Department of Plastic and Reconstructive Surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China.
Lasers Med Sci. 2019 Sep;34(7):1317-1324. doi: 10.1007/s10103-019-02716-5. Epub 2019 Jan 25.
To determine the combined therapeutic effect of fractional carbon dioxide laser and silicone gel on fresh traumatic scars using a rabbit ear hypertrophic scar (EHS) model, as well as on human subjects. The rabbit EHS model was established by punching four circular wounds in each ear and respectively treated with carbon dioxide laser, silicone gel, and the combination of both, while one wound was left untreated. In addition, a validation group of five rabbits was also included wherein the wounds were treated with triamcinolone, IFN-α, and normal saline, with one untreated control. The gross hyperplasic changes and the histological features were analyzed, and the scar elevation index (SEI) was calculated for each treatment group. In the rabbit model, the untreated control wounds showed hypertrophic growth, whereas triamcinolone or IFN-α showed an inhibitory effect, similar to that on hypertrophic scars in humans, thereby proving the feasibility of our animal model. The SEI peaked 2 months after treatment and was respectively 2.28 ± 0.56, 1.85 ± 0.33, 1.91 ± 0.34, and 1.45 ± 0.22 in the untreated control, and the silicone, laser, and combined treatment groups, clearly indicating a significant therapeutic effect of the combined treatment modality (p < 0.01). The fibroblast and microvascular counts also showed similar trends in each group. Early application of fractional carbon dioxide laser can prevent hypertrophic scars; the combined use of laser and silicone gel was more effective with less recovery time, thereby worthy of clinical promotion.
为了确定二氧化碳点阵激光联合硅酮凝胶对新鲜创伤性瘢痕的治疗效果，我们建立了兔耳增生性瘢痕（EHS）模型，并进行了临床研究。通过在每只兔耳上打四个圆形伤口，建立兔耳 EHS 模型，分别用二氧化碳激光、硅酮凝胶和两者联合治疗，同时留一个伤口不治疗。此外，还包括一个验证组的 5 只兔子，其中伤口分别用曲安奈德、IFN-α和生理盐水治疗，一个未治疗的对照组。分析了各组伤口的大体增生变化和组织学特征，并计算了每个治疗组的瘢痕隆起指数（SEI）。在兔模型中，未治疗的对照组伤口表现为增生性生长，而曲安奈德或 IFN-α表现出抑制作用，与人类的增生性瘢痕相似，从而证明了我们动物模型的可行性。SEI 在治疗后 2 个月达到峰值，未治疗对照组、硅酮组、激光组和联合治疗组的 SEI 分别为 2.28±0.56、1.85±0.33、1.91±0.34和 1.45±0.22，明显表明联合治疗模式具有显著的治疗效果（p<0.01）。各组的成纤维细胞和微血管计数也表现出相似的趋势。早期应用二氧化碳点阵激光可以预防增生性瘢痕；激光联合硅酮凝胶的使用效果更好，恢复时间更短，值得临床推广。
