Lasers And Intense Pulsed Light For The Prevention And Treatment Of Early Surgical Wound Scars:A Network Meta-Analysis

Objective:This paper uses network meta-analysis to analyze and compare the efficacy of various kinds of lasers and intense pulsed light on early postoperative incision scar.Methods:PubMed,Cochrane Library,Embase,CNKI,CBM),and Wanfang Data Knowledge service platform were searched up to February 2023.Randomized controlled trials on the prevention and treatment of early postoperative wound scarring with different lasers and intense pulsed light were included.Rev Man 5.4 and Stata 16 software were used for literature quality assessment and data analysis.Results:21 randomized controlled trials involving 984 early surgical wound scars and 9interventions,including pulsed dye laser,intense pulsed light,CO₂fractional laser,intense pulsed light+CO₂fractional laser,intense pulsed light+ablative Er:YAG fractional laser,LLLT,ablative Er:YAG fractional laser,pulsed dye laser+Nd:YAG laser,and He-Ne laser.The results of network meta-analysis showed that（1）in terms of improving the final Vancouver Scar Assessment Scale score of early postoperative wound scar,the ranking results of network meta-analysis from best to worst were as follows:Pulsed dye laser+Nd:YAG laser>intense pulsed light+CO₂lattice laser>LLLT>intense pulsed light+ablative Er:YAG lattice laser>pulsed dye laser>CO₂lattice laser>intense pulsed light>blank control>ablative Er:YAG lattice laser.（2）In terms of the improvement level of Vancouver Scar Assessment Scale score from baseline,the ranking results of network meta-analysis from best to worst are as follows:Pulsed dye laser+Nd:YAG laser>ablative Er:YAG laser>blank control>intense pulsed light>intense pulsed light+ablative Er:YAG laser>pulsed dye laser>CO₂lattice laser>intense pulsed light+CO₂lattice laser.（3）In terms of satisfaction rate,the ranking results of network meta-analysis from superior to inferior were as follows:intense pulsed light+CO₂lattice laser>CO₂lattice laser>intense pulsed light>Helium-neon laser>blank control;（4）In terms of efficiency,the ranking results of network meta-analysis from superior to inferior were:CO₂lattice laser>pulsed dye laser>Helium-neon laser>blank control.Conclusion:1.Prevention and treatment of early postoperative wound scars using PDL+Nd:YAG laser may enable patients to obtain the best cosmetic results of scar.The combination of IPL and ablative fractional lasers and the LLLT can also achieve good results.2.Laser and IPL have good safety in the prevention and treatment of early postoperative wound scars.