrounding
      tissues by heat stacking and recommended further studies to determine the optimal treatment
      parameters and reduce unexpected adverse reactions.

      Platelet-rich plasma (PRP) is a high concentration of platelets in a small volume of plasma.
      PRP contains various growth factors and cytokines released by platelets, and those substances
      play a critical role in all aspects of the wound healing process. Among the stored mitogenic
      factors essential for wound repair are platelet-derived growth factor (PDGF) with the -AB and
      -C isoforms predominating, transforming growth factor β (TGF-β), vascular endothelial growth
      factor (VEGF), basic fibroblast growth factor (bFGF), platelet-derived epidermal growth
      factor (PDEGF) and insulin-like growth factor-1 (IGF-1). These are variously involved in
      stimulating chemotaxis, cell proliferation, and maturation. PDGF is a powerful
      chemoattractant and stimulator of cell proliferation. All of them are potent angiogenic
      factors and endothelial cell mitogens. The wound healing effect of PRP is relatively well
      known, and PRP has been used in bone surgery, tendon and ligament repair, and chronic leg
      ulcer treatment.
allocation: Non-Randomized
intervention model: Factorial Assignment
primary purpose: Treatment
masking: Double (Investigator, Outcomes Assessor)
measure: Change in Patients' response denoting early Clinical improvement
time frame: 4 weeks after the 1st session
description: calculating the change in 17 questions' responses of a new Patient Oriented Tool questionnaire for assessing Atrophic Acne Scarring through two parts; a) assessment of Acne Scar Appearance and b) Acne Scar Quality of Life questionnaire. Patients will record their responses before the 1st session and on the date of 2nd session.
measure: Final Clinical improvement assessed using (0-10) scoring scale by blind assessors
time frame: 12 weeks after the 4th session
description: The change in scores comparing 2 sets of digital photographs for each patient evaluated by 3 blind assessors, before and after 12 weeks of the 4th session. This blind assessment score will be compared to patients' score in their previous questionnaire.
measure: Higher new collagen formation in scars treated using lasers plus PRP technique
time frame: Immediately after the 1st session
description: Picrosirus Red stained specimens under circularly polarized microscopy will be segmented into two color threshold bands (Green/Yellow G/Y and Red/Orange R/O) in the color HSB space. This will be numerically evaluated using ImageJ computer program
measure: Immunohistochemical evaluation of Collagen I, Collagen III, and MMP-2
time frame: Immediately after the 1st session
description: Using a 4 grade scale (0, +, ++, +++), the 288 slides (i.e. 3 slides prepared from 96 specimens obtained from 32 patients) will be arranged for comparison among control, sham comparator and, active comparator. Also, results will be correlated to previous numerical ImageJ computerized assessment and patients' clinical improvement.
arm group label: Control
arm group type: No Intervention
description: 32 biopsy specimens from acne scars will be excised without any treatment.
arm group label: Lasers plus Normal Saline Solution
arm group type: Sham Comparator
description: 32 biopsy specimens will be excised immediately after being treated with lasers and subsequent injection of normal saline solution.
arm group label: Lasers plus Platelets Rich Plasma (PRP)
arm group type: Active Comparator
description: 32 biopsy specimens will be excised immediately after being treated with lasers and subsequent injection of platelets Rich Plasma (PRP).
intervention type: Device
intervention name: Lasers
description: Fractional carbon dioxide laser will be applied only over spots of deep post-acne scars, while Erbium: Glass will be applied all over face except to the two predetermined spots, i.e. control and another spot where NSS will be injected.
arm group label: Lasers plus Normal Saline Solution
arm group label: Lasers plus Platelets Rich Plasma (PRP)
other name: Fractional CO2 and Erbium Glass Lasers
intervention type: Other
intervention name: Platelets Rich Plasma
description: Platelet Rich Plasma (PRP) will be prepared from autologous blood collection in a syringe prefilled with anticoagulant solution followed by centrifugation then adding calcium gluconate 10% for induction of platelet activation. Activated PRP will be injected for all carbon dioxide laser spots in each patient immediately after each laser session except for two predetermined spots, i.e. control and sham comparator, which will be injected by normal saline solution (NSS).
arm group label: Lasers plus Platelets Rich Plasma (PRP)
other name: PRP
intervention type: Combination Product
intervention name: Lasers plus Normal Saline Solution
description: Normal Saline Solution will be injected only in one spot after combined lasers resufacing to act as sham comparator compared to the other spot of Lasers plus PRP injection
arm group label: Lasers plus Normal Saline Solution
other name: NSS
criteria: 
gender: All
minimum age: 18 Years
maximum age: N/A
healthy volunteers: Accepts Healthy Volunteers
last name: Lluis Puig, MD, PhD
role: Study Director
affiliation: Universitat Autonoma de Barcelona (UAB)
last name: Alberto Calligaro, MD, PhD
role: Principal Investigator
affiliation: University of Pavia
facility: 
facility: 
country: Italy
country: Kuwait
citation: Layton A, Dreno B, Finlay AY, Thiboutot D, Kang S, Lozada VT, Bourdes V, Bettoli V, Petit L, Tan J. Erratum to: New Patient-Oriented Tools for Assessing Atrophic Acne Scarring. Dermatol Ther (Heidelb). 2016 Jun;6(2):235-6. doi: 10.1007/s13555-016-0107-8. No abstract available.
PMID: 27008237
citation: Manstein D, Herron GS, Sink RK, Tanner H, Anderson RR. Fractional photothermolysis: a new concept for cutaneous remodeling using microscopic patterns of thermal injury. Lasers Surg Med. 2004;34(5):426-38. doi: 10.1002/lsm.20048.
PMID: 15216537
citation: Cho SB, Lee SJ, Kang JM, Kim YK, Oh SH. Combined fractional laser treatment with 1550-nm erbium glass and 10 600-nm carbon dioxide lasers. J Dermatolog Treat. 2010 Jul;21(4):221-8. doi: 10.1080/09546630903089650. No abstract available.
PMID: 19603309
citation: Lee JW, Kim BJ, Kim MN, Mun SK. The efficacy of autologous platelet rich plasma combined with ablative carbon dioxide fractional resurfacing for acne scars: a simultaneous split-face trial. Dermatol Surg. 2011 Jul;37(7):931-8. doi: 10.1111/j.1524-4725.2011.01999.x. Epub 2011 Jun 2.
PMID: 21635618
citation: Prignano F, Campolmi P, Bonan P, Ricceri F, Cannarozzo G, Troiano M, Lotti T. Fractional CO2 laser: a novel therapeutic device upon photobiomodulation of tissue remodeling and cytokine pathway of tissue repair. Dermatol Ther. 2009 Nov;22 Suppl 1:S8-15. doi: 10.1111/j.1529-8019.2009.01265.x.
PMID: 19891690
responsible party type: Sponsor
mesh term: Atrophy
sharing ipd: No