Effect of fractional carbon dioxide laser combined with recombinant bovine basic fibroblast growth factor gel in the treatment of mature scar after facial scald burns: a retrospective cohort study.

To evaluate the safety and efficacy of fractional carbon dioxide (CO) laser combined with recombinant bovine basic fibroblast growth factor (rb-bFGF) gel for treating mature scars secondary to facial scald burns. In this retrospective cohort study, we analyzed 123 patients with mature facial scald burn scars treated with fractional CO laser. According to whether the rb-bFGF gel was used during the treatment, patients were divided into CO + rb-bFGF group (n = 56) and CO group (n = 67). The modified Patient and Observer Scar Assessment Scale (POSAS) scar score was used to evaluate the clinical effect. Patient satisfaction and adverse events were also assessed. At the last follow-up visit, the PSAS score (mean ± SD) was statistically different between the two groups (7.74 ± 2.15 vs. 9.41 ± 1.97; P < 0.01), including color (1.79 ± 0.77 vs. 2.80 ± 1.15; P < 0.01), stiffness (1.75 ± 0.62 vs. 2.00 ± 0.50; P < 0.01), and thickness (1.96 ± 0.48 vs. 2.16 ± 0.51; P < 0.01); the OSAS score (mean ± SD) was statistically different between the two groups (11.34 ± 3.21 vs. 12.96 ± 3.12; P < 0.01), including pigmentation (1.75 ± 0.78 vs. 2.61 ± 1.20; P < 0.01), thickness (1.92 ± 0.51 vs. 2.10 ± 0.42; P < 0.05), relief (1.64 ± 0.60 vs. 1.86 ± 0.50; P < 0.05), and pliability (1.96 ± 0.62 vs. 2.24 ± 0.52; P < 0.05). For patient satisfaction and adverse events, the CO + rb-bFGF group demonstrated accelerated wound healing (4 days vs. 7 days, P < 0.01), reduced incidences of persistent erythema (5.36% vs. 19.40%, P < 0.05) and hyperpigmentation (0% vs. 8.96%, P < 0.05), and higher patient global assessment score (8.09 ± 0.60 vs. 7.02 ± 1.01; P < 0.01). Combination therapy with fractional CO₂ laser and rb-bFGF gel demonstrates superior clinical outcomes compared to laser monotherapy for mature facial scald burn scars, with significant improvements in scar characteristics, fewer complications, and better patient acceptance.