Vasily David B, Cerino Mary E, Ziselman Ethel M, Zeina S Tannous
Aesthetic Cosmetic and Laser Surgery Center, Bethlehem, PA 18018, USA.
J Drugs Dermatol. 2009 Nov;8(11):998-1005.
Non-ablative, fractional lasers generate microscopic columns of coagulated tissue through the epidermis and dermis to evoke a wound healing response. In this study, the authors examined the efficacy and safety of the non-ablative 1540 nm erbium:glass fractional laser in the treatment of surgical and post-traumatic scars.
Clinical studies were conducted on a range of surgical and post-traumatic scars with a 1540 nm erbium:glass fractional laser varying energy, pulse widths, treatment passes, and number of treatments. A histological study was conducted on a postsurgical scar to follow the time course of healing post-treatment and the impact of the fractional treatment on normalization of scar tissue, as compared to baseline histology of the scar.
Histologic findings demonstrated rapid re-epithelialization of the epidermis within 72 hours of treatment. Remodeling of scar tissue with renewal and reorganization of collagen fibers in the dermis was noted two weeks post-treatment. Clinical subjects, with Fitzpatrick skin types II-V, received three to seven treatments with microbeam energies up to 60 mJ/pb and five passes. Relative to baseline, 73% of treated scars improved 50% or more and 43% improved 75% or more. Side effects included mild swelling (95% of subjects), erythema (94%) and purpura (5%), which all resolved within two to three days. Downtime was minimal-to-none for all subjects.
These data illustrate the safety and efficacy of the 1540 nm erbium:glass fractional laser in the treatment of surgical and post-traumatic scars. Practitioners can vary energy and microbeam density in order to tailor the treatment to reflect the individual scar characteristics.
非剥脱性、分次激光通过表皮和真皮产生微小的凝固组织柱，以引发伤口愈合反应。在本研究中，作者研究了非剥脱性1540纳米铒玻璃分次激光治疗手术瘢痕和创伤后瘢痕的疗效和安全性。
使用1540纳米铒玻璃分次激光，针对一系列手术瘢痕和创伤后瘢痕进行临床研究，改变能量、脉冲宽度、治疗次数和治疗疗程。对一个手术瘢痕进行组织学研究，以跟踪治疗后愈合的时间进程，以及与瘢痕的基线组织学相比，分次治疗对瘢痕组织正常化的影响。
组织学结果显示，治疗后72小时内表皮迅速重新上皮化。治疗后两周，注意到瘢痕组织发生重塑，真皮中的胶原纤维更新并重新组织。菲茨帕特里克皮肤分型为II - V型的临床受试者接受了三至七次治疗，微束能量高达60毫焦/脉冲，治疗五次。相对于基线，73%的治疗瘢痕改善了50%或更多，43%改善了75%或更多。副作用包括轻度肿胀（95%的受试者）、红斑（94%）和紫癜（5%），所有这些都在两到三天内消退。所有受试者的停工期极短或无停工期。
这些数据说明了1540纳米铒玻璃分次激光治疗手术瘢痕和创伤后瘢痕的安全性和有效性。从业者可以改变能量和微束密度，以便根据个体瘢痕特征调整治疗方案。
