Xi Wenjing, Xie Yixin, Zhang Zheng, Li Ke, Wang Jingyan, Li Jie, Feng Shaoqing, Hultman C Scott, Liu Ying, Zhang Yixin
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
Lasers Surg Med. 2021 Feb;53(2):227-235. doi: 10.1002/lsm.23262. Epub 2020 May 20.
There has been reports on fractional CO laser successfully improving contracture scars that impair the function of a joint. It seems that certain contracture problems could be solved by laser instead of surgery. However, the clinical application could be difficult when the efficacy of the method remains unknown. The purpose of this study is to report the releasing capacity of the fractional CO laser on contracture scars based on a defined treatment method.
STUDY DESIGN/MATERIALS AND METHODS: We conducted a retrospective study in patients with limited function in joints caused by contracture scars. Fractional CO laser and our "3D mesh releasing" protocol were applied. The primary outcome was the improvement measured in range of motion (ROM) of the relevant joint before all intervention and 6 months after the last treatment.
From November 2016 to January 2018, 11 joints of 10 cases were treated by the fractional CO laser. Patients went through 2.27 (standard deviation [SD] 1.42, 1-5) sessions. The average progress of ROM before and 6 months after all treatments was 19.13° (SD 10.25, P < 0.02). In six cases, we recorded that there was an 8.53° (SD 5.81, P < 0.02) of increase in ROM immediately after the laser session, and the average improvement reached up to 13.58° (SD 8.15, P < 0.02) after 2-3 months during the next follow-up.
The fractional CO laser could achieve functional improvement in contracture scars and it maintained its effect for at least 6 months. The "3D Mesh Releasing" protocol would help to standardize the treatment procedure. This modality has minimal-invasiveness and potentially could become a supplement to the current treatment choices for mild contracture scars. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.
已有报道称，分次二氧化碳激光成功改善了影响关节功能的挛缩瘢痕。似乎某些挛缩问题可用激光而非手术解决。然而，当该方法的疗效未知时，其临床应用可能会有困难。本研究的目的是基于一种明确的治疗方法，报告分次二氧化碳激光对挛缩瘢痕的松解能力。
研究设计/材料与方法：我们对因挛缩瘢痕导致关节功能受限的患者进行了一项回顾性研究。应用了分次二氧化碳激光和我们的“三维网状松解”方案。主要结局是在所有干预前及最后一次治疗后6个月，测量相关关节的活动范围（ROM）的改善情况。
2016年11月至2018年1月，对10例患者的11个关节进行了分次二氧化碳激光治疗。患者接受了2.27次（标准差[SD]1.42，1 - 5次）治疗。所有治疗前及治疗后6个月ROM的平均进展为19.13°（SD 10.25，P < 0.02）。在6例患者中，我们记录到激光治疗后ROM立即增加了8.53°（SD 5.81，P < 0.02），在下一次随访的2 - 3个月后平均改善达到13.58°（SD 8.15，P < 0.02）。
分次二氧化碳激光可实现挛缩瘢痕的功能改善，并至少维持6个月的效果。“三维网状松解”方案有助于规范治疗程序。这种方式具有微创性，有可能成为轻度挛缩瘢痕当前治疗选择的一种补充。激光外科医学。©2020威利期刊有限责任公司。
