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微等离子体射频分次治疗联合剥脱性点阵二氧化碳激光治疗增生性瘢痕的有效性和安全性:一项回顾性研究。

Effectiveness and safety of fractional micro-plasma radio-frequency treatment combined with ablative fractional carbon dioxide laser treatment for hypertrophic scar: a retrospective study.

机构信息

Department of Plastic Surgery, Affiliated Hospital of Jiangnan University, Wuxi, China.

Department of Burns and Plastic Surgery, Affiliated Hospital of Jiangnan University, Wuxi, China.

出版信息

Ann Palliat Med. 2021 Sep;10(9):9800-9809. doi: 10.21037/apm-21-2153.

Abstract

BACKGROUND

Hypertrophic scars can be caused by various injuries and lead to a decrease in quality of life of those affected. This study was performed retrospectively in our center to investigate the safety and effectiveness of fractional micro-plasma radio-frequency treatment combined with ablative fractional carbon dioxide (CO2) laser treatment in patients with hypertrophic scar.

METHODS

This was a retrospective study performed in a single center between January 2019 and December 2020. All patients with hypertrophic scars receiving fractional micro-plasma radio-frequency treatment, ablative fractional CO2 laser treatment, or combined therapy of both were recruited to the study. The participants were then divided into a single therapy group or combined therapy group. The Vancouver scar scale was used to score and subsequently assess the effectiveness of scar treatment and the changes of scar thickness. Some adverse complications were also recorded to evaluate the safety of treatments. A subgroup analysis was then performed to investigate the differences of effectiveness and safety of combined therapy in scar patients at the early stage and late stage.

RESULTS

A total of 64 patients with hypertrophic scars were enrolled in this study, including 45 receiving combined treatment, and 19 receiving single treatment. There was no significant difference in demographic data between the two groups. Notably, combined therapy could more effectively reduce the score of Vancouver scar scale (P=0.026) without significantly increasing the incidence of adverse complications. However, no significant difference was observed in scar thickness between the two groups. Moreover, multiple treatments could further increase the effectiveness of combined therapy according to either the score of Vancouver scar scale or the thickness of scars. Subgroup analysis revealed that combined therapy could reduce the score of Vancouver scar scale and scar thickness in patients much more at the early stage than at the late stage (P=0.032 and 0.042, respectively).

CONCLUSIONS

This study revealed that fractional micro-plasma radio-frequency treatment combined with ablative fractional CO2 laser treatment could be more effective in improving hypertrophic scars then single therapy. Also, multiple treatments could enhance the effectiveness of combined treatment, and patients should be encouraged to receive treatment as early as possible.

摘要

背景

肥厚性瘢痕可由各种创伤引起,并降低患者的生活质量。本研究在我院回顾性研究了微等离子体射频联合剥脱性 CO2 激光治疗肥厚性瘢痕的安全性和有效性。

方法

本研究为单中心回顾性研究,于 2019 年 1 月至 2020 年 12 月进行。所有接受微等离子体射频、剥脱性 CO2 激光或两者联合治疗的肥厚性瘢痕患者均纳入本研究。患者分为单一治疗组或联合治疗组。采用温哥华瘢痕量表(Vancouver scar scale)评分,评估瘢痕治疗效果及瘢痕厚度变化,记录不良反应并发症,评估治疗安全性。进一步对早期和晚期瘢痕患者的联合治疗效果和安全性进行亚组分析。

结果

共纳入 64 例肥厚性瘢痕患者,其中联合治疗组 45 例,单一治疗组 19 例。两组患者一般资料差异无统计学意义。联合治疗组温哥华瘢痕量表评分降低更显著(P=0.026),不良反应发生率无显著差异。两组患者瘢痕厚度无显著差异。进一步多次治疗可增加联合治疗的效果。根据温哥华瘢痕量表评分或瘢痕厚度,联合治疗在早期患者中的效果优于晚期患者(P=0.032 和 0.042)。

结论

微等离子体射频联合剥脱性 CO2 激光治疗肥厚性瘢痕较单一治疗更有效。多次治疗可提高联合治疗的效果,鼓励患者尽早接受治疗。

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