Department of Dermatology and Venereology, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Australas J Dermatol. 2022 Feb;63(1):27-35. doi: 10.1111/ajd.13730. Epub 2021 Oct 10.
Hypertrophic scars present collagen deposition and an abnormal extracellular matrix that cause abnormal shape changes and limit normal movement. Although fractional carbon dioxide (CO ) laser therapy has provided promising evidence, the improvement of scarring has not been thoroughly reviewed. A systematic review of prospective randomised trial articles collected from PubMed, MEDLINE, EMBASE, Cochrane and Scopus databases was conducted on 15 March 2020 in accordance with the PRISMA-P statement. Types and duration of fractional carbon dioxide laser used in this study along with the comparative modalities were recorded in this review. Treatment efficacy was assessed as the primary outcome. Adverse events and patient satisfaction were assessed as the secondary outcome. Five prospective randomised studies were included in this study. All studies included showed a consistent result with a conclusion that CO fractional laser treatment demonstrated statistically significant improvement for various scar scoring methods. Combination with other modalities may yield better results in some studies with the risk of more severe adverse events. Temporary side effects such as itching or burning sensation, erythema and oedema were present but appeared to be minimal and well tolerated. Overall patients reported significant improvement in quality of life. Some of the studies are uncontrolled with relatively short-term follow-up. Controlled comparative studies within the same scar with larger sample size and longer follow-up period are required. This evidence suggests that fractional CO laser treatment is effective for improving the clinical appearance of hypertrophic scars with a good safety profile.
增生性瘢痕表现为胶原沉积和细胞外基质异常，导致形状异常改变并限制正常运动。尽管分 子 CO2（CO2）激光治疗提供了有希望的证据，但瘢痕的改善尚未得到彻底审查。根据 PRISMA-P 声明，于 2020 年 3 月 15 日在 PubMed、MEDLINE、EMBASE、Cochrane 和 Scopus 数据库中对前瞻性随机试验文章进行了系统综述。本研究记录了所使用的分 子 CO2 激光的类型和持续时间以及比较方式。治疗效果作为主要结局进行评估。不良事件和患者满意度作为次要结局进行评估。本研究纳入了 5 项前瞻性随机研究。所有研究的结论一致，表明 CO2 分 子激光治疗在各种瘢痕评分方法上均显示出统计学上显著的改善。与其他方式联合使用可能会在一些研究中产生更好的效果，但不良事件的风险也更高。暂时的副作用，如瘙痒或烧灼感、红斑和水肿存在，但似乎轻微且耐受良好。总体而言，患者报告生活质量显著改善。一些研究是无对照的，随访时间相对较短。需要在同一瘢痕内进行具有更大样本量和更长随访时间的对照比较研究。这一证据表明，分 子 CO2 激光治疗对改善增生性瘢痕的临床外观是有效的，且安全性良好。
