Ouyang Hua-Wei, Li Gao-Feng, Lei Ying, Gold Michael H, Tan Jun
Department of Plastic & Laser Cosmetic, Hunan Provincial People's Hospital, Changsha, Hunan, China.
Gold Skin Care Center, Nashville, TN, USA.
J Cosmet Dermatol. 2018 Feb;17(1):54-60. doi: 10.1111/jocd.12487.
The objective was to investigate the clinical effect of an adjustable pulse width Pulsed Dye Laser (PDL) vs an adjustable pulse width PDL combined with fractional CO laser in treating immature red hypertrophic scars.
Fifty-six patients (56 sites)were randomly divided into a treatment group and control group. The control group was treated with the 595 nm PDL at a fluence of 7-15J/cm and pulse widths of 1.5-3 ms, 7 mm spot size. The treatment group was treated with a fractional CO laser (UltraPulse CO : Deep FX, Energy: 30~50 mJ, Frequency: 300 Hz, Density 5%, Scan Shape, and Spot Size were decided by shape and area of scar) after utilizing the 595 nm adjustable pulse width PDL (Fluence: 7-15J/cm , Pulse widths: 1.5-3 ms, Spot size: 7 mm). MEBT/MEBO, previously described as a post-treatment wound ointment, was used after laser treatment. The scars of the treatment group and the control group were evaluated for changes in pigment, height, vascularity, and pliability using the Vancouver Scar Scale (VSS) after two laser treatments.
The total VSS score, as well as the score for melanin, height, vascularity, pliability in both groups, showed an obvious decrease following the treatments. There were statistically significant differences between before treatment and after treatment (P < .05); however, the total score of the VSS, and score of the melanin, height, vascularity, and pliability in the control group decreased more than that of treatment group, and there was a statistically significant difference (P < .05).
The 595 nm adjustable pulse width PDL combined with the fractional CO fractional laser appears to have a beneficial clinical effect on fresh red hypertrophic scars, with no severe adverse reactions seen.
目的是研究可调脉宽脉冲染料激光(PDL)与可调脉宽PDL联合分数CO2激光治疗未成熟红色增生性瘢痕的临床效果。
56例患者(56个部位)随机分为治疗组和对照组。对照组采用波长595nm的PDL治疗,能量密度为7-15J/cm²,脉宽为1.5-3ms,光斑大小为7mm。治疗组在使用波长595nm可调脉宽PDL(能量密度:7-15J/cm²,脉宽:1.5-3ms,光斑大小:7mm)后,再用分数CO2激光(UltraPulse CO2:Deep FX,能量:30~50mJ,频率:300Hz,密度5%,扫描形状和光斑大小根据瘢痕的形状和面积确定)治疗。激光治疗后使用之前描述为治疗后伤口软膏的MEBT/MEBO。在两次激光治疗后,使用温哥华瘢痕量表(VSS)评估治疗组和对照组瘢痕在色素、高度、血管分布和柔韧性方面的变化。
两组治疗后VSS总分以及黑色素、高度、血管分布、柔韧性评分均明显下降。治疗前后差异有统计学意义(P<0.05);然而,对照组VSS总分以及黑色素、高度、血管分布和柔韧性评分下降幅度大于治疗组,差异有统计学意义(P<0.05)。
595nm可调脉宽PDL联合分数CO2激光对新鲜红色增生性瘢痕似乎有有益的临床效果,未见严重不良反应。