Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine (China), 639 Zhi Zao Ju Road, Shanghai, 200011, China.
Department of Plastic and Reconstructive Surgery, University of Rome "Tor Vergata", Rome, Italy.
Sci Rep. 2020 Dec 10;10(1):21694. doi: 10.1038/s41598-020-78738-9.
Hypertrophic and keloid scars result from abnormal wound healing and can have a variable response to a number of available treatment modalities. The evolution of laser treatments in recent years has shown a wide range of clinical applications including their use in the treatment of scars. We investigated the effectiveness of a 1470 nm diode laser using an intralesional optical fibre delivery device in the treatment of hypertrophic and keloid scars. We evaluated its safety and efficacy as a novel and minimally invasive treatment alternative for scar modulation and volume reduction. A prospective cohort study was performed involving 21 patients with hypertrophic scars (HS) (n = 9) and keloids (n = 12) resulting from various aetiology. Patients were treated with one to three treatment sessions. Comprehensive evaluations were performed using the Vancouver Scar Scale, Doppler ultrasound, Cutometer, Mexameter and PeriCam PSI. Scar thickness was reduced by an average of 0.308 ± 0.138 cm (p < 0.001). In particular the two subgroups showed a significant 27.7% and 28.2% reduction in scar thickness of HS and Keloids, respectively. Scar firmness showed a significant improvement of 1.2% (p < 0.05) for HS, though for keloids this was 0.4% (p = 0.26). Keloids had a significant reduction in pigmentation at 21.3%. Blood perfusion had a significant reduction of 29.6% in HS and 22.7% in Keloids. Overall VSS total score improvement of 42% in the HS and at 37.9% in the Keloid subgroup. No adverse events such as hypo/hyperpigmentation, skin infection, or recurrence were reported. This study shows that the intralesional 1470 nm bare-fibre diode laser significantly improved hypertrophic and keloid scars based on both subjective and objective analyses and supports this type of laser therapy as a safe and effective minimally-invasive treatment option.
增生性瘢痕和瘢痕疙瘩是由于异常的伤口愈合引起的，对许多可用的治疗方法有不同的反应。近年来激光治疗的发展显示出广泛的临床应用，包括其在瘢痕治疗中的应用。我们研究了一种使用腔内光纤传输装置的 1470nm 二极管激光治疗增生性瘢痕和瘢痕疙瘩的效果。我们评估了其作为一种新型微创治疗选择，用于瘢痕调节和体积减少的安全性和有效性。对 21 名因各种病因导致增生性瘢痕（HS）（n=9）和瘢痕疙瘩（n=12）的患者进行了前瞻性队列研究。患者接受了 1 至 3 次治疗。使用温哥华瘢痕量表、多普勒超声、皮肤弹性计、Mexameter 和 PeriCam PSI 进行全面评估。瘢痕厚度平均减少了 0.308±0.138cm（p<0.001）。特别是两组的 HS 和瘢痕疙瘩的瘢痕厚度分别显著减少了 27.7%和 28.2%。HS 的瘢痕硬度显著改善了 1.2%（p<0.05），而瘢痕疙瘩的改善为 0.4%（p=0.26）。瘢痕疙瘩的色素沉着减少了 21.3%。HS 的血流灌注减少了 29.6%，瘢痕疙瘩减少了 22.7%。HS 的 VSS 总评分改善了 42%，瘢痕疙瘩的改善了 37.9%。未报告任何不良反应，如色素减退/沉着过度、皮肤感染或复发。这项研究表明，腔内 1470nm 裸光纤二极管激光显著改善了增生性瘢痕和瘢痕疙瘩，基于主观和客观分析，并支持这种类型的激光治疗作为一种安全有效的微创治疗选择。
