Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health System, Charlottesville, Virginia 22908, USA.
Dermatol Surg. 2012 Apr;38(4):595-602. doi: 10.1111/j.1524-4725.2011.02283.x. Epub 2012 Jan 23.
Dermabrasion has been the standard resurfacing procedure for postsurgical scars, but recovery can be long. Fractionated carbon dioxide (CO2 ) laser is a safe, effective tissue resurfacing modality, but no prospective trial has compared its safety or efficacy with that of dermabrasion for postsurgical scar resurfacing.
To compare the safety and efficacy of single-treatment fractional photothermolysis with that of single-treatment dermabrasion for postsurgical scar resurfacing on the face.
A split-scar method was used to compare fractionated CO2 laser and diamond fraise dermabrasion on postsurgical scars of the face. Primary endpoint was safety at day 0, 1 week, and 1 month. Secondary endpoint was efficacy at 3 months as measured by blinded evaluation of standardized photographs.
Safety data revealed that there was less erythema (p = .001) and bleeding (p = .001) at day 0, less erythema (p = .01) and edema (p = .046) at 1 week, and a trend toward less erythema at 1 month (p = .06) with fractionated CO2 . Efficacy data at 3 months revealed equivalent scar improvements (p = .77).
Fractionated CO2 laser therapy should be considered a safe alternative for surgical scar resurfacing on the face. The safety profile exceeds that of dermabrasion, and it has a quicker clinical recovery and equivalent cosmetic efficacy.
磨皮术一直是外科手术后瘢痕修复的标准方法,但恢复时间较长。 分 化 二 氧 化 碳 (CO2) 激光是一种安全有效的组织表面重建方式,但尚无前瞻性试验比较其安全性或疗效与磨皮术用于外科手术后瘢痕表面重建的疗效。
比较单次分 化 光 热 疗 法 和单次磨皮术治疗面部外科手术后瘢痕的安全性和疗效。
采用分割瘢痕的方法比较分 化 CO2 激光和钻石 Fraise 磨皮术治疗面部外科手术后的瘢痕。主要终点是治疗后 0、1 周和 1 个月时的安全性。次要终点是 3 个月时通过盲法评估标准化照片来衡量的疗效。
安全性数据显示,分 化 CO2 在治疗后 0 天、1 周和 1 个月时的红斑(p =.001)和出血(p =.001)较少,1 周时红斑(p =.01)和水肿(p =.046)较少,1 个月时红斑趋势减少(p =.06);而磨皮术则没有显著差异。3 个月时的疗效数据显示,瘢痕改善程度相当(p =.77)。
分 化 CO2 激光治疗可被视为面部外科手术后瘢痕表面重建的安全替代方法。其安全性优于磨皮术,临床恢复更快,美容效果相当。