Kim Sun Goo, Kim Eun Yeon, Kim Yu Jin, Lee Se Il
Seran Plastic Surgery Clinic, Incheon, Korea.
Arch Plast Surg. 2012 May;39(3):232-7. doi: 10.5999/aps.2012.39.3.232. Epub 2012 May 10.
Skin injuries, such as lacerations due to trauma, are relatively common, and patients are very concerned about the resulting scars. Recently, the use of ablative and non-ablative lasers based on the fractional approach has been used to treat scars. In this study, the authors demonstrated the efficacy and safety of ablative fractional resurfacing (AFR) for traumatic scars using a 2,940-nm erbium: yttrium-aluminum-garnet (Er:YAG) laser for traumatic scars after primary repair during the early posttraumatic period.
Twelve patients with fifteen scars were enrolled. All had a history of facial laceration and primary repair by suturing on the day of trauma. Laser therapy was initiated at least 4 weeks after the primary repair. Each patient was treated four times at 1-month intervals with a fractional ablative 2,940-nm Er:YAG laser using the same parameters. Post-treatment evaluations were performed 1 month after the fourth treatment session.
All 12 patients completed the study. After ablative fractional laser treatment, all treated portions of the scars showed improvements, as demonstrated by the Vancouver Scar Scale and the overall cosmetic scale as evaluated by 10 independent physicians, 10 independent non-physicians, and the patients themselves.
This study shows that ablative fractional Er:YAG laser treatment of scars reduces scars fairly according to both objective results and patient satisfaction rates. The authors suggest that early scar treatment using AFR can be one adjuvant scar management method for improving the quality of life of patients with traumatic scars.
皮肤损伤,如外伤导致的撕裂伤相对常见,患者非常关注由此产生的疤痕。最近,基于分次治疗方法的剥脱性和非剥脱性激光已被用于治疗疤痕。在本研究中,作者使用2940纳米铒:钇铝石榴石(Er:YAG)激光,在创伤后早期对一期修复后的外伤性疤痕进行剥脱性分次激光表面重塑(AFR),证明了其治疗外伤性疤痕的有效性和安全性。
招募了12例有15处疤痕的患者。所有患者都有面部撕裂伤病史,并在受伤当天进行了一期缝合修复。激光治疗在一期修复后至少4周开始。每位患者使用相同参数,每隔1个月用2940纳米剥脱性Er:YAG激光治疗4次。在第四次治疗后1个月进行治疗后评估。
所有12例患者均完成了研究。经剥脱性分次激光治疗后,疤痕的所有治疗部位均有改善,这在温哥华疤痕量表以及由10名独立医生、10名独立非医生和患者本人评估的整体美容量表中得到了体现。
本研究表明,剥脱性分次Er:YAG激光治疗疤痕,根据客观结果和患者满意率,能相当程度地减轻疤痕。作者建议,使用AFR进行早期疤痕治疗可以作为一种辅助性疤痕管理方法,以提高外伤性疤痕患者的生活质量。