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剥脱性二氧化碳激光治疗烧伤后及创伤后萎缩性瘢痕:三级护理中心的经验

Treatment of post-burn and post-traumatic atrophic scars with fractional CO laser: experience at a tertiary care centre.

作者信息

Keen Abid, Sheikh Gousia, Hassan Iffat, Jabeen Yasmeen, Rather Shagufta, Mubashir Syed, Latif Insha, Zeerak Sumaya, Ahmad Muzafar, Hassan Aqib, Ashraf Peerzada, Younis Faizan, Saqib Najamul

机构信息

Postgraduate Department of Dermatology, Sexually Transmitted Diseases and Leprosy, Government Medical College Srinagar, Srinagar, India.

Department of Dermatology, Sexually Transmitted Diseases and Leprosy, Government Medical College Srinagar, University of Kashmir, Srinagar, Jammu and Kashmir, 190010, India.

出版信息

Lasers Med Sci. 2018 Jul;33(5):1039-1046. doi: 10.1007/s10103-018-2469-x. Epub 2018 Feb 23.


DOI:10.1007/s10103-018-2469-x
PMID:29473114
Abstract

Scars are abnormal wound responses in predisposed individuals. They occur after any kind of wound and skin inflammation in predisposed individuals. Despite their benign nature, they can be aesthetically disabling. Although several approaches have been tried in their management, most of them have produced poor results. This study aims to assess the efficacy and safety of fractional CO laser treatment in the management of post-burn and post-traumatic scars. One hundred consecutive patients (77 females and 23 males) affected by post-burn scars as well as post-traumatic atrophic scars were treated with monthly sessions of fractional CO laser treatment. Patient's response to treatment was assessed clinically as well as improvement of scars by comparing the photographs taken before treatment with those taken 6 months after the last treatment session. Changes in skin texture, surface irregularity and pigmentation were assessed on a quartile grading scale and scored individually from 0 to 4. A mean of the three individual scores was calculated and the response was labelled as 'excellent' if the mean score achieved was > 3. A score of 2-3 was labelled as good response while a score below 1 was labelled as 'poor' response. A mean of six treatments per scar were required and all patients, followed up for 1 year after the last treatment, had optimum results and no recurrence. Response to treatment was excellent in 53.75%, good in 16.25% patients, and poor in 30% patients. Fractional CO laser gives a very good result in the management of patients with post-burn scars as well as post-traumatic scars with minimal adverse effects.

摘要

瘢痕是易感个体的异常伤口反应。它们发生在易感个体的任何伤口和皮肤炎症之后。尽管其性质良性,但可能会影响美观。虽然在其治疗方面已经尝试了几种方法,但大多数效果不佳。本研究旨在评估分次二氧化碳激光治疗在烧伤后和创伤后瘢痕管理中的疗效和安全性。对100例连续的患者(77例女性和23例男性)进行治疗,这些患者患有烧伤后瘢痕以及创伤后萎缩性瘢痕,每月进行一次分次二氧化碳激光治疗。通过比较治疗前拍摄的照片与最后一次治疗后6个月拍摄的照片,临床评估患者对治疗的反应以及瘢痕的改善情况。根据四分位数分级量表评估皮肤质地、表面不规则性和色素沉着的变化,并分别从0到4进行评分。计算三个个体评分的平均值,如果平均得分>3,则将反应标记为“优秀”。得分2 - 3被标记为良好反应,得分低于1被标记为“差”反应。每个瘢痕平均需要进行六次治疗,所有患者在最后一次治疗后随访1年,均取得了最佳效果且无复发。53.75%的患者治疗反应优秀,16.25%的患者反应良好,30%的患者反应较差。分次二氧化碳激光在烧伤后瘢痕以及创伤后瘢痕患者的管理中取得了非常好的效果,且不良反应最小。

相似文献

[1]
Treatment of post-burn and post-traumatic atrophic scars with fractional CO laser: experience at a tertiary care centre.

Lasers Med Sci. 2018-7

[2]
Efficacy and Safety of Fractional CO2 Laser Resurfacing in Non-hypertrophic Traumatic and Burn Scars.

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[3]
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[4]
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J Cutan Med Surg. 2014-11

[5]
[Clinical effects of sequential laser treatments on early stage hypertrophic burn scars].

Zhonghua Shao Shang Za Zhi. 2018-9-20

[6]
Ablative CO2 fractional resurfacing in treatment of thermal burn scars: an open-label controlled clinical and histopathological study.

J Cosmet Dermatol. 2015-12

[7]
Efficacy of fractional CO2 laser in treatment of atrophic scar of cutaneous leishmaniasis.

Lasers Med Sci. 2016-5

[8]
Ultrapulsed fractional ablative carbon dioxide laser treatment of hypertrophic burn scars: evaluation of an in-patient controlled, standardized treatment approach.

Lasers Med Sci. 2017-7

[9]
Fractional CO2 laser resurfacing for atrophic acne scars: a randomized controlled trial with blinded response evaluation.

Lasers Surg Med. 2012-8

[10]
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Ann Plast Surg. 2013-5

引用本文的文献

[1]
Effect of fractional carbon dioxide laser combined with recombinant bovine basic fibroblast growth factor gel in the treatment of mature scar after facial scald burns: a retrospective cohort study.

Lasers Med Sci. 2025-8-12

[2]
Advanced Fractional CO₂ Laser Treatment for Steroid-Induced Atrophy Scars: Clinical Outcomes.

Am J Case Rep. 2025-7-7

[3]
Scar Management in Pediatric Patients.

Medicina (Kaunas). 2025-3-21

[4]
Efficacy of fractional carbon dioxide laser-assisted drug delivery in the management of post-burn scars - A prospective study.

J Cutan Aesthet Surg. 2024

[5]
Effectiveness and safety of the modified multiple mode procedures versus traditional multiple mode procedures on treating facial atrophic acne scars: a propensity score matching retrospective cohort study.

Lasers Med Sci. 2024-10-19

[6]
Subcision with platelet-rich plasma and microneedling versus subcision with saline and micro-needling in posttraumatic scars.

Arch Dermatol Res. 2024-8-19

[7]
Fractional picosecond laser treatment of non-acne atrophic scars and scar erythema in Chinese patients.

Skin Res Technol. 2024-7

[8]
Fractional CO2 Laser for Burn Scars: A Comparison of Patient-Reported Outcomes Between Those With and Without Laser Treatment.

J Burn Care Res. 2024-11-14

[9]
Prospective Evaluation of Fractional Carbon Dioxide Laser Treatment of Mature Burn Scars, Post-traumatic Scars, and Post-acne Scars.

Cureus. 2024-4-16

[10]
Observation of Wound Healing Effect and Aesthetic Satisfaction of Patient with Second Degree Burn Wounds Treated by Kangfuxin Solution.

Evid Based Complement Alternat Med. 2022-7-7

本文引用的文献

[1]
Fractional Carbon Dioxide Laser of Recent Surgical Scars in the Head and Neck Region: A Split-Scar, Evaluator-Blinded Study.

Dermatol Surg. 2017-1

[2]
Efficacy of fractional CO2 laser in treatment of atrophic scar of cutaneous leishmaniasis.

Lasers Med Sci. 2016-5

[3]
Efficacy and Safety of Fractional CO2 Laser Resurfacing in Non-hypertrophic Traumatic and Burn Scars.

J Cutan Aesthet Surg. 2015

[4]
A comparison of the scar prevention effect between carbon dioxide fractional laser and pulsed dye laser in surgical scars.

Dermatol Surg. 2014-9

[5]
Treatment of split-thickness skin graft-related forearm scar contractures with a carbon dioxide laser protocol: 3 case reports.

J Hand Surg Am. 2013-11

[6]
Fractional CO2 laser as an effective modality in treatment of striae alba in skin types III and IV.

J Res Med Sci. 2012-10

[7]
Early postoperative treatment of surgical scars using a fractional carbon dioxide laser: a split-scar, evaluator-blinded study.

Dermatol Surg. 2013-4-30

[8]
Rapid healing of scar-associated chronic wounds after ablative fractional resurfacing.

Arch Dermatol. 2012-11

[9]
Evaluation of clinical results, histological architecture, and collagen expression following treatment of mature burn scars with a fractional carbon dioxide laser.

JAMA Dermatol. 2013-1

[10]
Fractional CO2 laser resurfacing for atrophic acne scars: a randomized controlled trial with blinded response evaluation.

Lasers Surg Med. 2012-8

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