Early fractional carbon dioxide laser intervention for postsurgical scars in skin of color

Abstract

BackgroundFractional CO2 laser is one of the most effective treatment options used to resurface scars.ObjectiveTo evaluate the efficacy and safety of early treatment of postsurgical scar by fractional ablative CO2 laser.MethodsA total of 27 Egyptian patients with recent postoperative scars were enrolled in this study. Three sessions of fractional CO2 laser with a 1-month interval were started 4 weeks after surgery. Vancouver Scar Scale (VSS) was used as an assessment tool at 1 and 3 months after the final treatment. Patients reported their satisfaction using a subjective 4-point scale.ResultsResults demonstrated a statistically significant overall average improvement of the VSS (5.33±1.33) before compared with (2.55±1.06) 3 months after the last laser treatment (P≤0.001). Among the individual parameters in the VSS, the most significant improvements were found in pigmentation, height, and pliability. Patient’s subjective satisfaction scores showed a significant greater degree of satisfaction after laser treatment.ConclusionFractional ablative CO2 laser is an effective and safe treatment modality for surgical scars in the early postsurgical period.

Comparative Study between Nd‐YAG laser, fractional CO2 Laser, and combined Nd‐YAG with fractional CO2 Laser in the Management of keloid: clinical and molecular Study

“…Using columns of coagulation in a pixilated pattern (microthermal zones) with no destructive effect on the epidermis in between columns not only leaves intact skin between these tiny cores of coagulation but also preserves the epidermis integrity 19 . Although the exact mechanism of fractional photothermolysis in treatment of keloid scars is not yet known, it is believed that columns of thermal energy characterized by focal epidermal necrosis and collagen denaturation may result in cascade of events via production of proinflammatory cytokines and growth factors that may eventually results in a normalization of collagenesis‐collagenolysis cycle 20 …”

Laser Treatment of Traumatic Scars and Contractures: 2020 International Consensus Recommendations

“…A recent randomized, split‐scar study investigated treatment with a 1,540‐nm NAFL versus no laser treatment at three time points: immediately before surgery; at suture removal; and 6 weeks after surgery, revealing modest but consistent and statistically significant improvement of VSS scores in the NAFL‐treated sides . Statistically significant improvement of VSS was also noted in a study examining the use of AFL in 27 Egyptian patients (skin type III–V) at 4 weeks post‐operative, with notable improvement of pigmentation, height, and pliability .…”

“…This is especially pertinent for patients with darker phototypes (i.e., IV–VI). Beam fractionation of ablative and non‐ablative devices has enhanced the safety and efficacy profile of laser treatment by reducing bulk heating and confluent epithelial damage while increasing the available depth of penetration . With water as the target chromophore, fractional lasers have utility for the full range of skin types.…”

Fractional CO 2 laser to improve noticeable scars after skin cancer surgery: An appraisal by the patients, laypersons, and experts

“…Several scientific studies have proven that fractional ablative and non‐ablative laser systems achieve a constant functional and cosmetic improvement of scars. 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 These lasers work according to the principle of fractional photothermolysis and lead to dermal collagen remodeling and neocollagenesis. 10 fCO 2 can be utilized earlier postoperatively than conventional ablative CO 2 laser, as well as having a shorter postprocedural recovery time.…”

“…No. of laser treatment sessions, Mean (range) 2.2(1)(2)(3)(4)(5)(6) Interval between laser treatment sessions (weeks), Mean (range)7.3 (4-12)Follow-up time (months), Mean (range) 14.7 …”