Department of Plastic Surgery, the First Affiliated Hospital of Fujian Medical University, NO.20 Chazhong Rd., Taijiang District, Fuzhou, 350020, Fujian Province, China
Eur J Dermatol. 2022 Nov 1;32(6):770-780. doi: 10.1684/ejd.2022.4380.
Laser intervention is increasingly recognized as an effective approach to preventing scars, however, as lasers of different wavelengths reach different target tissues, an appropriate combination of laser treatment is required.
To evaluate the efficacy of combining erbium: yttrium aluminium garnet (Er:YAG) 2,940-nm laser and fractional carbon dioxide (CO2) 10,600-nm laser for the treatment of facial scarring.
MATERIALS & METHODS: Medical records of 39 patients with facial scars were retrospectively reviewed. Treatments initiated within six months post-injury were defined as "early-intervention", whereas those initiated >six months post-injury were defined as "delayed-intervention". Patients' scores on the Vancouver Scar Scale (VSS) and Visual Analogue Scale (VAS) were collected and compared between different timepoints using the paired t-test. Improvement in pigmentation, height, vascularity and pliability was analysed between baseline and after final treatment.
Between March 2020 and March 2022, 39 patients underwent dual-laser therapy at our laser clinic. The average number of treatments was 4.69 1.54; 18 patients in the early-intervention and 21 patients in the delayedintervention group. Facial scars significantly improved after the first treatment in the delayed-intervention group (p < 0.001), however, there was no significant improvement until two sessions were completed in the early-intervention group (p < 0.001). In the delayed-intervention group, improvement in vascularity was insignificant (p = 0.083), however, improvement in height and flexibility was prominent (p < 0.001). In the early-intervention group, facial scars improved in all four dimensions of VSS (p < 0.05), with improvement of vascularity being the most significant. Side effects were self-limited, and complications were not noted.
The combination of Er:YAG and fractional CO2 laser is a safe and effective therapeutic modality for facial scarring.
激光干预越来越被认为是预防疤痕的有效方法，然而，由于不同波长的激光到达不同的靶组织，因此需要适当的激光治疗组合。
评估铒：钇铝石榴石（Er:YAG）2,940nm 激光和分 10,600nm 二氧化碳（CO2）激光联合治疗面部瘢痕的疗效。
回顾性分析 39 例面部瘢痕患者的病历。伤后 6 个月内开始的治疗定义为“早期干预”，伤后>6 个月开始的治疗定义为“延迟干预”。收集患者温哥华瘢痕量表（VSS）和视觉模拟量表（VAS）的评分，并采用配对 t 检验比较不同时间点的评分。分析基线和最后一次治疗后色素沉着、高度、血管和柔韧性的改善情况。
2020 年 3 月至 2022 年 3 月，39 例患者在我院激光诊所接受双激光治疗。平均治疗次数为 4.69±1.54；18 例早期干预，21 例延迟干预。延迟干预组在首次治疗后面部瘢痕明显改善（p<0.001），但早期干预组直到完成两次治疗才有明显改善（p<0.001）。在延迟干预组，血管改善不显著（p=0.083），但高度和柔韧性改善显著（p<0.001）。在早期干预组，VSS 的所有四个维度（p<0.05）的面部瘢痕均有改善，其中血管改善最为显著。不良反应均为自限性，未发生并发症。
Er:YAG 和分 CO2 激光联合是治疗面部瘢痕的安全有效的治疗方法。
