Department of Burn and Plastic Surgery, Fourth Center of Chinese People's Liberation Army General Hospital, 51# Fucheng Road, Haidian District, Beijing, 100048, China.
Department of Burn Surgery, PLA Army 32122, Zhifu District, Yantai, 264000, Shandong, China.
Lasers Med Sci. 2021 Aug;36(6):1275-1282. doi: 10.1007/s10103-020-03178-w. Epub 2020 Nov 6.
The focus of treatment of faciocervical scar contractures includes cervical reconstruction and elimination of hypertrophic scars. Unfortunately, most previous studies have neglected the esthetic appearance of scars. In this study, we tried to combine surgical therapy and ultrapulse fractional CO laser (UFCL) to eliminate facial scars while restoring neck reconstruction and to establish the optimal conventional management for faciocervical contracture. Thirty-eight individuals were enrolled and divided into two groups. After received cervical release surgeries, comprehensive UFCL therapy group received treatment of UFCL at 3-month intervals, silicone sheets, and pressure garments, while another group only received treatment of silicone sheeting and compression. Twelve months after the termination of therapy, faciocervical scars of both two groups were assessed by two uninvolved physicians according to the Vancouver Scar Scale (VSS), and patients' satisfaction survey was also recorded by the study participants using a patient four-point satisfaction scale. Thirty-six patients completed the treatment and follow-up. The results show that the VSS scores of both two groups decreased after 12 months, but comprehensive UFCL therapy group dropped more significantly than the conventional treatment group at follow-up session, which was statistically significant (P < 0.001), and the patient satisfaction was higher than that of the conventional treatment group. This comprehensive treatment combined of surgery, UFCL, silicone sheets, and pressure garments works as an effective and esthetic reconstruction for moderate to severe postburn faciocervical scar contractures.
面颈部瘢痕挛缩的治疗重点包括颈部重建和消除增生性瘢痕。不幸的是，大多数先前的研究都忽视了瘢痕的美观外观。在这项研究中，我们试图将手术治疗和超脉冲分数 CO2 激光（UFCL）结合起来，在恢复颈部重建的同时消除面部瘢痕，并建立面颈部挛缩的最佳常规管理方法。共纳入 38 名患者，并分为两组。接受颈部松解手术后，综合 UFCL 治疗组每 3 个月接受一次 UFCL 治疗、硅胶片和压力服治疗，而另一组仅接受硅胶片和压迫治疗。治疗结束 12 个月后，由两位不参与研究的医生根据温哥华瘢痕量表（VSS）评估两组的面颈部瘢痕，并由研究参与者使用患者四点满意度量表记录患者满意度调查。36 名患者完成了治疗和随访。结果表明，两组的 VSS 评分在 12 个月后均下降，但综合 UFCL 治疗组在随访时的下降幅度明显大于常规治疗组，差异具有统计学意义（P<0.001），且患者满意度高于常规治疗组。这种综合治疗方法结合手术、UFCL、硅胶片和压力服对面颈部中重度烧伤后瘢痕挛缩的重建具有有效且美观的效果。
