Abdo Hamed, Shawky Ahmed, Elkholy Mohammed Shaban, Nasr Muhammad I
Department of Dermatology, Venereology, and Andrology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Arch Dermatol Res. 2025 Jan 13;317(1):236. doi: 10.1007/s00403-024-03727-1.
Atrophic acne scars present a significant therapeutic challenge. While subcision with various adjunctive treatments, including fractional CO₂ lasers and polydioxanone (PDO) threads, has been employed for scar remodeling, comparative evidence on their efficacy remains limited. This study aims to compare the clinical efficacy and patient satisfaction between subcision with fractional CO₂ laser and subcision with PDO screw threads in managing atrophic acne scars. A randomized, controlled study was conducted on 40 patients with atrophic acne scars. Patients were assigned to two groups: Group A underwent subcision with PDO screw threads insertion, and Group B underwent subcision followed by fractional CO₂ laser resurfacing. Outcomes were assessed using the Goodman and Baron grading system, Antera 3D imaging, and patient satisfaction. Significant scar improvement was observed in both groups, with Group B demonstrating greater reduction in scar severity and depth (p = 0.022). While Group A showed faster recovery and lower downtime, Group B yielded higher patient satisfaction scores. Subcision combined with fractional CO₂ laser resulted in superior long-term scar improvement, although PDO threads provided quicker recovery. The choice of treatment may depend on patient preferences and scar characteristics.
萎缩性痤疮瘢痕带来了重大的治疗挑战。虽然采用了包括分次二氧化碳激光和聚二氧六环酮（PDO）线在内的各种辅助治疗进行皮下分离以重塑瘢痕，但关于其疗效的比较证据仍然有限。本研究旨在比较分次二氧化碳激光皮下分离术和PDO螺纹皮下分离术在治疗萎缩性痤疮瘢痕方面的临床疗效和患者满意度。对40例萎缩性痤疮瘢痕患者进行了一项随机对照研究。患者被分为两组：A组接受PDO螺纹插入皮下分离术，B组接受皮下分离术，随后进行分次二氧化碳激光换肤术。使用古德曼和巴伦分级系统、Antera 3D成像和患者满意度对结果进行评估。两组均观察到瘢痕有显著改善，B组瘢痕严重程度和深度的降低更为明显（p = 0.022）。虽然A组恢复更快、停工期更短，但B组的患者满意度得分更高。皮下分离联合分次二氧化碳激光导致长期瘢痕改善更优，尽管PDO线恢复更快。治疗方法的选择可能取决于患者的偏好和瘢痕特征。
