二氧化碳点阵激光治疗烧伤瘢痕的研究进展

This paper reviews the new progress in the research of fractional carbon dioxide laser in treating hypertrophic scar after bum injury,which remains a challenging problem for burn care surgeons.There have been many traditional therapeutic approaches,such as compression remedy,operation,and so on.However,a satisfactory method is lacking to date.In recent years,the newly developed fractional carbon dioxide laser has been employed to treat different kinds of scars,and it has been proved to be effective in terms of an improvement of scar color,texture,and rigidity.It seems to be a promising method for scar treatment in future.     

Before-after cohort study to assess the efficacy of fractional ablative carbon dioxide laser treatment of pediatric hand scars

Lasers in Medical Science - The purpose of this study is to investigate the efficacy of fractional ablative carbon dioxide laser (AFXL) surgery in patients with pediatric hand scars. This study...     

Argon and carbon dioxide laser treatment of hypertrophic and keloid scars

Laser physiology has shown that while wound healing is generally excellent after laser impaction, it nevertheless is delayed. It is thought that this factor may be important in the treatment of hypertrophic and keloid scars. These scars have been treated in a variety of ways with the laser, and the results, which have been good, are reported. A possible explanation of the complex mode of action has been given. It is thought that more work should be undertaken in this field.     

Effectiveness and safety of ablative fractional CO2 laser for the treatment of burn scars: A case-control study

BackgroundBurn scars are a major clinical challenge. The aim of this study was to determine the effectiveness and safety of one treatment with the ablative fractional CO₂ laser (AFL-CO₂) compared to standard burn scar treatment.MethodFrom December 2014 to October 2018 patients were prospectively recruited and treatment effects analyzed by assessing various outcome parameters from the date of first consultation and after treatment. A case control study was conducted looking at the impact of one AFL-CO₂ treatment compared to a cohort subjected to conventional conservative treatment. Adverse effects were noted at follow up.Results187 patients were included, with 167 in the AFL-CO₂, and 20 in the control cohort. Baseline demographics and scar characteristics showed no significant differences. Ultrasound measured scar thickness as well as the Vancouver Scar Scale (VSS) revealed a significant reduction in the treatment cohort, but no significant improvement in the control group. The POSAS-O was significantly improved in both cohorts. Subjective parameters (POSAS-P, DN4-Pain, and modified D4Pruritus scores) decreased significantly in the AFL-CO₂ cohort but remained unchanged in the control group. The BSHS-B quality of life score increased significantly in the AFL-CO₂ group, but worsened at the follow up of the untreated patients. Sub-domain analyses found the biggest differences in Affect, Body Image, Heat Sensitivity, Treatment and Work. Complications occurred in 5 patients (2.9%).ConclusionsThis study demonstrates that AFL-CO₂ is an effective and safe treatment modality for burn scars improving thickness, symptoms and quality of life of burn survivors when compared to conventional scar treatment.     

压力治疗联合点阵CO2激光治疗增生性瘢痕的疗效观察

目的观察压力治疗联合点阵CO₂激光治疗增生性瘢痕的临床疗效。方法回顾分析2018年1月至2020年6月收治的烧伤后增生性瘢痕患者74例。其中,对照组采用压力治疗(42例);观察组采用压力联合点阵CO₂激光治疗(32例)。治疗结束6个月后采用温哥华瘢痕量表(VSS)进行瘢痕评分,以视觉模拟评分法(VAS)进行瘢痕瘙痒及疼痛评分,并记录不良反应发生情况。结果观察组VSS评分显著高于对照组(P<0.05),且瘢痕的瘙痒及疼痛较对照组明显减轻,差异有统计学意义(P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。结论压力治疗联合点阵CO₂激光是一种安全有效的治疗增生性瘢痕的方法。     

Preliminary results of argon and carbon dioxide laser treatment of keloid scars

Argon and CO2 lasers have been used to treat 13 patients with well-established keloid scars of the trunk or earlobe. Multiple-bore-hole argon technique and total excision with the CO2 laser were attempted. One patient with an earlobe keloid responded to treatment, all other patients had no improvement.     

增生性瘢痕的激光治疗进展

<正>瘢痕是机体组织受到创伤后异常修复的结果,在愈合过程中组织过度增生,就会形成增生性瘢痕(hypertrophic scar,HS)[1]。增生性瘢痕发生率高,常发生于手术、外伤、烧伤及炎症后,即使技术很熟练的手术和伤口护理也很难避免其发生。在瘢痕成熟和治疗的漫长时间里,数以百万的患者承受着持续的症状和功能障碍,对患者的心理、生理危害很大。既往的治疗方法有瘢痕内注射、压迫疗法、抗肿瘤药物治疗、细胞因子相关治疗、硅树脂凝胶覆盖、     

Topigel in the treatment of hypertrophic scars after burn injuries

The authors present the results of a medium-term study in which they investigated the therapeutic effect of the silicone elastomer TopiGel on developing hypertrophic scars in a group of patients after burn injuries classified as IIb or deeper. The hitherto published results are very encouraging. This medium-term study confirmed the hypothesis that TopiGel has a positive effect on the reduction, stabilization and normalization of hypertrophic scars. In 48 patients (96%) out of a total of 50, stabilization of the scar occurred as well as its functional and cosmetic normalization, although the subjective view of the patients or parents (in case of pediatric patients) differed in some instances. In two children (4%) only a significant reduction of the scar occurred and not normalization, due to incorrect application of the gel by the parents, lack of adherence to basic hygienic principles or the recommended procedure of gel application. In case of repeated complications, treatment was not pursued. In two patients (4%) treatment was discontinued for a short time due to an allergic skin reaction subsequently, treatment was resumed until complete stabilization of the scar was achieved. The study ruled out a positive therapeutic effect of the silicone sheet on the painfulness of a scar and old, mature hypertrophic scars.     

Urethral reconstruction using the carbon dioxide laser: an experimental evaluation

In an effort to test the efficacy of the carbon dioxide laser in urethral reconstruction, patch graft urethroplasty was carried out comparing laser repair to microsurgical repair. The male Sprague Dawley rat was used as the model. An oval defect was created in the ventral urethra in 65 animals and repaired with a full thickness preputial skin graft conventional microsurgical repair, laser assisted microsurgical repair, or laser repair with a protein solder. The success rate, defined as the number of animals surviving without complications at the end of 21 days, was 50, 20, and 65% respectively. In conclusion, laser assisted repair using the protein solder was significantly better than microsurgical repair (p less than 0.05).     

Fractional carbon dioxide laser for the treatment of facial atrophic acne scars: prospective clinical trial with short and long-term evaluation

The aim of this study was to evaluate the efficacy and safety of fractional carbon dioxide laser for the treatment of acne scars. Thirty-one participants, 15 female and 16 male, whose mean age was 34.84 ± 10.94 years, were included in this prospective study. The study took place between 2012 and 2016. Participants were evaluated with the “ECCA Grading Scale” before the first session, 3 months (short-term evaluation) and 3 years after the last session (long-term evaluation). Participants received two or three treatment sessions at 4-week intervals, with a 10,600 nm fractional carbon dioxide laser with pulse energies ranging between 100 and 160 mJ, 120 spot type, 75–100 spot/cm² density, and 30 W power. Self-assessments by the participants were done 3 months and 3 years after the last session. The mean ECCA score was 107.90 ± 39.38 before the first session, and 82.17 ± 36.23 at the time of short-term evaluation (p = 0.000). The grade of improvement at the short-term evaluation was as follows: no improvement, mild, moderate, and significant improvement for 7 (22.6%), 11 (35.5%), 9 (29%), and 4 (12.9%) of the participants, respectively. Regarding self-assessments, 80.6 and 61.3% of the participants rated themselves as having at least mild improvement at the short-term and the long-term follow-up periods, respectively. The results of this study suggest that fractional carbon dioxide laser is an efficient treatment option for acne scars. Furthermore, self-assessment results show that more than half of the participants still experience at least mild improvement at the end of 3 years.     

Treatment of keloids and hypertrophic scars with an argon laser

A report is given on the treatment of keloids and hypertrofic scars using an argon laser. Of the 45 patients who participated, only three patients had a diminishing of over 50%, and 40 patients were classified as obtaining slight improvement, which means a diminishing of between 20 and 50% of the original keloid. Twenty-seven patients showed no change after treatment with the argon laser and one patient had a poorer result, due to a complication after the last treatment. Directly after treatment, most keloids showed an obvious shrinkage. After several days, however, the keloids became the same size as before treatment. Decrease of tension of the skin after treatment seems to influence the result favorably. We find the best response to treatment with an argon laser in long narrow keloids (hypertrofic scars). In general, the results are disappointing, especially because until now the literature claims good results on this subject.     

醋酸曲安奈德配合585nm脉冲染料激光治疗增生性瘢痕疗效分析

目的：探讨醋酸曲安奈德联合585nm脉冲染料激光治疗增生性瘢痕的疗效。方法：收集并分析我科2004年1月～2008年12月使用醋酸曲安奈德加585nm脉冲染料激光治疗躯干、四肢及头面部58例增生性瘢痕患者的临床资料。结果：经过3个月的随访,58例增生性瘢痕患者临床治愈12例（占20．7％）,好转39例（占67．2％）,无效7例（占12．1％）,有效率为87．9％。结论：醋酸曲安奈德联合脉冲染料激光治疗是一项简单、有效的治疗方法,应用该方法可减轻患者痛苦和改善外观。     

铒玻璃1540nm点阵激光治疗面部瘢痕的疗效观察

目的:评估Lux 1540nm铒玻璃点阵激光治疗面部瘢痕的临床疗效。方法:面部瘢痕患者60例,接受1 540nmnm铒玻璃点阵激光治疗,每隔4周治疗1次,共治疗4次,评估治疗后疗效和不良反应。结果:60例患者中痊愈14例(23.33%),显效27例(45.00%),有效12例(20.00%),无效7例(11.67%),总有效率88.33%。不良反应为治疗即刻疼痛、红斑、水肿、炎症后色素沉着。结论:Lux 1 540nm铒玻璃点阵激光治疗面部瘢痕安全、有效。     

CO2点阵激光治疗汗管瘤的临床观察

目的 探讨CO2点阵激光治疗眼周汗管瘤的疗效和安全性.方法 对28例汗管瘤患者进行CO2点阵激光治疗,并分别在治疗前、治疗结束后1个月和3个月进行数码照相、记录治疗结果和不良反应.通过治疗前后对比,观察临床效果和不良反应,医师和患者各自对治疗效果的满意度进行0～4级评分.结果 28例治疗后1个月,74.99％的患者改善率超过50％;67.85％的患者达到满意或非常满意的效果.治疗后3个月,78.57％的患者改善率超过50％;71.42％的患者达到满意或非常满意的效果,与治疗后1个月对比差异无统计学意义(P＞0.05).不良反应轻微.结论 CO2点阵激光是汗管瘤安全、有效可行的治疗手段.