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1210nm 激光辅助皮肤愈合(LASH)技术治疗后术后疤痕的 1 年随访:一项随机对照试验。

A 1-Year Follow-Up of Post-operative Scars After the Use of a 1210-nm Laser-Assisted Skin Healing (LASH) Technology: A Randomized Controlled Trial.

机构信息

Plastic and Reconstructive Surgery, University Hospital La Conception, APHM, 264, Rue Saint-Pierre, 13385, Marseille, France.

Laboratoires Urgo, 42 Rue de Longvic, BP 157, 21304, Chenôve, France.

出版信息

Aesthetic Plast Surg. 2017 Aug;41(4):938-948. doi: 10.1007/s00266-017-0820-4. Epub 2017 Feb 23.

Abstract

BACKGROUND

Laser therapies are used prophylactically for excessive scar formation. The Laser-Assisted Skin Healing treatment induces a controlled heat stress that promotes tissue regeneration. This comparative trial is the first to evaluate the performance of a new automated 1210-nm laser system, compatible with all Fitzpatrick scale phototypes.

METHODS

Forty women undergoing bilateral breast reduction were enrolled in this double-blinded randomized controlled trial. The horizontal sutured incision of one breast was treated with the portable 1210-nm laser while in the operating theatre. The other breast was used as the study control. Objective measurements, subjective clinical assessments and safety evaluation were carried out over 1 year by both clinicians and patients.

RESULTS

Six weeks following surgery, better overall appearance and modified OSAS scores were reported for the laser-treated scars when compared to the control group (p = 0.024 and p = 0.079). This supports an early effect of the laser treatment during the inflammatory stage of the healing process. After a post-treatment period of 6 months, there continued to be a strong tendency in favour of the laser treatment based on the subjective scores and corroborated by the objective improvement of the treated scar volume (p = 0.038). At 1 year, the laser-treated scars continued to improve compared to the control ones in terms of volume (p = 0.004), surface (p = 0.017) and roughness (p = 0.002), and these comparatively better results were strengthened with the blind expression of patients' preference for their laser-treated scar (p = 0.025).

CONCLUSIONS

This new 1210-nm laser treatment, used as a single session performed immediately after surgery, provides significant objective and subjective improvements in scar appearance. These data can be useful when preparing patients to undergo their surgical procedure.

LEVEL OF EVIDENCE I

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

摘要

背景

激光疗法被预防性地用于治疗过度的瘢痕形成。激光辅助皮肤愈合治疗会引起受控的热应激,从而促进组织再生。这项比较试验是首次评估一种新的自动化 1210nm 激光系统的性能,该系统与所有 Fitzpatrick 肤色类型兼容。

方法

40 名接受双侧乳房缩小术的女性参与了这项双盲随机对照试验。在手术室中,用便携式 1210nm 激光处理一侧乳房的水平缝合切口。另一侧乳房作为研究对照。临床医生和患者在 1 年内进行了客观测量、主观临床评估和安全性评估。

结果

术后 6 周,激光治疗组的疤痕外观总体和改良 OSAS 评分均优于对照组(p=0.024 和 p=0.079)。这支持激光治疗在愈合过程的炎症阶段早期发挥作用。治疗后 6 个月,基于主观评分和治疗后疤痕体积的客观改善,激光治疗仍有强烈的优势(p=0.038)。1 年后,激光治疗组的疤痕在体积(p=0.004)、表面(p=0.017)和粗糙度(p=0.002)方面继续优于对照组,并且这些比较好的结果随着患者对激光治疗疤痕的偏好表达的盲法表达而得到加强(p=0.025)。

结论

这种新的 1210nm 激光治疗方法,作为术后立即进行的单次治疗,可显著改善疤痕外观的客观性和主观性。这些数据在为患者准备手术过程时可能会有所帮助。

证据水平 I:本杂志要求作者为每篇文章分配一个证据水平。有关这些循证医学评级的完整描述,请参考目录或在线作者指南 www.springer.com/00266

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