cosmetica Dr. Ronald Feiner MBBS DRCOG FFMACCS “COBLATION” SKIN RESURFACING
Laser skin resurfacing has been used for over 10 years now for rejuvenation of age related skin deterioration resulting from
sun damage, acne scars and uneven pigmentation. Coblation-stands for “cool ablation”- uses radiofrequency energy at relatively lower temperatures than Carbon Dioxide & Erbium laser resurfacing but achieves comparable results with less downtime. The depth of skin resurfacing with Coblation lies between CO2 & Erbium laser resurfacing. This allows for a thorough renewal of the top layer of the skin-epidermis-without the high risk of side effects that have been experienced with CO2 laser and the disappointing results experienced with Erbium laser. It should be appreciated that Coblation or Laser resurfacing is not a substitute for face lifting in a face that is suffering the effects of gravity. It is a procedure that is used for the rejuvenation of sun damaged and aged effected skin. It improves the quality of the skin but not the effects of gravity. At our clinic we perform Coblation resurfacing either: Under local anaesthetic infiltration in our clinic treatment room OR Under general anaesthetic in the Castle Hil Day Surgery operating theatres.
The advantages of local anaesthesia include the avoidance of the possible medical complications of undergoing a general anaesthetic and cost savings in that there are no anaesthetic fees or hospital/theatre fees. However some people do not feel comfortable about being conscious during a procedure and this needs to be considered in your choice. Please note that if local anaesthesia is not successful then the procedure may, on occasions, need to be terminated. PRE-TREATMENT INSTRUCTIONS
Please do not take aspirin (or aspirin containing medication) or arthritis medication for 10 days before and 10 days after the procedure. Please do not smoke for the same period (and then preferably never smoke again!) If your procedure is to be performed under local anaesthesia you should eat and drink as normal. For men please shave the morning of the procedure but do not use after-shave or alike. Do not wear moisturiser, make-up, lipstick, perfume, wigs, hairpins or jewel ery. Try to have a good night’s sleep the night before the procedure. For patients having a general anaesthetic: If your procedure is scheduled for the morning, strictly fast from midnight. If your procedure is scheduled after midday you may have coffee, tea, water, clear fruit juice and some dry toast at least 8 hours before your scheduled surgery time and then observe a strict fast. Report to the hospital as arranged where you wil be received for admission. You wil be admitted by the nursing staff and seen by the anaesthetist for a pre-operative visit. After the procedure you wil be taken from the operating theatre to the recovery area until the recovery staff is satisfied that you can be discharged from hospital. Please note that a responsible adult should drive you to and from the hospital or clinic and a responsible person should look after you at home on the day of discharge from hospital. PAGE 1 of 2
Suite 31 Shire Central, 15 Terminus Street, Castle Hill NSW 2154
Ph: 02 9894 1180 Fax: 02 9894 1173 Email: info@cosmetica.com.au
cosmetica Dr. Ronald Feiner MBBS DRCOG FFMACCS “COBLATION” SKIN RESURFACING
POST-TREATMENT CARE
Please be aware that your face will look very red and scalded so be prepared for the fact that your face will look quite scalded for the first few days. Your face may be dressed with a membrane to assist healing that should remain in place for the first 3 days. Alternatively ointments may be used and frequently applied from the outset. You will also be prescribed oral antibiotics and anti-Herpes medication. If you have had a membrane applied, do not wash your face or apply any ointments (except the exposed areas where the membrane may have come away). You wil need a small clean towel draped around your neck to absorb any skin fluid leakage from under the membrane. After this 3-day period please fol ow instructions for ointment applications and washing as per instructions below. At home rest & keep your head elevated for the first few days. Try to sleep on your back with at least 2 pil ows to keep your head elevated. Take Paracetamol or Paracetamol with Codeine (eg Panadeine or the stronger Panadeine Forte) or Tramal oral medication for pain relief (as per packaging instructions) as necessary. You may use cold compresses but not ice over the treated area for the first 2 days for swelling and pain relief. After the membrane is removed on about day 3, apply soothing ointment (Vaseline or Lucas’ Paw Paw) frequently so as not to let the skin dry out. A small amount of Bactroban ointment should also be applied twice daily for 7 days to avoid infection. Men
should not shave for the first week. For Herpes (Cold Sore) sufferers Zovirax ointment should be used 3 times daily on the areas usual y affected areas-general y the upper lip-nasal area. Once daily the treated skin should be gently washed using only your hands to gently cleanse with warm water and either Cetaphil, Ego QV wash or Hamiltons Body Wash. You do not need to wash away all the ointment that has previously been applied. Pat the skin dry and apply more soothing ointment. You may very cautiously bathe on day 2 but avoiding excessive heat and water on the face. You may wash you hair after the membrane has removed after 3 days, but do not use a hair dryer. You will be able to drink on the first day, followed by a soft diet the next day and then progress to a more complex diet. Remember treated skin wil be swollen & red at first. This diminishes over the first week and you may be able to wear some light make up after 7-10 days. Sun avoidance is very important so wear a hat and/or a broad-spectrum sun cream if you are exposed to the sun. Do not exercise strenuously for one month and also do not swim in chlorinated water for one month. We will review you in the clinic on the 3rd to 7th post procedure day and again at 2 weeks, 4 weeks and 6 months. At that time we will suggest further management. We are committed to the minimisation of potential side effects and complications of this procedure. This notwithstanding you should be aware that complications as a consequence of the Coblation procedure can include: pain, scar formation, pigmentation of skin, depigmentation of skin, infection, bruising and allergic reactions.
Your anaesthetist may outline potential anaesthetic complications and you should discuss any concerns in this regard at the
pre-anaesthetic visit on the day of the procedure. We encourage you to contact us at any time you may be concerned about your recovery. During business hours cal 02 9894 1180 or for after hours page Dr. Feiner.
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Suite 31 Shire Central, 15 Terminus Street, Castle Hill NSW 2154
Ph: 02 9894 1180 Fax: 02 9894 1173 Email: info@cosmetica.com.au
Prof. Dr. R. Kubale, Dr. B. Junk, Dr. M. Rech, L.O. Schmidt, Dr. C. Pazolt Gemeinschaftspraxis für Radiologie und Nuklearmedizin CT-Untersuchung Anamnesebogen vor jodhaltiger Kontrastmittel-Gabe Name:_________________________________ Datum:_____________ Vorname:______________________________ Geb.-Datum:_____________ Liegt bei ihnen eine Nierenerkrankun
EMC-Toxicologie Pathologie 2 (2005) 178–184 Syndrome de stress post-traumatique : clinique et thérapie Post-traumatic stress disorders: clinical and therapeutic aspects D. Cremniter (Praticien hospitalier, coordonnateur de l’inter-région Paris-Île-de-France) *, A. Laurent (Psychologue) Samu de Paris, cellule d’urgence médicopsychologique, hôpital Necker, 149–161, rue de S