Plume Concerns During COVID-19

Researchers compared plume generated by RF-based microneedling and Er:YAG fractional skin resurfacing to provide guidance to practitioners on the potential for viral transmission.

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As practitioners consideration enhanced safety protocols in the midst of the pandemic resurgence, they can reduce the potential for transmission via laser plumes by offering radiofrequency (RF)-based microneedling treatments in lieu of ablative lasers. This was the recommendation of authors Erez Dayan, MD, et al, based on the findings of a study published November 8, 2020 in Lasers in Surgery and Medicine.

The researchers treated five patients seeking skin resurfacing with the Sciton Joule Er:YAG laser and/or InMode Morpheus8 fractional radiofrequency device. Two patients underwent Er:YAG fractional resurfacing in addition to fractional radiofrequency during the same treatment session. Two had fractional radiofrequency only, and one patient had laser treatment with the Er:YAG only.

During treatments, the patients were evaluated with a calibrated particle meter (PCE) used at a consistent focal distance. The ambient baseline particles/second (pps) was 8 (STD ±6). During fractional radiofrequency treatment at 1 mm depth, the mean recording was 8 pps (STD ±8). At the more superficial depth of 0.5 mm, recordings showed 10 pps (STD ±6). The Er:YAG laser resurfacing laser had mean readings of 44 pps (STD ±11).

When reviewing the data by particle size, the fractional radiofrequency device plume had overall smaller particle sizes with a count of 251 for 0.3 µm (STD ±147) compared with Er:YAG laser with a count of 112 for 0.3 µm (STD ±84). The fractional radiofrequency did not appear to emit particles >5 µm throughout the treatment, however, the Er:YAG laser consistently recorded majority of particles in the range of 5­10 µm. Particle measurements were taken both with and without the use of a smoke evacuator. The addition of the smoke evacuator demonstrated a 50% reduction in both particles per second recorded as well as all particle sizes.

Based on these findings, the authors recommend the use of devices that generate little to no plume, such as fractional radiofrequency, during Phase I reopening of practices. Treatment with Er:YAG laser resurfacing devices should be avoided and “only used with appropriate personal protective equipment in addition to a smoke evacuator in Phase IV reopening.”

Access the full paper here

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