Keshk Zaynab Sayed, Salah Manal Mohammad, Samy Nevien Ahmed
National Institute of Laser Enhanced Science, Egypt Cairo University, Al Giza, Egypt.
Lasers Med Sci. 2025 Mar 12;40(1):137. doi: 10.1007/s10103-025-04371-5.
Hypertrophic scar could be associated with several complications that interfere with patient daily activities, physical and psychological health and impact patient quality of life. Several therapeutics and maneuvers are used for treatment of hypertrophic scar with variable success and side effects. We aim to evaluate safety and efficacy of fractional carbon dioxide laser on treatment of hypertrophic scar both clinically and histopathologically. Hypertrophic scars in each patient of total thirty patients were subjected to random division with sealed envelope into two parts, part A treated with fractional carbon dioxide laser every month for 5 sessions, and part B lift without treatment for control. Hypertrophic scars in each patient were single or multiple, Single scar was more than 15 cm length. Clinical evaluation was done by two blinded dermatologists, using Vancouver Scar Scale (VSS) and Patient and Observer Scar Assessment Scale (POSAS) for each part before, 3 months and 6 months after treatment. Histopathological evaluation was done for each part before and 3 months after treatment by measuring epidermal thickness, collagen area percent, and elastin area percent. The upper significant clinical and histopathological improvement was shown in carbon dioxide laser treated parts than control parts without significant side effects for fractional carbon dioxide laser treatment. Treatment of hypertrophic scar with fractional carbon dioxide laser is beneficial and generally considered safe, with minimal risk of harm when performed with appropriate laser parameters for male and female patients with skin type III and IV, at different ages and different body regions.
增生性瘢痕可能与多种并发症相关，这些并发症会干扰患者的日常活动、身心健康，并影响患者的生活质量。目前有多种治疗方法和手段用于治疗增生性瘢痕，但疗效和副作用各不相同。我们旨在从临床和组织病理学方面评估二氧化碳点阵激光治疗增生性瘢痕的安全性和有效性。将总共30例患者的增生性瘢痕用密封信封随机分为两部分，A部分每月接受5次二氧化碳点阵激光治疗，B部分作为对照不进行治疗。每位患者的增生性瘢痕为单发或多发，单个瘢痕长度超过15厘米。由两名不知情的皮肤科医生进行临床评估，在治疗前、治疗后3个月和6个月，使用温哥华瘢痕量表（VSS）和患者与观察者瘢痕评估量表（POSAS）对每部分瘢痕进行评估。在治疗前和治疗后3个月，通过测量表皮厚度、胶原面积百分比和弹性蛋白面积百分比对每部分瘢痕进行组织病理学评估。与对照部分相比，二氧化碳激光治疗部分在临床和组织病理学方面有显著改善，且二氧化碳点阵激光治疗无明显副作用。对于不同年龄、不同身体部位、皮肤类型为III型和IV型的男性和女性患者，使用适当的激光参数，二氧化碳点阵激光治疗增生性瘢痕是有益的，且一般认为是安全的，危害风险极小。
