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超脉冲 CO2 激光治疗亚洲人萎缩性面瘢痕的一种新方法。

A novel technique for treating atrophic facial scars in Asians using ultra-pulse CO laser.

机构信息

Department of Dermatology, Yanbian University Hospital, Yanji, China.

Department of Dermatology, Suzhou Mylike Cosmetic Hospital, Suzhou, China.

出版信息

J Cosmet Dermatol. 2020 May;19(5):1099-1104. doi: 10.1111/jocd.13335. Epub 2020 Feb 19.

Abstract

BACKGROUND AND AIMS

Fractional lasers have become increasingly popular for treating atrophic scars, but their effectiveness is limited for deeper scars. We developed a novel technique (manual fractional thermal contraction technology, MFTCT) using an ultra-pulse CO laser and evaluated its efficacy and safety for treating atrophic facial scars.

METHODS

A total of 44 patients with atrophic facial scars were treated with MFTCT every 8 weeks for 1-4 times. Overall scar improvement was assessed by photographs taken at baseline and 3 months after the last treatment according to the 4-point global assessment scale (GAS) and ECCA grading scale. Improvements in color, distortion, and texture were assessed by the modified Manchester Scar Scale and scored individually from 1 to 4. Pain degrees and adverse reactions during and after treatment were recorded.

RESULTS

A total of 44 patients completed the treatment and follow-ups; of them, 89% reported at least 50% overall improvement after the last treatment. The mean ECCA scores fell from 67.50 ± 23.98 to 45.68 ± 18.57 (a 32% improvement), and the change was significant (P = .000). The average score for overall improvement was 3.48. The average scores for color, distortion, and texture were 3.07 ± 0.62, 3.27 ± 0.50, and 3.52 ± 0.51, respectively. Mean pain degree score was 4.27 ± 1.04, and mean erythema duration was 28.43 ± 6.58 days. Some patients developed pigmentation for a few months that resolved with topical treatment.

CONCLUSION

Manual fractional thermal contraction technology has definite clinical efficacy in the treatment of atrophic facial scars with fewer adverse reactions and is worth using in the clinical setting.

摘要

背景与目的

分束激光已成为治疗萎缩性瘢痕的热门方法,但对于较深的瘢痕,其效果有限。我们开发了一种新的技术(手动分束热收缩技术,MFTCT),使用超脉冲 CO2 激光,并评估其治疗萎缩性面部瘢痕的疗效和安全性。

方法

共 44 例萎缩性面部瘢痕患者,每 8 周接受 MFTCT 治疗 1-4 次。根据 4 分总体评估量表(GAS)和 ECCA 分级量表,在基线和末次治疗后 3 个月拍摄照片,评估整体瘢痕改善情况。采用改良曼彻斯特瘢痕量表评估颜色、变形和质地的改善情况,分别评分为 1-4 分。记录治疗中和治疗后的疼痛程度和不良反应。

结果

共 44 例患者完成了治疗和随访;末次治疗后,89%的患者报告整体改善至少达到 50%。ECCA 评分从 67.50±23.98 降至 45.68±18.57(改善 32%),差异有统计学意义(P=0.000)。总体改善的平均评分为 3.48。颜色、变形和质地的平均评分为 3.07±0.62、3.27±0.50 和 3.52±0.51。平均疼痛程度评分为 4.27±1.04,平均红斑持续时间为 28.43±6.58 天。部分患者出现数月的色素沉着,经外用治疗后缓解。

结论

手动分束热收缩技术治疗萎缩性面部瘢痕具有明确的临床疗效,不良反应较少,值得在临床中应用。

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