Application Manual • Nail Fungus • Warts · Application Manual • Nail Fungus ... MEDNET GmbH...

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www.neo-laser.com The neoV 1064 Application Manual • Nail Fungus • Warts

Transcript of Application Manual • Nail Fungus • Warts · Application Manual • Nail Fungus ... MEDNET GmbH...

www.neo-laser.com

The neoV 1064Application Manual

• Nail Fungus• Warts

21023

European Authorized Representative:

MEDNET GmbH Borkstr 10, 48163 Munster, GERMANY

DHF-001-R-023 neoV1064 Application Manual

3© neoLaser 2014

CONTENT

© 2014 neoLaser. Alle Rechte vorbehalten. Namen anderer hier genannter Firmen und Produkte sind Marken ihrer jeweiligen Rechtsinhaber. Jede Nutzung des Materials, einschließlich der Vervielfältigung im Ganzen oder in Teilen, bedarf schriftlicher Genehmigung von neoLaser. Es wurden alle Anstrengungen unternommen, um sicherzustellen, dass die in diesem Handbuch aufgeführten Informationen korrekt und auf dem neusten Stand sind. neoLaser übernimmt jedoch keine Gewähr für die Richtigkeit des Inhalts dieses Handbuchs und haftet nicht für persönlichen Schäden oder Verletzungen, die direkt oder indirekt verursacht werden, allein durch die Nutzung dieses Dokuments. Im Zweifelsfall wenden Sie sich bitte vor Benutzung dieses Geräts an neoLaser. Mai 2014

ENGLISCH

© 2014 neoLaser - all rights reserved. Names other here named carrier companies or products are trademarks theirs respective holder of rights. Any use of the material, including reproduction in whole or in part, requires permission in writing from neoLaser. While every endeavour has been taken by the authors to ensure the information in this document is accurate and up to date. neoLaser shall not be liable for any personal damage or injury caused directly or indirectly, by solely using this document. In case of any doubt, please contact neoLaser before using the device. May 2014

INHALT

Lasers Safety 4

Device Overview 7

Optical Handpieces 9

Nail Fungus 11

Warts 15

4

LASERS SAFETY

LASER RADIATION & TEMPERATURE EFFECT

TEMPERATURE EFFECT

> 40° C Enzyme induction, membrane disaggregation, edema

45° – 65° C Tissue damage, irreversibility depends on irradiation time

> 65° C Coagulation

> 100° C Dehydration

> 150° C Carbonisation

THERAPY INDICATIONS

1 This manual covers various podiatry ap-plications approved for use with the neoV laser; manual is designed to assist both the “beginner” and “experienced” users

2 Clinical information detailed in this man-ual is intended to be used by a healthcare professional who posses relevant medical background, as well basic knowledge with medical lasers

3 It is strongly advisable to refer to appro-priate literature relevant to the intended use If no such literature is available, please contact your local neoLaser repre-sentative for support

4 Laser parameters values are usually detailed with min /max values These parameters were developed based on the extensive use of the device by healthcare professionals

5 The user should always utilize his/her ex-perience and knowledge, as well as clini-cal best practice, taking into consideration relevant patient information Neither the author nor the manufacturer will be liable for a treatment failure caused by misuse of the device

MANAGING UNWANTED EFFECTS

Since safety goggles must be worn through-out the procedure, the operator must be aware that his/her vision is temporarily altered (col-or shades appear differently, contrast may be

dimmed, etc ) - this can lead to visual misjudg-ment It is than recommended from time to time to turn off the laser, remove the goggles and inspect the treated area without goggles

In case of any eye injury due to disregard of the eye protection by safety goggles, an ophthalmologist hast to be consulted

Laser radiation can cause immediate and unwanted tissue damage, therefore it is highly advisable to have within reach measures for burn control (such as: ice or cooling pads, topical products, spe-cial dressings for burns, etc )

Laser radiation can cause unwanted he-mostasis and coagulation damages The extent strongly depends on the exposure time to the laser’s radiation

Coagulated tissue is not harmful and normally will not cause issues In case of overheating of tempera-ture-sensitive areas, applying immediate cooling should be done and treatment should be stopped and reevaluated

Discomfort from the heating which is generated by the laser may occur To avoid this, the user should follow the application parameter guidelines If possible, cooling can reduce patient discomfort during and after treatment

5© neoLaser 2014

L ASERS SAFET Y

Manual FOX July 2014

File: User-Manual_Fox_III_EN 24

WARNING LABELS

Warning label fiber exit (Console top)

Warning label laser radiation (Cover stand top)

Warning label laser radiation (Cover stand top)

Manual FOX July 2014

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WARNING LABELS

Warning label fiber exit (Console top)

Warning label laser radiation (Cover stand top)

Warning label laser radiation (Cover stand top)

Manual FOX July 2014

File: User-Manual_Fox_III_EN 24

WARNING LABELS

Warning label fiber exit (Console top)

Warning label laser radiation (Cover stand top)

Warning label laser radiation (Cover stand top)

Manual FOX July 2014

File: User-Manual_Fox_III_EN 24

WARNING LABELS

Warning label fiber exit (Console top)

Warning label laser radiation (Cover stand top)

Warning label laser radiation (Cover stand top)

Warning/Hazard labels found on the NeoV Laser device

The neoV laser produces an intense, highly directional beam of light. If directed, reflected, or focused upon an object, laser light will be partially absorbed, raising the temperature of the surface and/or the interior of the object, potentially causing an alteration or deforma-tion of the material and can also cause tissue

damage Moreover, this beam of light can be hazardous to the eye even when the laser light is reflected from a different surface.The energy generated by the neoV1064 laser is in the infrared portion of the electromagnetic spectrum

Infrared lasers are particularly hazardous, since the body’s protective “blink reflex” re-sponse is triggered only by visible light In this sense, people exposed to high power laser emit-ting invisible 1064 nm radiation, may not feel pain or notice immediate damage to their eye-sight A pop or click noise emanating from the eyeball may be the only indication that retinal damage has occurred i e the retina was heated to over 100 °C resulting in localized explosive boiling accompanied by the immediate creation of a permanent blind spot

Lasers are categorized and classified into 4 classes, ranging from Class 1 to Class 4 The neoV is a Class 4 laser, which is the highest and most dangerous class of laser. By definition, a class 4 laser can burn the skin, or cause devas-tating and permanent eye damage as a result of direct, diffuse or indirect beam viewing. These lasers may ignite combustible materials, and thus may represent a fire risk. These hazards may also apply to indirect or non-specular re-flections of the beam, even from apparently matte surfaces—meaning that great care must be taken to control the beam path and to protect the eyes of any person within the laser use area

How the laser perform in a specific application is based on laser radiation and tissue interac-tion, as the laser radiation may be absorbed, scattered or reflected by the treated area. Air has very little effect on the laser radiation so interaction between air and the laser radiation can be neglected. Reflection do plays a major role with metal, glass and other reflecting sur-faces, but not so much when it comes to human tissue

When emitting laser radiation on human tissue, reflection is minimal but not zero! Although

laser radiation may be scattered on a tissue‘s surface, it does not influence much the overall energy absorption Absorption is mainly de-rived by the laser radiation physical properties (wavelength). Absorption defines how much of the laser radiation is converted into heat, which causes the desired clinical effects (coagulation / vaporisation)

6

BASIC LASER SAFETY INSTRUCTIONS

To avoid any injuries it is important to follow the laser safety instructions:

• Operating personnel – the neoV laser system can be operated by authorized personnel only

• Laser Safety Goggles – Laser safety gog-gles are crucial for the safety of all persons in the laser use area Make absolutely sure that before turning the laser to READY mode (Yellow indicator on user screen and Yellow light on diagonal stripe on top of laser), every person in the area that may be impacted by laser radiation is wearing laser safety goggles Make sure that the goggles are suitable for eye protection from the neoV laser radiation (see User Manual for further information) This includes all persons in the laser treatment area or laser room, including patient, physician, nurse, general staff and anyone in the vicinity of the treatment area

• Training - all users of the neoV laser system have to be trained by neoLaser authorized personnel or by your trained authorized dealer

• Laser Warning Symbols – laser Warn-ing Symbols must be clearly placed in all areas where the laser system is used

• Laser Operating Area – the laser operating area should be clearly marked and sealed while laser is in operation All personnel should be aware when the laser is operating and should not enter the Laser Operating Area without adequate safety protections while the laser is in use

• System Check – before use, verify that the system and all its components work as intended If the system does not come up, you may try to isolate the problem, as explained in the neoV User Manual If prob-lem persists, contact your local authorized dealer for technical support If any of the components are deemed malfunctioning – do not use the system, and contact your local dealer

• Fiber Delivery - the fiber spot, which is illustrated by the aiming beam should always be round and well defined no scat-tering should occur

• Defined Application – do not use the laser for any application other than its defined application, as stated in this appli-cation manual The laser must be used only for the defined application; never illumi-nate/irradiate any other material or tissue besides the intended use

• Reflected laser radiation - reflected laser radiation can cause the same harm as direct application, therefore you should make sure to avoid irradiating reflecting materials

• Standby Mode – the neoV laser should be in Standby mode whenever the laser is not in use, e g during operation breaks or at the end of the surgery/procedure

L ASERS SAFET Y

7© neoLaser 2014

DEVICE OVERVIEWMANUAL neoV August 2013

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i. Housing Front The front panel of the device consists of the following controls and keys:

ii. neoV Fiber Port The neoV Laser has a fiber port at the head of the device, intended to incorporate the patented click plug for a wide range of hand pieces and applicators. To protect the fiber port neoLaser inserted the protective cap. The silver port allows connection of a full range of fiber accessories, from 300 microns and up, as the mating element is part of the fiber. A T T E N T I O N ! Fibers are not delivered with the laser and should be purchased separately.

Touch Screen for setting control

Standby/Ready button

Fiber Port Laser Status light: Green (standby), Yellow (ready), Red (firing), Flashing Red (error)

Cooling inflow

Emergency Button

Power supply

Door interlock

neoLaser flash drive

Do not connect unauthorized USB sticks into the unit, use only neoLaser supplied sticks.

On/OffButton

Foot Pedal

Rear Panel/Sockets

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i. Display / Main Menu

The icons and display parameters of the Main Menu are provided in the image above. The power setting of the laser is provided in the center of the screen. This number corresponds to the peak power output from the fiber distal end to the tissue, and given in fractions of Watts. On the right hand side you may read (1) the Pulse Interval which dictates the length of each pulse in the pulse train, or CW for Continuous Wave transmission; (2) the Interval Length, which dictates the Interval time until the following pulse will be transmitted, or SP in case of a Single Pulse transmission; (3) the Energy Display which can be toggled to show 4 different parameters of dosage as described below. On the top line you may see the current Program selected, as well as Home, Save and Settings icons. On the bottom line you may see the Surgeon selected, and the Laser Status indicator on the bottom right hand corner showing whether the laser is in Standby or in Ready mode.

Power Display / Control Standby / Ready Button

Power Up/Down Control Panel

Up/Down Buttons

Pulse Length

Interval Length

Pulse/Energy Display

MANUAL neoV August 2013

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i. Display / Main Menu

The icons and display parameters of the Main Menu are provided in the image above. The power setting of the laser is provided in the center of the screen. This number corresponds to the peak power output from the fiber distal end to the tissue, and given in fractions of Watts. On the right hand side you may read (1) the Pulse Interval which dictates the length of each pulse in the pulse train, or CW for Continuous Wave transmission; (2) the Interval Length, which dictates the Interval time until the following pulse will be transmitted, or SP in case of a Single Pulse transmission; (3) the Energy Display which can be toggled to show 4 different parameters of dosage as described below. On the top line you may see the current Program selected, as well as Home, Save and Settings icons. On the bottom line you may see the Surgeon selected, and the Laser Status indicator on the bottom right hand corner showing whether the laser is in Standby or in Ready mode.

Power Display / Control Standby / Ready Button

Power Up/Down Control Panel

Up/Down Buttons

Pulse Length

Interval Length

Pulse/Energy Display

MANUAL neoV August 2013

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ii. Settings

The settings screen is accessible from the main menu by pressing the Settings Icon on the top right hand corner of the screen. Once entering the settings screen, all user settings will be easily accessible, each one having its own up/down control button, as can be seen by the image below.

Screen Brightness - Allows altering the brightness of the display screen to match the OR environment. Changes will impact the display immediately

Volume - Enables alteration of overall volume of noise generating functions of the unit (such as feedback sound when pressing an icon).

Aiming Beam Brightness - Allows adjusting the brightness of the green aiming beam from 1% to 100% of the applicable power.

Scre

en B

right

ness

(5-

100%

)

Vo

lum

e (5

%-1

00%

)

Aim

ing

Beam

Fre

quen

cy

(0-6

Hz)

Aim

ing

Beam

Brig

htne

ss

(1-1

00%

)

Read

y Ye

llow

Brig

htne

ss

(5%

-100

%)

Re

ady

to S

tand

by

(2m

in-in

f)

Al

arm

Ton

e (1

0%-1

00%

)

Al

arm

Vol

ume

(5%

-100

%)

La

ngua

ge

System Info

Go back button

Humidity

Temperature

Reset Settings

Go back to Home page

Advanced Settings

Edit Password

Remember Surgeon Settings

8

OVERVIEW

The icons and display parameters of the Main Menu are provided in the image above Thepower setting of the laser is provided in the center of the screen, and corresponds tothe peak power output from the fiber distal end to the tissue in Watts. On the right hand side you may read (1) the Pulse Interval which dictates the length of each pulse, or CW for Continuous Wave; (2) the Interval Length, which dictates the off time between consecutive pulses, or SP in case of a Single Pulse transmission; (3) the Energy Display which can be toggled to show 4 differ-ent parameters of dosage On the top line you may see the current Program selected, as well as Home, Save and Settings icons On the bottom line you may see the Surgeon selected, and the Laser Status indicator on the bottom right hand corner showing whether the laser is in Standby or in Ready mode Changing ParametersYou may change the Peak Power setting as well as the Pulse Length and Interval Length on the main menu by (1) clicking on the parameter to activate its control and (2) clinking on the cor-responding arrows to change it When clicking the parameter it will be highlighted in Green to indicate it may be now changed

MANUAL neoV August 2013

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1. Changing Parameters You may change the Peak Power setting as well as the Pulse Length and Interval Length on the main menu by (1) clicking on the parameter to activate its control and (2) clinking on the corresponding arrows to change it. When clicking the parameter it will be highlighted in Green to indicate it may be now changed.

2. Saving Parameters After changing parameters, the changes may be stored under the program name by clicking the Save icon on the top right hand side.

You may notice that once saved the Save icon will become inactive until a change is made. Once a parameter is changed, the Save icon will again activate to allow saving of the new parameters.

3. Power The main Peak Power may be changed by clicking on it to activate its control and then by using the arrows and bars on the left hand side to change the setting. The power control is activated when marked in green. Once activated you may change the power setting by either (1) pressing the arrow keys up or down to increase or decrease the power in 0.1W steps or (2) pressing the bar indicator of power on the left directly for immediate and larger changes in power.

4. Pulse Length Adjustment The Pulse Length may be changed by clicking on it to activate its control and then by using the arrows on the bottom right hand side to change the setting. The Pulse Length control is activated when marked in green. Once activated you may change the setting by pressing the arrow keys up or down to increase or decrease the Pulse Length between the activated settings in a cyclical manner.

The activated settings can be determined by pressing down on the Pulse Length area for more than 2 seconds. The Pulse Length Activation screen will show up as described below.

9© neoLaser 2014

OPTICAL HANDPIECES

OPTICAL HANDPIECES - SPOT SIZE Ø

Handpiece with OF-WFST400-D [400µm]

Blue Ø 0.5 mm

Red Ø 1.0 mm

Green Ø 2.0 mm

Silver Ø 3.0 mm

OPTICAL HANDPIECES

The optical hand pieces (Blue, Red, Green and Silver) are used for focusing/ parallelization the laser beam for different applications. They work only with the double sided fiber connector OF-WFST400-D

Saving ParametersAfter changing parameters, the changes may be stored under the program name by clicking the Save icon on the top right hand side

You may notice that once saved the Save icon will become inactive until a change is made Once a parameter is changed, the Save icon will again activate to allow saving of the new parameters

User has wide selection of hand pieces to achieve the proper spot size and power density on the target tissue from 0 5 to 3mm

HP-FOC1, HP-FOC2, HP-FOC3 HP-NF

OF-WFST400-D [400 µm]

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N A I L F U N G U S

NAIL FUNGUS

Nail fungus (onychomyco-sis) is the most common nail disease, impacting 6-8% of the adult population In the past, nail fungus was treat-ed by medication, but this requires months of intake, it is expensive and has severe risk of liver damage Using the neoV laser allows for effective treatment with no medication

11© neoLaser 2014

NA IL FUNGUS

The neoV1064 produces a high intensity laser beam at 1064nm (near infrared) which goes through the nail, penetrates the nail plate, heats up the nail bed and destroys the fungus (pathogens) with minimal pain. The heat affects the pathogens by warming the cells, des-troying the cell walls and thus killing the affected cells. The neoV radiation does not have any effect on the nail itself, the cuticle or the surrounding skin At the end of the process, the nail fungus is eradicated and there is visible increase in nail clearness

CONTRA INDICATION

This treatment is not indicated for:

• Patients suffering from neuropathy, (including diabetics with neuropathy)

• Patients with inflamed tissue around the fungus / treatment area

• Patients with hyperkeratosis infection

SETUP

The neoV1064 system should be equipped with a dual connector fiber (400 micron OF-WFST400-D) and a focusing hand piece (HP-FOC2, or HP-NF depending on physician prefe-rence). Laser should be operated and fiber and hand piece connected according to User Manual instructions (see DHF-001-R-003 neoV User Manual)

MANUAL neoV August 2013

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d. Inserting the Applicator When the preselected power and pulses comply with the treatment parameters, the applicator can be plugged into the laser aperture. Gently push the applicator plug into the socket until it firmly "clicks" into place. In case it does not click in correctly, try to twist the plug inside the socket.

If the plug has not properly clicked into place, the device will not change into READY mode, and the neoV laser will not work.

Please pay attention to a clearly perceptible “click” when inserting the plug! You may need to twist the plug a bit while its partially inserted in order to be able to fully click it into place.

Once the plug has been locked into place, you can hold the applicator/hand piece in your hand. At this point the infrared radiation can be emitted through the applicator upon activation of the foot pedal. Therefore, please ensure the applicator is aimed away from any person, other than the patient target area, and is not pointed towards flammable materials.

e. Ready/STBY Once the plug is in place, you may move to READY mode. Switching to READY mode can be performed simply by pressing the STANBY icon on the Main Menu screen.

MANUAL neoV August 2013

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d. Inserting the Applicator When the preselected power and pulses comply with the treatment parameters, the applicator can be plugged into the laser aperture. Gently push the applicator plug into the socket until it firmly "clicks" into place. In case it does not click in correctly, try to twist the plug inside the socket.

If the plug has not properly clicked into place, the device will not change into READY mode, and the neoV laser will not work.

Please pay attention to a clearly perceptible “click” when inserting the plug! You may need to twist the plug a bit while its partially inserted in order to be able to fully click it into place.

Once the plug has been locked into place, you can hold the applicator/hand piece in your hand. At this point the infrared radiation can be emitted through the applicator upon activation of the foot pedal. Therefore, please ensure the applicator is aimed away from any person, other than the patient target area, and is not pointed towards flammable materials.

e. Ready/STBY Once the plug is in place, you may move to READY mode. Switching to READY mode can be performed simply by pressing the STANBY icon on the Main Menu screen.

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NA IL FUNGUS

TREATMENT PARAMETERS

The duration of the treatment depends on the size of the nails, the number of nails to be treated, the laser settings, the speed of the movement, and the tolerance of the specific patient to pain.

• Apply laser dosage to all nails, as to ensure optimal results and avoid reinfection due to untre-ated nails

• Scan each treated nail at least twice in each treatment session

• Scan the laser beam continuously over the nail to ensure uniform deposition of energy on the entire nail surface as well as nail edge and surrounding tissue Move over the nail both in horizontal and vertical movements

• Pass over the complete nail, including the nail plate, nail wall and eponychium

• If using HP-NF, the laser beam should be kept at a distance of ~1cm from the nail, and with a spot size of ~3mm If using HP-FOC2, the metal distance setting prongs should be in contact with the nail ensuring spot size of 1mm on the nail

• If using a Continuous Scan Mode (high pulse rate of 30 pulses per second) – use HP-FOC2 and scan the nail in a uniform speed continuously Do not stop in one spot Keep motion at >2mm/sec

• In using a Discrete Scan Mode, (low pulse rate of 2 pulses per second) – use HP-NF and move at least half a spot size between consecutive pulses

Below are the settings recommended for both techniques The user should choose his preferred technique based on his experience as well as patient preference

“NeoV Laser“ is Trademark of NeoLaser

LASER SETTINGS FOR USERS USING CONTINUOUS SCAN MODE

Nail Size Power (W) Pulse ON (ms) Pulse OFF (ms) Total Energy [J] Time [Sec]

Small Toe 10 20 10 150-250 20-35

Middle Toe 10 20 10 300-500 45-75

Big Toe 10 20 10 600-800 90-120

LASER SETTINGS FOR USERS USING DISCRETE SCAN MODE

Nail Size Power (W) Pulse ON (ms) Pulse OFF (ms) Total Energy [J] Time [Sec]

Small Toe 10 200 300 150-250 20-35

Middle Toe 10 200 300 300-500 45-75

Big Toe 10 200 300 600-800 90-120

13© neoLaser 2014

NA IL FUNGUS

The patient will feel a heating sensation If this sensation gets too discomforting, cease treatment for 5-10 secs. If the patient suffers from constant discomfort, turn down the power from 10W to 8W or lower

If the patient has dark skin, it is recommended to consider taking down power as patient skin absorption may be higher due to pigments and therefore result in increased pain sensation

Post treatment heating sensation will cease after 1-2hours

When applying energy, you can choose to view the accumulated energy delivered to the patient, or the accumulated number of pulses delivered (on main screen below the Pulse On and Pulse Off in-terval times; see User Manual) In either case, it is highly recommended to record and document the dosage applied in each session Choosing the Accumulated Energy setting will allow you to view the total dosage applied in Joules Please note - all personnel, including the patient, have to wear eye protection goggles; this may lead to decreased vision regarding contrast and color by the personnel and surgeon In case of any eye injury due to disregard of the eye protection by safety goggles, immediate medical attention should be sought

POST TREATMENT CARE

• Disinfect the hand piece by wiping it after each treatment with a special alcohol-containing disinfectant solution Hand pieces should not be used on consecutive patients without disin-fecting them first.

• The neoV laser treatment should not have side effects, when applied correctly. However, the heat generated by the laser radiation may cause patient discomfort Post treatment, use cool-ing to reduce patient discomfort Please note – discomfort may increase if laser treatment is not applied correctly All treatments should therefore follow the above application parameters and guidelines

• In severe cases, laser heating can cause burning of the tissue, depending on the amount of energy that is applied to the nail This may result in burn wounds, which in extreme situations can cause necrosis In case of overheating of temperature-sensitive areas, cool the area and use other forms of burn treatment

AVOIDING REINFECTION

Several key steps are recommended to reduce chance of reinfection and increase probability of successful long term outcome These should be communicated to the patients and may include:

• Exchange regular shoes into new shoes

• Place shoes in the freezer overnight to kill any remaining fungal infection

• Use clean socks on daily basis

• Wash socks only at temperatures of >60° C to kill any remaining fungal infection

• Use antifungal powder in your socks/shoes on daily basis, or use of antifungal cream

• Wear absorbent socks (no synthetic material)

• After showering, dry the feet especially between the toes

• Wear well ventilated shoes

• If you run frequently, spray or powder on daily basis with fungicide

The patient should be followed up and examined 4-6 weeks after the last laser treatment to evalua-te progress of clear nails In any case of concern regarding outcome an additional laser session, identical in nature to the sessions described above should be considered Final outcome and increase in clear nails can be viewed within 9-12 months of first treatment.

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NA IL FUNGUS

15© neoLaser 2014

W A R T S

WARTS

16

WARTS

BACKGROUND

Warts are benign (not cancerous) skin growths that appear when a virus infects the top layer of the skin Viruses that cause warts are called human papillomavirus (HPV) You are more likely to get one of these viruses if you cut or damage your skin in some way

Wart viruses are contagious.

Warts can spread by contact with the wart or something that touched the wart.

Warts that develop on the foot are commonly referred to as plantar warts.

Plantar warts have these traits:

• Grow most often on the soles (plantar surface) of the feet

• Can grow in clusters (mosaic warts)

• Often are flat or grow inward (walking creates pressure, which causes the warts to grow inward)

• Can hurt, feels like you have pebbles in your shoe

• Can have black dots

Source: American Academy of Dermatology

PREREQUISITE

• Review User Manual for all safety and sys-tem operation topics prior to using the unit

• Ensure all users wear safety goggles per requirements of User Manual and that treatment room is properly marked and protected

• Setup laser system, fiber, and hand piece per User Manual requirements (see also page 12 above for Nail Fungus setup)

• This application is applicable to neoV1064 (Part Number LSV1064-20) lasers only with up to 20Watts of power

17© neoLaser 2014

WARTS

PATIENT/SETUP

• Document the treatment area prior to treatment for clinical reference

• Debridement of the area for improved laser transmission is recommended; use disin-fected instruments

• Topical and/or local anesthetic may be used to increase patient comfort

• Gel is not to be used

• Smoke evacuation and laser plume masks highly recommended

TREATMENT

Settings should be• 1mm spot size red focusing hand piece

• For skin types I-IV: 16 Watts, 200-300 msec Pulse On, 300 msec Pulse Off, total Fluence: 200-240 J/cm2

• For skin types V-VI: 12 Watts, 150-250 msec Pulse On, 300 msec Pulse Off, total Fluence: 120-150 J/cm2

Treat the entire wart area• Make sure pulses overlap slightly

• Cover the wart area and a 1mm margin around the wart

• Endpoint: Dusky, ashen or blanched appea-rance to the wart with a halo or round red circle around the edge

POST TREATMENT

• Immediate cooling of the area with frozen gel pack may help patient comfort Burn sensation may be felt up to 12 hours post treatment

• If blistering occurs, wound healing treat-ment should be implemented, including potential topical antibiotic or soothing ointment

• Warts will usually present a black or crusty appearance within 24 hours, a blood blister

may form within 7-10 days, then crusting and sloughing off within 2 weeks

• The area should be kept clean, patient should use new shoes and socks and wash the area thoroughly

• More than one treatment may be necessary if wart persists Treatments should be performed 3-4 weeks apart

The Product in this Brochure is Not For Sale in the US

1064

neoLaser • Ha‘Eshel St. 7, 3088900, Caesarea, Israel • POB 3203 [email protected] • office +972 4 677 9919 • fax +972 4 859 1505

Distributor: