Medical Dermatology Associates of Chicago, Chicago, Illinois.
University of Iowa Hospitals and Clinics, Department of Dermatology, Iowa City, Iowa.
Dermatol Surg. 2020 Jun;46(6):780-788. doi: 10.1097/DSS.0000000000002152.
BACKGROUND: The appearance and symptoms of scars can cause significant distress to patients. OBJECTIVE: To assess and compare efficacy of the 1,500-nm nonablative fractional laser (NAFL) and 10,600-nm ablative fractional laser (AFL) in reducing symptoms and improving the appearance of traumatic or surgical scars. MATERIALS AND METHODS: Single-center prospective, randomized, blinded, split-scar study was conducted on 100 patients with a scar obtained through trauma or surgery. Three treatments of NAFL or AFL were administered to each half of the scar at 4-week intervals. Scars were self-rated by the patient using the Patient and Observer Scar Assessment Scale and a satisfaction score and objectively evaluated by blinded dermatologists using the Manchester Scar Scale and visual analog scale. RESULTS: Blinded observers found no statistically significant difference in scar appearance. Patient rating showed improvement of scar appearance (p < .0001). Pain was worse after treatment with AFL (p = .0492). Overall, there was no statistically significant evidence of one laser being superior or inferior to the other for patient and blinded observer scores (p = .3173 and p = .2513, respectively). CONCLUSION: Scar treatment with AFL or NAFL is associated with high patient satisfaction. Objective evaluation of scars did not identify improvement in scar appearance.
背景:疤痕的外观和症状会给患者带来明显的困扰。
目的:评估和比较 1500nm 非剥脱性点阵激光(NAFL)和 10600nm 剥脱性点阵激光(AFL)治疗外伤性或手术性疤痕的疗效,以减轻症状和改善外观。
材料与方法:对 100 名因创伤或手术导致的疤痕患者进行了一项单中心前瞻性、随机、双盲、分割性疤痕研究。每半个疤痕接受 3 次 NAFL 或 AFL 治疗,间隔 4 周。患者使用患者和观察者疤痕评估量表(POSAS)和满意度评分自评疤痕,由盲法皮肤科医生使用曼彻斯特疤痕量表(MSS)和视觉模拟评分(VAS)进行客观评估。
结果:盲法观察者发现疤痕外观无统计学显著差异。患者评分显示疤痕外观改善(p <.0001)。AFL 治疗后疼痛更严重(p =.0492)。总体而言,在患者和盲法观察者评分方面,没有统计学证据表明一种激光优于另一种(p =.3173 和 p =.2513)。
结论:AFL 或 NAFL 治疗疤痕可获得较高的患者满意度。对疤痕的客观评估并未发现外观改善。
J Plast Reconstr Aesthet Surg. 2016-4