Clinical effect of fractional carbon dioxide laser in the treatment of contracture scars

Xi Wenjing; Zhang Zheng; Li Jie; Su Weijie; Li Hua; Pu Zheming; Zhang Yan; Feng Shaoqing; Zhang Yixin

doi:10.3760/cma.j.cn501120-20210624-00225

Volume 37 Issue 8

Aug. 2021

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Article Navigation > CHINESE JOURNAL OF BURNS AND WOUNDS > 2021 > 37(8): 711-717

Cao Xiaozan, Xie Ting, Lu Shuliang. Receptor pathways of glycated basic fibroblast growth factor affecting the proliferation and vascularization of human dermal microvascular endothelial cells[J]. Chin j Burns, 2021, 37(1): 17-24. DOI: 10.3760/cma.j.cn501120-20200916-00412

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Xi WJ,Zhang Z,Li J,et al.Clinical effect of fractional carbon dioxide laser in the treatment of contracture scars[J].Chin J Burns,2021,37(8):711-717.DOI: 10.3760/cma.j.cn501120-20210624-00225.

Citation:

Xi WJ,Zhang Z,Li J,et al.Clinical effect of fractional carbon dioxide laser in the treatment of contracture scars[J].Chin J Burns,2021,37(8):711-717.DOI: 10.3760/cma.j.cn501120-20210624-00225.

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Clinical effect of fractional carbon dioxide laser in the treatment of contracture scars

doi: 10.3760/cma.j.cn501120-20210624-00225

Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China

Funds:

General Program of National Natural Science Foundation of China 81772098

Youth Program of National Natural Science Foundation of China 81801918, 82000456, 82002064, 81801917

Shanghai Hospital Development Center Three-year Program of China SHDC2020CR2045B

Excellent Technology Leader Plan of Shanghai Science and Technology Commission of China 18XD1423700

Scientific Research Project of Shanghai Municipal Commission of Health and Family Planning of China 20154Y0023

Peak Plateau Plan of Shanghai Education Commission "Research Doctors" Project of China 20152227

Industry Supporting Foundation of Huangpu District of Shanghai XK2020008

Interdisciplinary Program between Medicine and Engineering of Shanghai Jiao Tong University YG2019QNB09

Construction Project of Clinical Research Multidisciplinary Diagnosis and Treatment Team of Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine 2017-1-007

Clinical Research Booster Program of Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine JYLJ027

Interdisciplinary Foundation of Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine JYJC202009

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Corresponding author: Zhang Yixin, Email: zhangyixin6688@163.com
Received Date: 2021-06-24

Abstract

Abstract

Objective To explore the clinical effect of the fractional carbon dioxide laser in the treatment of contracture scars. Methods A retrospective before-after self-control study was conducted. From December 2016 to April 2021, 16 patients (7 males and 9 females, aged 3-49 years) with contracture scars causing impaired function of the adjacent joint were admitted to Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. Eighteen joint scars of 16 patients were treated with fractional carbon dioxide laser every 2-3 months until the joint retained its normal range of motion or the effect plateaued. The treatment times of each patient were recorded. Before the first treatment and 6 months after the last treatment, the ranges of motion of the affected joint were measured in each patient, and the difference was calculated, meanwhile, the Vancouver Scar Scale (VSS) was used to evaluate the scar of each patient. In the treatment of 1 joint scar in each of 6 patients (totally 6 times of treatments), the ranges of motion of the affected joint before the current treatment, immediately after the treatment, and at the first follow-up after the treatment were documented, and the differences between the ranges before and immediately after the treatment as well as between the ranges before and at the first follow-up after the treatment were calculated. Adverse effects after the treatment in the treatment area were documented. At the last follow-up, a self-made questionnaire was used to collect the implementation status of the physical therapy and other scar management modalities during the treatment interval and follow-up period. Data were statistically analyzed with Wilcoxon rank sum test. Results Eighteen joint scars in 16 patients received 2 (1, 3) times of fractional carbon dioxide laser treatment. The range of motion of the affected joint of 16 patients 6 months after the last treatment was 56.5 (39.0, 128.8)°, notably higher than 38.4 (22.9, 116.3)° before the first treatment (Z=-3.724, P<0.01), showing a remarkable improvement by 17.4 (8.0, 24.1)°. The vascular distribution, softness, and thickness scores, and total score in VSS scoring of scars of 16 patients 6 months after the last treatment were significantly lower than those before the first treatment (Z=-2.989, -3.762, -2.814, -3.739, P<0.01), with the most obvious improvement in softness. In 6 times of treatments, the range of motion of the affected joint immediately after treatment and at the first follow-up of (2.5±0.6) months after treatment were 156.2 (148.0, 164.2)° and 160.2 (156.7, 166.4)°, both notably higher than 151.4 (145.7, 155.3)° before treatment (Z=-2.201, -2.201, P<0.05), showing a remarkable improvement by 9.1 (4.4, 13.0)° and 13.1 (8.0, 15.7)°, respectively. No adverse effects such as blisters, infection, or hypertrophic scar formation were observed in the treatment area of 16 patients after treatment. Most patients adopted physical therapy, compression, silicone gel or sheets, and braces during the treatment interval and follow-up period. Conclusions The fractional carbon dioxide laser can soften the scar and increase the range of motion of the affected joint, which is suitable for the clinical treatment of mild contracture scars.
- Cicatrix,
- Laser therapy,
- Comparative effectiveness research

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References

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Clinical effect of fractional carbon dioxide laser in the treatment of contracture scars

doi: 10.3760/cma.j.cn501120-20210624-00225