脉冲CO2点阵激光治疗痤疮瘢痕不良反应及并发症分析

目的：明确脉冲CO2点阵激光的不良反应及并发症。方法：回顾性分析48例接受脉冲CO2点阵激光治疗的患者的随访资料,评价治疗后不良反应、并发症类型及持续时间。结果：48例痤疮瘢痕患者治疗后红斑平均持续时间（6．1±2）天,痂平均持续时间（4．2±1．9）天,疼痛平均持续时间（2．3±1．2）天,Vas疼痛评分（3．3±2．1）分。45．2％的患者出现炎症后色素沉着,平均持续时间（32±7）天,术后并发症的发生率为22．9％,其中单纯疱疹发生率为6．2％,炎症反应发生率为10．4％。结论：脉冲CO2点阵激光治疗后不良反应及并发症均为短期自限性。     

Combination therapy using non‐ablative fractional laser and intralesional triamcinolone injection for hypertrophic scars and keloids treatment

Combinations of various treatment modalities were shown to be more effective than monotherapy when treating hypertrophic scars and keloids. This study was conducted to assess the effectiveness of combination therapy with non‐ablative fractional laser and intralesional steroid injection. From May 2015 to June 2017, a total of 38 patients with hypertrophic scars or keloids were evaluated. The control group of 21 patients received steroid injection alone, and 17 patients (the combined group) received 1550‐nm erbium‐glass fractional laser treatment and steroid injection simultaneously. The mean number of treatment sessions was statistically fewer in the combined group than in the control group (6.95 vs 5.47, P = .042). There was a significant difference in the patient's scale in the combined group (14.62 vs 22.82, P = .005); however, the observer's scale was not significantly different (17.92 vs 20.55, P = .549). The recurrence rate was 38.1% (8/21) in the control group and 35.3% (6/17) in the combined groups and showed no significant difference (P = .859). However, the mean remission period was statistically longer in the combined group (3.00 months vs 4.17 months, P = .042). Combination therapy with non‐ablative fractional laser and intralesional steroid injection showed better results for the treatment of hypertrophic scars and keloids with fewer treatment sessions, better patient satisfaction, and longer remission periods.     

点阵铒激光治疗面部各种瘢痕的疗效及影响因素分析

目的:观察应用点阵铒激光治疗面部各种瘢痕的疗效,并对影响疗效的各种因素进行分析。方法:应用点阵铒激光对132例面部瘢痕患者皮损进行磨削、大范围平扫,分析对比依据不同影响因素分组后各组显效率差异,探索对治疗效果有影响的相关因素。结果:所有患者治疗后随访6个月,有效率97.8%,显效率85.7%,无严重不良反应。患者病史长短、皮损的临床分型、病损程度各组显效率差异有统计学意义(P<0.05),性别等其他因素对疗效无影响。结论:点阵铒激光治疗面部瘢痕疗效好,不良反应小,皮损稳定后及早治疗预后较好,皮损程度轻者预后较好,不同临床分型治疗效果不同。     

超脉冲CO_2激光联合点阵铒激光治疗面部凹陷性瘢痕与增生性瘢痕的疗效比较

目的：比较超脉冲CO2激光联合点阵铒激光治疗面部凹陷性瘢痕与增生性瘢痕的临床效果。方法：2007年3月～2010年1月,我们应用超脉冲CO2激光联合点阵铒激光治疗面部瘢痕患者71例,其中凹陷性瘢痕33例和增生性瘢痕38例,分析两组病例疗效差别及可能的原因。结果：所有患者总有效率为77.5%,凹陷性瘢痕组有效率为87.9%,而增生性瘢痕组为68.4%,两组间有效率差别有统计学意义（P〈0.05）。结论：超脉冲CO2激光联合点阵铒激光是治疗面部瘢痕的方法之一,面部凹陷性瘢痕的疗效优于增生性瘢痕。     

Combined treatment for facial rejuvenation using an optimized pulsed light source followed by a fractional non‐ablative laser

Background

Combination laser treatments can potentially increase the effectiveness of treatment without the additional downtime associated with another procedure.

Objective

To assess the effectiveness and safety of combining non‐ablative fractional treatments with optimized intense pulsed light.

Methods and Materials

Ten subjects (Group A) received full face treatments with a non‐ablative fractional either followed or preceded by an optimized intense pulsed light source. Twenty‐six subjects (Group B) received only full face treatments with the same non‐ablative, fractional laser device.

Results

For Group A, the overall average Fitzpatrick Wrinkle Scale for all patients improved from 6.3 ± 1.1 at baseline to 5.9 ± 0.8 one month following one treatment for an average improvement of 0.4 ± 0.6 (P < 0.10 paired t‐test n = 9). The average pigment improvement score was 1.8 ± 0.9 on a 4‐point scale. In Group B, the average Fitzpatrick Wrinkle Scale improved from 6.0 ± 1.6 at baseline to 5.2 ± 1.4 at 3 months for an average improvement of 0.8 ± 0.7 (P < 0.001, n = 26 paired t‐test). The average pigment improvement score was 1.4 ± 1.0 (P < 0.001, t‐test, n = 26). Adverse events were similar in the two groups.

Conclusion

The combination of an optimized intense pulsed light source with a non‐ablative fractional laser during the same treatment session is safe and effective. Lasers Surg. Med. 45:405–409, 2013. © 2013 Wiley Periodicals, Inc.     

Early postoperative treatment of thyroidectomy scars using botulinum toxin: A split‐scar,double‐blind randomized controlled trial

Operational scars, especially those located on the exposed parts of the body, can be distressing. Despite high demand for an early intervention to minimize surgical scars, there is yet no universal consensus on optimal treatment. A split‐scar, double‐blind randomized controlled trial was held to assess the safety and efficacy of early postoperative botulinum toxin type A (BTA) injection in surgical scars. A single session of treatment was performed where BTA was allocated to one half of the scar and 0.9% saline to the control half. Scars were assessed using the modified Stony Brook Scar Evaluation Scale (SBSES) with standardized photographs. Fifteen patients completed the study, and their data were analyzed. At 6 months' follow‐up, a significant improvement in SBSES score was noted for the BTA‐treated halves of the scars (p < 0.001), with minimal change on the saline‐treated side (p = 0.785). The mean calculated difference in SBSES scores (final/initial) between the BTA‐treated side and the saline‐treated side was also significant (p < 0.001). Early postoperative BTA injection was safe and effective in modulating thyroidectomy scars and may be a promising option for scar prevention.     

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.