Ortiz Arisa E, Tremaine Anne Marie, Zachary Christopher B
Department of Dermatology, University of California at Irvine, Irvine, California 92697, USA.
Lasers Surg Med. 2010 Feb;42(2):168-70. doi: 10.1002/lsm.20885.
Recently, there has been much debate regarding the long-term efficacy of fractional resurfacing devices. While pulsed CO(2) laser resurfacing is considered a highly effective treatment, fractionated resurfacing is a newer modality and its long-term efficacy has yet to be assessed. We report the long-term outcomes of subjects previously treated with fractional CO(2) resurfacing for photodamaged skin and acne scars.
STUDY DESIGN/MATERIALS AND METHODS: Ten subjects from our previous studies who received fractional resurfacing for the treatment of acne scarring and photodamage returned for long-term follow-up visits at 1 and 2 years, respectively. Investigators graded maintenance of improvement on a quartile scale based on clinical photography.
Subjects maintained 74% of their overall improvement at their long-term visits compared to 3-month follow-up visits. While clinical improvement was maintained long-term, the results were not as remarkable as those seen at 3-month visits. The authors speculate that results seen at 3 months may be enhanced by persistent inflammatory changes, as evidenced by heat shock protein 47 activity and ongoing collagen remodeling seen in previous histologic studies. Relaxation of tightening is to be expected with any procedure along with the natural progression of aging. However, patient satisfaction was upheld long-term.
Fractional CO(2) laser resurfacing does have long-term efficacy and persistence of improvement of acne scarring and photodamage compared to baseline. However, additional treatments may be necessary to enhance long-term results.
近来，关于分次换肤设备的长期疗效存在诸多争议。虽然脉冲二氧化碳激光换肤被认为是一种高效的治疗方法，但分次换肤是一种较新的方式，其长期疗效尚未得到评估。我们报告了先前接受分次二氧化碳换肤治疗光损伤皮肤和痤疮瘢痕的受试者的长期结果。
研究设计/材料与方法：我们之前研究中的10名接受分次换肤治疗痤疮瘢痕和光损伤的受试者分别在1年和2年时返回进行长期随访。研究人员根据临床照片，采用四分位数量表对改善情况的维持程度进行分级。
与3个月的随访相比，受试者在长期随访时维持了74%的总体改善。虽然临床改善在长期内得以维持，但结果不如3个月随访时显著。作者推测，3个月时看到的结果可能因持续的炎症变化而增强，如先前组织学研究中所见的热休克蛋白47活性和持续的胶原重塑所证明。随着衰老的自然进程，任何手术都会出现紧绷感的缓解。然而，患者满意度在长期内得以维持。
与基线相比，分次二氧化碳激光换肤确实对痤疮瘢痕和光损伤具有长期疗效且改善情况持续存在。然而，可能需要额外的治疗来提高长期效果。
