Buelens Sarah, Van Hove Anne-Sophie, Ongenae Katia, Lapeere Hilde, Huvenne Wouter, Vermeersch Hubert, Verhaeghe Evelien, Boone Barbara
*Faculty of Medicine, University of Ghent, Ghent, Belgium; †Department of Dermatology, Ghent University Hospital, Ghent, Belgium; ‡Department of Head, Neck and Maxillo-Facial Surgery, Ghent University Hospital, Ghent, Belgium.
Dermatol Surg. 2017 Jan;43 Suppl 1:S75-S84. doi: 10.1097/DSS.0000000000000963.
Postoperative scarring is a common cause of patient dissatisfaction. Several strategies have been developed to improve its clinical aspects.
To assess efficacy and safety of the 10,600 nm ablative fractional carbon dioxide (CO2) laser in the treatment of recent surgical scars in the head and neck region.
A prospective, randomized, single-blind intrapatient controlled study was conducted on 9 postoperative scars in the head and neck region. On half of the scar, 3 treatment sessions were performed. Physician/Patient Global Assessment (PhGA/PGA) and Patient and Observer Scar Assessment Scales (POSAS) were used to evaluate treatment efficacy. Safety was evaluated by registration of pain and adverse events.
No statistically significant differences were noted in terms of PhGA or POSAS (observer). Patient Global Assessment (p = 0.058) and POSAS (patient) (p = 0.091) showed a trend toward better improvement of the treated half. Itch score (p = 0.046) and global end evaluation (patient) (p = 0.026) demonstrated a statistically significant difference in favor of the treated part. Adverse events were minor, and no long-term side effects were noted.
The use of CO2 fractional laser is safe and is associated with high patient satisfaction. However, objective measurements could not confirm its efficacy in the treatment of recent surgical scars.
术后瘢痕形成是患者不满意的常见原因。已经开发了几种策略来改善其临床情况。
评估10600纳米剥脱性分数二氧化碳（CO2）激光治疗头颈部近期手术瘢痕的疗效和安全性。
对9名头颈部术后瘢痕患者进行了一项前瞻性、随机、单盲的患者内对照研究。在瘢痕的一半部位进行3次治疗。采用医生/患者整体评估（PhGA/PGA）和患者及观察者瘢痕评估量表（POSAS）评估治疗效果。通过记录疼痛和不良事件来评估安全性。
在PhGA或POSAS（观察者）方面未观察到统计学上的显著差异。患者整体评估（p = 0.058）和POSAS（患者）（p = 0.091）显示治疗部位有更好改善的趋势。瘙痒评分（p = 0.046）和整体最终评估（患者）（p = 0.026）显示治疗部位有统计学上的显著差异。不良事件轻微，未观察到长期副作用。
使用CO2分数激光是安全的，且患者满意度高。然而，客观测量无法证实其对近期手术瘢痕的治疗效果。
