Haedersdal M, Poulsen T, Wulf H C
Lasers Surg Med. 1993;13(1):55-61. doi: 10.1002/lsm.1900130111.
Scarring is a well-known side effect to cutaneous laser treatment. Therefore we investigated if wounds and scarring could be decreased by pharmacological interference in the acute inflammatory reaction following laser therapy. A copper vapor laser operating at 578 nm was used at three different intensities and doses. The antiinflammatory drugs methylprednisolone (1 mg/kg/24 h) and indomethacin (2 mg/kg/24 h) were administered through the drinking water. The laser induced wounds were evaluated daily and histologic and biochemical analyses were used to estimate scarring. The administration of antiinflammatory drugs resulted at some laser intensities in increased scores of maximum wound area, healing time, cumulated wound area, fibrosis, hydroxyproline, and hydroxylysine, being mostly pronounced for indomethacin at 0.8 W/spot. The maximum wound area and the wound healing time could be used as a predictor of scarring. A dose response was shown between the laser intensities and the mentioned parameters. We recommend carefulness in the laser treatment of patients receiving indomethacin and disrecommend use of the drug in the prophylaxis against laser induced scarring.
瘢痕形成是皮肤激光治疗众所周知的副作用。因此，我们研究了在激光治疗后的急性炎症反应中，通过药物干预是否可以减少伤口和瘢痕形成。使用了一台波长为578 nm的铜蒸气激光，设置了三种不同的强度和剂量。通过饮用水给予抗炎药物甲泼尼龙（1 mg/kg/24 h）和吲哚美辛（2 mg/kg/24 h）。每天评估激光诱导的伤口，并通过组织学和生化分析来评估瘢痕形成。在某些激光强度下，给予抗炎药物会导致最大伤口面积、愈合时间、累积伤口面积、纤维化、羟脯氨酸和羟赖氨酸的评分增加，在0.8 W/光斑时，吲哚美辛的这种影响最为明显。最大伤口面积和伤口愈合时间可作为瘢痕形成的预测指标。激光强度与上述参数之间呈现剂量反应关系。我们建议在对接受吲哚美辛治疗的患者进行激光治疗时要谨慎，并不建议使用该药物预防激光诱导的瘢痕形成。
