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早期应用二氧化碳点阵激光改善手术瘢痕。

Improvement of Surgical Scars by Early Intervention With Carbon Dioxide Fractional Laser.

机构信息

Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, 466 Middle Xin Gang Road, Guangzhou City, Guangdong Province, 510317, China.

出版信息

Lasers Surg Med. 2020 Feb;52(2):137-148. doi: 10.1002/lsm.23129. Epub 2019 Jul 8.

Abstract

BACKGROUND AND OBJECTIVES

Laser therapy during the early stage of wound healing can reduce surgical scar formation. Previous clinical trials showed that ablative fractional laser (AFL) therapy might have achieved the best outcomes; however, there was no consensus on the laser therapy protocol. The current study investigated the efficacy of early intervention with carbon dioxide FL (CO FL) in reducing the surgical scars in patients of all age groups to understand the effects of specific intervention timing, light dose, number of treatments, treatment interval on the therapeutic outcome, and side effects.

STUDY DESIGN/MATERIALS AND METHODS: Within 1 week after suture removal, 18 patients received low-energy CO FL therapy on their incisional wounds from facial or neck surgery. The treatments were performed once every 3 months for 1-3 sessions. After the surgical treatment, we applied a topical gel that contained recombinant human epidermal growth factor (EGF) on the incisional wounds to facilitate wound healing. The outcomes were evaluated by the Vancouver Scar Scale (VSS) and a satisfaction survey (the quartile grading scale) before and 3 months after completing the therapy was conducted. During the same period, 15 patients who had not received any treatment for about one year after face and neck surgery were randomly selected as the untreated control group.

RESULTS

In the treatment group, 18 patients had no obvious scar marks after the laser therapy. The satisfaction survey showed excellent outcomes in 16 (88.9%) patients and good outcomes in two (11.1%). After treatment, the average VSS scale and satisfaction score of the treatment group were 1.11 and 3.89, respectively; while the average VSS scale of the control group was 3.07 and the satisfaction score was 1.93. There were significant differences in VSS scale and satisfaction score between the treatment group and the control group (P < 0.01). No adverse effects were observed.

CONCLUSIONS

Early intervention with CO FL on surgical wounds achieved satisfactory outcomes in improving the surgical scars. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

摘要

背景与目的

在伤口愈合的早期阶段进行激光治疗可以减少手术瘢痕的形成。之前的临床试验表明,消融性微剥脱激光(AFL)治疗可能取得了最佳的效果;然而,对于激光治疗方案尚未达成共识。本研究旨在探讨早期应用二氧化碳(CO)飞秒激光(FL)治疗减少各年龄段患者手术瘢痕的疗效,以了解特定干预时机、光剂量、治疗次数、治疗间隔对治疗效果和不良反应的影响。

研究设计/材料与方法:在拆线后 1 周内,对 18 例接受面部或颈部手术的患者的切口进行低能量 CO2 FL 治疗。每 3 个月进行 1-3 次治疗。在手术治疗后,我们在切口上涂抹含有重组人表皮生长因子(EGF)的外用凝胶以促进伤口愈合。在治疗结束前和结束后 3 个月,采用温哥华瘢痕量表(VSS)和满意度调查(四分位等级量表)对疗效进行评估。同期,选择 15 例面部和颈部手术后约 1 年未接受任何治疗的患者作为未治疗对照组。

结果

治疗组 18 例患者激光治疗后无明显瘢痕痕迹。满意度调查显示,16 例(88.9%)患者疗效极佳,2 例(11.1%)患者疗效良好。治疗后,治疗组的平均 VSS 量表和满意度评分分别为 1.11 和 3.89,而对照组的平均 VSS 量表为 3.07,满意度评分为 1.93。治疗组和对照组在 VSS 量表和满意度评分方面差异均有统计学意义(P<0.01)。未观察到不良反应。

结论

早期应用 CO2 FL 治疗手术切口可显著改善手术瘢痕。激光外科医学杂志。© 2019 年 Wiley 期刊出版公司

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