| Objective:1.To discuss the safety and efficiency of combination of CO2 laser continuous pinpoint irradiation technique with fractional CO2 laser in treatment of hypertrophic scar.2.To contrast the efficiency of fractional CO2 laser alone versus combination of CO2 laser continuous pinpoint irradiation technique with fractional CO2 laser in treatment of hypertrophic scar with prospective randomized self-controlled trail.MethodThirteen linear hypertrophic scars post cesarean section(the mean of the VSS scores was 9.85±2.19)were enrolled.The scars were randomly divided into two parts.The study group and control group were treated with same doctor at the same time in three sessions(2-month intervals).The wounds posttreatment were treated with granulocyte macrophage colony-stimulating factor cream 4 times per day.The two groups were treated with UltraPulse(?)Encore(Lumenis,Santa Clara,CA,USA).The study group was treated with combination of CO2 laser continuous pinpoint irradiation technique with fractional CO2 laser.At first,the CPG handpiece was used with one pass of the following settings:Ultrapulse model,energy 125 mJ,rate 40 Hz,continue 1-3 seconds,the space between every two points is 5 mm.And then,the DEEP handpiece was used with the following settings:ScaarFX,shape 2,size 10,pulse 1,density 3%,energy 80-120 mJ,and rate 150 Hz.The control group was treated with fractional CO2 laser alone.The DEEP handpiece was used with the following settings:ScaarFX,shape 2,size 10,pulse 1,density 5%,energy 100-150 mJ,and rate 150 Hz.Digital photographs and 3D scanning were taken before every treatment session,3 days,7 days,14 days,30 days,and 6 months after the last treatment session.And every part of scars was evaluated using VSS(Vancouver scar scale)at the same time.The degree of pain and itching of scars,the degree of pain within treatment and the grade of patient satisfaction,the degree of melanin,haemoglobin and volume of scars,the time of decrustation and side effect was recorded.Then take the data statistics and analysis.ResultThe mean of the VSS scores of hypertrophic scars pretreatment was 9.85±2.19,5.46±2.85 in study group posttreatment and 8.08± 1.98 in control group posttreatment(P<0.05).The mean degree of pain(1-10)of hypertrophic scars was 1.00± 1.22 pretreatment and 0.13±0.48 posttreatment(P<0.05).Themean degree of itching(1-10)of hypertrophic scars was 3.38±2.18 pretreatment and 1.15±1.21 posttreatment(P<0.05).The mean degree of pain(1-10)within treatment of hypertrophic scars was 4.23±1.83 in study group and 2.92±1.50 in control group(P<0.05).The grade ofpatient satisfaction(0-4)was 2.92±1.04 in study group and 1.77±0.93 in control group(P<0.05).The volume of hypertrophic scars in study group was 43.14±6.54 mm3 pretreatment and 11.63±5.87 mm3 posttreatment(P<0.05).The volume of hypertrophic scars in control group was 33.59±6.15 mm3 pretreatment and 19.63±7.56 mm3 posttreatment(P<0.05).The degree of melanin of hypertrophic scars in study group was 0.62±0.14 pretreatment and 0.41 ±0.21 posttreatment(P<0.05).The degree of melanin of hypertrophic scars in control group was 0.65±0.23 pretreatment and 0.51±0.19 posttreatment(P<0.05).The degree of haemoglobin of hypertrophic scars in study group was 1.78±0.54 pretreatment and 1.45±0.75 posttreatment(P<0.05).The degree of haemoglobin of hypertrophic scars in control group was 1.74±0.67 pretreatment and 1.59±0.89 posttreatment(P<0.05).The time of decrustation was 10.69±2.39 in study group and 8.77±2.45 in control group(P<0.05).No side effect occurred,like post-inflammatory pigmentation or infection,in the two groups.Conclusion1.The combination of CO2 laser continuous pinpoint irradiation technique with fractional CO2 laser can be used as a safe and efficacious method to treat hypertrophic scars.2.Compare with fractional CO2 laser alone,the combination of CO2 laser continuous pinpoint irradiation technique with fractional CO2 laser showed obvious therapeutic effects and less pain on the treatment of hypertrophic scars. |
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