The Experimental Study: The Express And Affect Actors Of Ck19、p63After Treatment Of Superficial Scars In Rabbit Ear Using An Ultrapulse CO₂Fractional Laser

Objective：Our primary objective was to observe the wound healing after treatment ofsuperficial scars in rabbit ear using an Ultrapulse CO₂fractional laser and to comparemoisture wound care with traditional surgical wound care. Secondary objectives wereto explore the express and affect actors of CK19、P63in scar’s wound healing processafter CO₂laser treatment try to found evidence of epidermal stem cells in scarsparticipate the process of the scar’s wound healing.Methods：A total of20New Zealand big white rabbits with square wounds （1.5cm*1.5cm）in total skin and perichondrium loses on the ventral side are treated. There are2wounds in each rabbit ear totalling80wounds. The mode of superficial scars of rabbitears is established. All wounds are divided into2groups to be treated by laser:Ultrapulse CO₂fractional laser Active FX groups and Ultrapulse CO₂fractional laserDeep FX groups. After being treated by laser, these wounds are separated into2groups again: iodophor groups and MEBO groups. The treatment’s effective and thecosting time of wounds was observed and recorded everyday. The changes of2groups are evaluated through pathological sections HE staining. The expression ofCK19and P63was examined and analyzed with immunohistochemical stainingbefore laser treatment、a moment、1day、4days、7days and14days after lasertreatment. And to analyse the affect actors of CK19、P63by two kinds of UltrapulseCO₂fractional laser modes （Active FX, Deep FX） and to compare the differencewound healing result. Result:1.General observation：The wounds of the iodophor groups turned out dry and scabby after being treatedby the two kinds of laser mode in the2th³thday, and the crust started to ablate in the9th¹0thday. The wound was repaired in the14thday. The scars were smoother andlighter of color than before treatment. In MEBO groups: the wound was moist afterthe Active FX mode and had dispersed punctiform scab in the2th³thafter treatment.At the5th⁶thday, the punctiform scab were ablated. The wounds had bare scab andwas completely healed in the6th⁷thday after the Deep FX mode.Ultrapulse CO₂fractional laser Active FX mode: The wound healing time ofiodophor group is （13.7±0.65） days while the MEBO group is （10.4±0.80） days, thedifferences are significant （P<0.05）. Ultrapulse CO₂fractional laser Deep FX mode:The wound healing time of iodophor group is （9.40±0.28） days while the MEBOgroup is （7.50±0.62） days, the differences are significant （P<0.05）. The woundhealing time of Deep FX groups is faster than Active FX groups （P<0.05）.2. Pathological section: collagen fibrils became more marshalling than thepretheraphy. Lacertus were homogeneousness red dye, fiber cells were less scars andtissues had less blood vessels.3. Histologic observation: Epidermal stem cells emerged in24h after treatment,and the number of CK19、P63increased in the4days and reached the peak in the7days and deceased in the14days on MEBO group. While the number of CK19、P63increased to the peak in the4days and decreased in7days and14days on iodophorgroup. Ultrapulse CO₂fractional laser Active FX mode: The expression of CK19、P63increased on the MEBO group （70%） is higher than on the iodophor group （40%、42.5%）（P<0.05）. Ultrapulse CO₂fractional laser Deep FX mode: The expression ofCK19、P63increased on the MEBO group （62.5%、75%） is higher than on theiodophor group （35%、47.5%）（P<0.05）; The difference between Active FX mode andDeep FX mode are without statistical significance （P>0.05）. Conclusion:1. Epidermal stem cells exists in the superficial scar of rabbit ear.2.Ultrapulse CO₂fractional laser Active FX mode and Deep FX mode may resultin mico-demages of superficial scars in rabbit ears, and the wound healing withMEBO treat can better activate and protect epidermal stem cells than iodophortreatment and promote wound repair and regeneration in situ. Meanwhile, the woundhealing time of Deep FX mode is faster than that of Active FX mode in the process ofwound healing.3. An observation of the express of CK19、P63shows that the epidermal stemcells play an important role in repairing superficial scars.4. There are no obvious differences in the effect of epidermal stem cells in thetwo treatment modes （Active FX, Deep FX）.