Nouri Keyvan, Jimenez Gloria P, Harrison-Balestra Catherine, Elgart George W
Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, Miami, Florida 33136, USA.
Dermatol Surg. 2003 Jan;29(1):65-73; discussion 73. doi: 10.1046/j.1524-4725.2003.29014.x.
The optimal time frame to improve the quality and cosmetic appearance of scars by laser therapy has not been clearly elucidated by prior controlled clinical trials.
To determine the efficacy of the 585-nm pulsed dye laser (PDL) in the treatment of surgical scars starting on the day of suture removal.
Eleven patients (skin types I-IV) with 12 postoperative linear scars that were greater than 2 cm were treated three times on monthly intervals with the 585-nm PDL (450 micro s, 10-mm spot size, 3.5 J/cm2 with 10% overlap) on one scar half, whereas the other half received no treatment. Scars were later evaluated by a blinded examiner using the Vancouver Scar Scale (VSS) for pigmentation, vascularity, pliability, and height. Scars were then blindly examined for cosmetic appearance using a visual analog scale.
One month after the last treatment, final scar analysis by the blinded examiner revealed a significant difference between treated and untreated sites, with the treated halves scoring better in all scar parameters in the VSS and in cosmetic appearance. The treated halves demonstrated an overall average improvement in the VSS between the first treatment score and the final score of 54% versus 10% in the controls (P=0.0002). The cosmetic appearance score (0=worst; 10=best) at final assessment was significantly better for the treated scars, scoring 7.3 versus the averaged control score of 5.2 (P=0.016).
The 585-nm PDL is effective and safe in improving the quality and cosmetic appearance of surgical scars in skin types I-IV starting on the day of suture removal.
先前的对照临床试验尚未明确阐明通过激光治疗改善瘢痕质量和外观的最佳时间范围。
确定585纳米脉冲染料激光(PDL)从拆线日开始治疗手术瘢痕的疗效。
11例(皮肤类型I-IV)有12条术后线性瘢痕且长度大于2厘米的患者,在一条瘢痕的一半上每月接受3次585纳米PDL治疗(450微秒,光斑大小10毫米,能量密度3.5焦耳/平方厘米,重叠率10%),而另一半不接受治疗。之后由一名不知情的检查者使用温哥华瘢痕量表(VSS)对瘢痕的色素沉着、血管分布、柔韧性和高度进行评估。然后使用视觉模拟量表对瘢痕外观进行不知情检查。
最后一次治疗后1个月,不知情检查者进行的最终瘢痕分析显示,治疗部位与未治疗部位之间存在显著差异,治疗的一半在VSS的所有瘢痕参数和外观方面得分更高。治疗的一半在VSS中首次治疗评分与最终评分之间的总体平均改善率为54%,而对照组为10%(P=0.0002)。最终评估时,治疗瘢痕的外观评分(0=最差;10=最佳)明显更好,评分为7.3,而对照组平均评分为5.2(P=0.016)。
585纳米PDL从拆线日开始治疗I-IV型皮肤的手术瘢痕,在改善瘢痕质量和外观方面有效且安全。