3D Mesh Releasing Method: A Retrospective Analysis of Fractional CO₂ Treatment on Contracture Scars

Abstract

Background and Objectives There has been reports on fractional CO2 laser successfully improving contracture scars that impair the function of a joint. It seems that certain contracture problems could be solved by laser instead of surgery. However, the clinical application could be difficult when the efficacy of the method remains unknown. The purpose of this study is to report the releasing capacity of the fractional CO2 laser on contracture scars based on a defined treatment method. Study Design/Materials and Methods We conducted a retrospective study in patients with limited function in joints caused by contracture scars. Fractional CO2 laser and our “3D mesh releasing” protocol were applied. The primary outcome was the improvement measured in range of motion (ROM) of the relevant joint before all intervention and 6 months after the last treatment. Result From November 2016 to January 2018, 11 joints of 10 cases were treated by the fractional CO2 laser. Patients went through 2.27 (standard deviation [SD] 1.42, 1‐5) sessions. The average progress of ROM before and 6 months after all treatments was 19.13° (SD 10.25, P < 0.02). In six cases, we recorded that there was an 8.53° (SD 5.81, P < 0.02) of increase in ROM immediately after the laser session, and the average improvement reached up to 13.58° (SD 8.15, P < 0.02) after 2–3 months during the next follow‐up. Conclusion The fractional CO2 laser could achieve functional improvement in contracture scars and it maintained its effect for at least 6 months. The “3D Mesh Releasing” protocol would help to standardize the treatment procedure. This modality has minimal‐invasiveness and potentially could become a supplement to the current treatment choices for mild contracture scars. Lasers Surg. Med. © 2020 Wiley Periodicals LLC

Effects of multiple modes of UltraPulse fractional CO2 laser treatment on extensive scarring: a retrospective study

“…Second, posttreatment collagen rearrangement changed the flexibility and texture of the scar, preventing further progression and joint dysfunction and conferring a therapeutic advantage. CO 2 laser treatment is also effective on contracted scars, and the treatment effect lasts at least 6 months [ 33 ]. In our study, the earliest laser treatment took place 4 weeks after injury, and the recipient did not show joint dysfunction even after a 1-year follow-up.…”

Abstracts

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Congress Report on the Second World Congress of Global Scar Society with Scar Academy and Japan Scar Workshop

“…Dr. Zhang mentioned that such minimal-invasiveness modality could potentially serve as a supplement to the current treatment ladder for contracture scars. 41 Laser therapies' effects on scar therapy are induced by disrupting the high blood flow in the scars, decreasing fibroblast proliferation, type III collagen deposition, and histamine release. Fractional laser therapy stimulates a wound healing response that involves heat shock proteins and myofibroblasts, resulting in promoting scar remodeling.…”

“…Dr. Zhang mentioned that such minimal-invasiveness modality could potentially serve as a supplement to the current treatment ladder for contracture scars. 41 …”