Early Intervention Of Carbon Dioxide Laser In Post-traumatic Scarring: A Randomized Controlled Study

Background and Objectives:Scarring is the result of the body's protective response to iatrogenic or traumatic injuries.Every year,hundreds of millions of patients worldwide are affected by the appearance and accompanying symptoms of scarring,especially on the head and face.There are many clinical treatments for scar,such as pressure therapy,surgical treatment,injection treatment and local treatment,but most of these treatments focus on"correcting"scar rather than"preventing and treating"scar.In recent years,with the development of the economy and the improvement of the concept of beauty,more and more patients have a strong demand for the early repair and aesthetic appearance of scars.With the development of laser,stripped lattice laser?including lattice CO₂laser and the Er:YAG laser?have been proven to be a powerful tool for treating scars,but few studies focused on the early treatment of fresh scar.In this study,fractional ablative CO₂laser was performed to intervene in the early phase of acute traumatic injury,observe the wound healing and scar hyperplasia,and evaluate the efficacy and safety of early treatment of traumatic injuries by fractional ablative CO2laser.Materials and Methods:From January 2019 to June 2019,60 patients with head and facial trauma in the emergency department of orthopedic surgery in our hospital were recruited and randomly divided into 3 groups.All the participants were over 18 years old and had full-thickness lacerations with a length of at least 3cm.The grouping was as follows:carbon dioxide laser group?group A?,silicone group?group B?,fractional ablative CO₂laser combined with silicone group?group C?.Patients in the group A received the first CO₂laser treatment on the fifth day after the removal of the suture,the laser treatment area was slightly larger than the scar area,after treatment.The operative area was kept clean and dry after treatment,with 3 to 5 solstice scabs falling off naturally.The frequency was once a month,a total of 3 times.For patients in group B,after the suture was removed and the scab was removed from the trauma site,an appropriate amount of silicone gel was applied to the affected site according to the scar size of the trauma site,and the silicone gel was used twice a day for three months.Patients in group C received the same laser treatment as group A on day 5-7after trauma and the same silicone gel treatment as group B after the laser treatment and ice compression.Vancouver scale scores?VSS?,patient satisfaction and the adverse reactions were recorded and compared in different stages of each group.Results:After 3 months of treatment,the VSS scores of group A,B,and C were 2.50±0.83,2.95±0.68and 2.01±0.56 respectively,and the difference between the groups was significant.There was no statistically significant difference between group A and group B?P>0.05?,but the score of group C was significantly lower than that of group A and group B,and the difference between the groups was statistically significant?P<0.05?.Scar score in group A was significantly lower than that in group B 6 months after treatment,with statistically significant difference?P<0.05?.The VSS of group C was lower than that of group A and group B,with statistically significant difference?P<0.05?.Group A had better satisfaction and treatment effect than group B,while group C had the best satisfaction and treatment effect,with no obvious adverse reactions after treatment.Conclusions:Carbon dioxide array laser has a significant anti-scar effect in early post-traumatic intervention therapy,and the treatment of lattice laser combined with silicone anti-scar drug is more satisfactory than that of monotherapy.