| Objective: To explore the efficacy of 595 nm pulsed dye laser and 595 nm pulsed dye laser combined with 1565 nm nonablative fractional laser in the treatment of early scar,and to evaluate the difference in efficacy and safety of the two treatments.Methods: Thirty patients with early scarring who presented to affiliated hospital of Inner Mongolia Medical University between August 2021 and September 2022 were collected,and all scars were divided into two parts equally,a random part of scars were treated with 595 nm pulsed dye laser as the control group,and the other part of scars were treated with 1565 nm nonablative fractional laser on the basis of 595 nm pulsed dye laser as the observation group.All scars were treated for 3 times,with an interval of 1 month.The Vancouver Scar Score Scale(VSS)and the Patient and Observer Scar Score Scale(POSAS)were used to evaluate the scar status before each treatment.Adverse reactions such as purpura,swelling and blister were followed up half a month after each treatment,and once at 3 months after the last treatment.The patients were followed up once 3 months after the last treatment.and the satisfaction of patients with the treatment of the two parts of scar was investigated,and the changes before and after scar treatment and the difference in efficacy between the two groups were compared.Results: Twenty-eight patients with early scarring completed treatment and follow-up,and 2patients discontinued treatment due to the novel coronavirus epidemic.There were no statistically significant differences in VSS and POSAS scores for the first two scars,and the two scars were comparable.The intra-group comparison of VSS score results showed that there was a significant difference in thickness compared with the pretreatment score in the observation group at follow-up(P<0.05),and no statistical difference in the control group compared with the pretreatment score,while there was a statistically significant difference in blood vessels,color,flexibility and total score between the two groups compared with the pretreatment score(P<0.05).The between-group comparison showed that there were no statistical differences in the vascular,color,softness and thickness scores of scars between the two groups at follow-up,but there were statistical differences in the total scar scores between the two groups(P=0.028).The VSS score change line chart showed that the vascular and color scores of scars in the two groups continued to decrease since the first treatment,and the observation group decreased faster and more,while the softness and thickness of the scars in the two groups increased after the first treatment,the observation group decreased after the second treatment,and the control group decreased after the third treatment,and the observation group decreased more significantly.The intra-group comparison of the total score results of the Observer Scale of POSAS showed a statistically significant difference in scar score between the two groups at follow-up compared with before treatment(P<0.001),and the between-group comparison showed a statistically significant difference in scar score between the two groups at follow-up(P=0.043),and a statistically significant difference in the improvement of scar score between the two groups(P=0.003).The intra-group comparison of the total score results of the patient scale for POSAS showed that there was a statistically significant difference between the two groups at follow-up compared with the pre-treatment score(P<0.001),and there was a statistically significant difference in scar score between the two groups at follow-up(P=0.009),and there was a statistically significant difference in the improvement of scar score between the two groups(P=0.007).The results of the patient scale pruritus score of POSAS showed that there was no statistically significant difference in the degree of pruritus scar between the two groups before treatment(P=0.617),which was comparable.The intra-group comparison showed that there was a statistically significant difference in the itch score between the two groups at follow-up compared with before treatment(P<0.001),and the between-group comparison showed that there was a statistically significant difference in the degree of scar pruritus between the two groups at follow-up(P=0.001),but there was no statistical difference in the degree of improvement in itching between the two groups(P=0.143).The line chart of pruritus score showed that the pruritus score in the observation group continued to decrease after the first treatment,and the scar itch in the control group still increased after the first treatment,and the score decreased after the second treatment,and the itch score in the observation group was lower than that in the control group at follow-up,and the itch score in the observation group decreased significantly.The satisfaction score results showed that the observation group had higher patient satisfaction than the control group,and the difference was statistically significant(P=0.013).Side effects follow-up was only purpura,swelling,blisters,which can resolve naturally,the pain caused by laser treatment can be tolerated without anesthesia,and the pain can completely subside on the same day,and all patients have no downtime.Conclusion: 595 nm pulsed dye laser alone or combined with 1565 nm nonablative fractional laser can achieve good efficacy in the treatment of early scars,combination therapy has better efficacy than single 595 nm pulsed dye laser,both treatment regimens are well tolerated by patients,no serious adverse reactions,the combined application of the two lasers can obtain higher patient satisfaction,595 nm pulsed dye laser combined with 1565 nm nonablative fractional laser can be used as an effective means for the clinical treatment of early scars. |
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