Department of Orthopedic, Traumatologic, Rehabilitative and Plastic-Reconstructive Sciences, Second University of Naples, Naples, Italy.
Lasers Med Sci. 2013 May;28(3):957-64. doi: 10.1007/s10103-012-1178-0. Epub 2012 Aug 21.
Keloids and hypertrophic scars are abnormal responses to wound healing. In general, keloids exhibit a proliferative growth beyond the margins of the scar and remain persistent; while hypertrophic scars are contained to the original wound and may regress over time. In particular, keloid formation is one of the most challenging clinical problems, with increasing frequency in surgical practice. Many treatments are available such as intralesional corticosteroids, topical applications, cryotherapy, surgical excision, radiation therapy, silicone gel sheeting, pressure therapy, and laser therapy. There are no set guidelines for the treatment of keloids and the most common treatments are individualized and depended on the distribution, size, thickness, and consistency of lesions. The authors have evaluated carbon dioxide laser successfully in the treatment of keloids and the aim of this study was to determine the immediate and long-term histologic and clinical effects of keloids after carbon dioxide laser. Fifty consecutive patients (40 females, 10 males, ages 18-60 years, mean age 40 years) with moderate to severe keloids were evaluated. All the patients received regional treatments (deltoid, elbow, chin, and ear) in an outpatient setting with a high-energy pulsed CO2 laser. Significant immediate and prolonged clinical improvement in skin tone, texture, and appearance of carbon dioxide laser was examined in all patients. Dermal remodeling was observed also on histologic examination of biopsied tissue after treatment. Carbon dioxide laser appears to be effective and well tolerated for the treatment of keloids, avoiding the adverse effects and lengthy recovery time.
瘢痕疙瘩和增生性瘢痕是创伤愈合的异常反应。一般来说，瘢痕疙瘩表现为超出瘢痕边缘的增生性生长，并持续存在；而增生性瘢痕则局限于原伤口，随着时间的推移可能会消退。特别是，瘢痕疙瘩的形成是外科实践中最具挑战性的临床问题之一，其发病率呈上升趋势。有许多治疗方法可供选择，如病灶内皮质类固醇、局部应用、冷冻疗法、手术切除、放射治疗、硅酮凝胶贴剂、压力治疗和激光治疗。对于瘢痕疙瘩的治疗尚无固定的指南，最常见的治疗方法是个体化的，取决于病变的分布、大小、厚度和质地。作者已经成功地评估了二氧化碳激光在瘢痕疙瘩治疗中的应用，本研究旨在确定二氧化碳激光治疗瘢痕疙瘩后的即刻和长期组织学和临床效果。对 50 例（40 例女性，10 例男性，年龄 18-60 岁，平均年龄 40 岁）中重度瘢痕疙瘩患者进行了评估。所有患者均在门诊接受高能脉冲 CO2 激光的区域性治疗（三角肌、肘、颏和耳）。所有患者的皮肤色调、质地和外观均有显著的即刻和长期临床改善。治疗后活检组织的组织学检查也观察到真皮重塑。二氧化碳激光治疗瘢痕疙瘩有效且耐受性良好，可避免不良反应和长时间的恢复时间。
