Volume 21 Issue 2
Feb.  2023
Turn off MathJax
Article Contents
LIU Ji-song, XING Fu-xi, FU Quan-you, ZHANG Xiang-zhou, LI Yong, XU Dong-wei. Evaluation of fractional carbon dioxide laser in the treatment of early hypertrophic scars after deep burns in children[J]. Chinese Journal of General Practice, 2023, 21(2): 250-254. doi: 10.16766/j.cnki.issn.1674-4152.002857
Citation: LIU Ji-song, XING Fu-xi, FU Quan-you, ZHANG Xiang-zhou, LI Yong, XU Dong-wei. Evaluation of fractional carbon dioxide laser in the treatment of early hypertrophic scars after deep burns in children[J]. Chinese Journal of General Practice, 2023, 21(2): 250-254. doi: 10.16766/j.cnki.issn.1674-4152.002857

Evaluation of fractional carbon dioxide laser in the treatment of early hypertrophic scars after deep burns in children

doi: 10.16766/j.cnki.issn.1674-4152.002857
Funds:

 AHW2021a042

 蚌人才(2020)8号

  • Received Date: 2022-06-17
    Available Online: 2023-04-20
  •   Objective  This study aims to investigate the efficacy and safety of dot-matrix carbon dioxide laser in the treatment of early hypertrophic scar after deep burn in children.  Methods  A total of 68 children with deep burns who met the inclusion criteria and were admitted to the Department of Burn and Plastic Surgery, the Third People's Hospital of Bengbu from July 2019 to May 2021 were selected, including 44 males and 24 females. The patients were randomly divided into observation group (n=33) and control group (n=35). Both groups were given conventional treatment (pressure therapy and drug therapy), while the observation group was given carbon dioxide fractional laser on the basis of conventional treatment. The vancouver scar scale (VSS) and the patient and observer scar assessment scale (POSAS) were used to score patients, and adverse reactions and patient satisfaction were recorded.  Results  The overall scores of VSS [(5.54±1.41) points], OSAS [(3.42±0.79) points] and PSAS [(4.00±0.79) points] in the observation group were significantly improved at 3 months after treatment compared with those VSS [(8.24±1.73)], OSAS [(5.00±0.82)], and PSAS [(5.48±0.97)] before treatment, and the differences were all statistically significant (all P < 0.05). The overall scores of VSS [(6.94±1.64) points], OSAS [(4.28±0.75) points] and PSAS [(4.91±0.70) points] in the control group at 3 months after treatment were slightly improved compared with those before treatment, and the differences were statistically significant (all P < 0.05). The overall scores of VSS, OSAS and PSAS in the observation group were lower than those in the control group (all P < 0.05). After treatment, the degree of scar improvement in the observation group was more obvious than that in the control group. During the treatment, 2 patients in the observation group had erythema, 1 patient had pigmentation, and 1 patient had erosions. In the control group, 3 patients had blisters and 2 patients had erosions.  Conclusion  For hypertrophic scar, the addition of fractional carbon dioxide laser treatment on the basis of conventional anti-scar can effectively improve the thickness and blood vessel distribution of scar, reduce itching and pain caused by scar, and improve the patient's quality of life.

     

  • loading
  • [1]
    MENEZES M C S, VASCONCELLOS L S, NUNES C B, et al. Evaluation of the use of tacrolimus ointment for the prevention of hypertrophic scars in experimental model[J]. An Bras Dermatol, 2019, 94(2): 164-171. doi: 10.1590/abd1806-4841.20197490
    [2]
    OGAWA R, DOHI T, TOSA M, et al. The latest strategy for keloid and hypertrophic scar prevention and treatment: the Nippon Medical School (NMS) protocol[J]. J Nippon Med Sch, 2021, 88(1): 2-9. doi: 10.1272/jnms.JNMS.2021_88-106
    [3]
    徐庆连, 宋均辉. 小儿烧伤后瘢痕增生特点与康复治疗方案[J]. 中华烧伤杂志, 2018, 34(8): 509-512. doi: 10.3760/cma.j.issn.1009-2587.2018.08.005

    XU Q L, SONG J H. Characteristics of scar hyperplasia after burn and the reha- bilitation treatment in children[J]. Chinese Journal of Burns, 2018, 34(8): 509-512. doi: 10.3760/cma.j.issn.1009-2587.2018.08.005
    [4]
    蒋薇, 胡德林, 周舜英, 等. 1 737例小儿烧伤临床特点分析[J]. 安徽医学, 2019, 40(5): 511-513. doi: 10.3969/j.issn.1000-0399.2019.05.010

    JIANG W, HU D L, ZHOU S Y, et al. Clinical analysis of 1 737 cases of pediatric burn[J]. Anhui Medical Journal, 2019, 40(5): 511-513. doi: 10.3969/j.issn.1000-0399.2019.05.010
    [5]
    PATEL S P, NGUYEN H V, MANNSCHRECK D, et al. Fractional CO2 laser treatment outcomes for pediatric hypertrophic burn scars[J]. J Burn Care Res, 2019, 40(4): 386-391. doi: 10.1093/jbcr/irz046
    [6]
    齐鸿燕. 儿童瘢痕的管理策略[J]. 中华烧伤杂志, 2019, 35(10): 712-714. QI H Y. 儿童瘢痕的管理策略[J]. 中华烧伤杂志, 2019, 35(10): 712-714.
    [7]
    SEAGO M, SHUMAKER P R, SPRING L K, et al. Laser treatment of traumatic scars and contractures: 2020 international consensus recommendations[J]. Lasers Surg Med, 2020, 52(2): 96-116. doi: 10.1002/lsm.23201
    [8]
    WON T H, MA Q Y, CHEN Z A, et al. The efficacy and safety of low-energy carbon dioxide fractional laser use in the treatment of early-stage pediatric hypertrophic scars: a prospective, randomized, split-scar study[J]. Lasers Surg Med, 2022, 54(2): 230-236. doi: 10.1002/lsm.23459
    [9]
    王振君, 潘孙峰, 方高丰, 等. 老年中厚皮供皮区回植自体刃厚皮疗效观察[J]. 中华全科医学, 2022, 20(5): 773-776. doi: 10.16766/j.cnki.issn.1674-4152.002451

    WANG Z J, PAN S F, FANG G F, et al. Observation on the curative effect of replantation of autologous thick skin in the donor area of elderly medium-thickness skin[J]. Chinese Journal of General Practice, 2022, 20(5): 773-776. doi: 10.16766/j.cnki.issn.1674-4152.002451
    [10]
    LEE H J, JANG Y J. Recent understandings of biology, prophylaxis and treatment strategies for hypertrophic scars and keloids[J]. Int J Mol Sci, 2018, 19(3): 711. doi: 10.3390/ijms19030711
    [11]
    ŢUŢUIANU R, ROŞCA A M, FLOREA G, et al. Heterogeneity of human fibroblasts isolated from hypertrophic scar[J]. Rom J Morphol Embryol, 2019, 60(3): 793-802.
    [12]
    ELROD J, SCHIESTL C, NEUHAUS D, et al. Patient-and physician-reported outcome of combined fractional CO2 and pulse dye laser treatment for hypertrophic scars in children[J]. Ann Plast Surg, 2020, 85(3): 237-244. doi: 10.1097/SAP.0000000000002377
    [13]
    黄娜, 文辉才, 黄进军, 等. 人工点阵CO2激光治疗增生性瘢痕的临床疗效观察[J]. 中国美容整形外科杂志, 2020, 31(11): 647-649. doi: 10.3969/j.issn.1673-7040.2020.11.004

    HUANG N, WEN H C, HUANG J J, et al. Clinical observation of artificial fractional CO2 laser in the treatment of hypertrophic scar[J]. Chinese Journal of Aesthetic and Plastic Surgery, 2020, 31(11): 647-649. doi: 10.3969/j.issn.1673-7040.2020.11.004
    [14]
    马倩玉, 元泰皓, 陈宗安, 等. 低能量剥脱性二氧化碳点阵激光治疗儿童早期增生性瘢痕的疗效研究[J]. 中国医疗美容, 2021, 11(8): 21-25. https://www.cnki.com.cn/Article/CJFDTOTAL-YLMR202108005.htm

    MA Q Y, YUAN T H, CHEN Z A, et al. The efficacy of low-energy carbon dioxide ablative fractional laser in the treatment of early-stage pediatric hypertrophic scars[J]. China Medical Cosmetology, 2021, 11(8): 21-25. https://www.cnki.com.cn/Article/CJFDTOTAL-YLMR202108005.htm
    [15]
    TAN J L, ZHOU J Y, HUANG L, et al. Hypertrophic scar improvement by early intervention with ablative fractional carbon dioxide laser treatment[J]. Lasers Surg Med, 2021, 53(4): 450-457. doi: 10.1002/lsm.23301
    [16]
    谢卫国, 雷芳, 王娟, 等. 序贯激光治疗早期增生性烧伤瘢痕的临床效果[J]. 中华烧伤杂志, 2018, 34(9): 615-623. doi: 10.3760/cma.j.issn.1009-2587.2018.09.011

    XIE W G, LEI F, WANG J, et al. Clinical effects of sequential laser treatments on early stage hypertrophic burn scars[J]. 中华烧伤杂志, 2018, 34(9): 615-623. doi: 10.3760/cma.j.issn.1009-2587.2018.09.011
    [17]
    吕开阳, 肖仕初, 夏照帆. "中国临床瘢痕防治专家共识"解读[J]. 中华整形外科杂志, 2018, 34(12): 985-990. doi: 10.3760/cma.j.issn.1009-4598.2018.12.001

    LYU K Y, XIAO S C, XIA Z F. Interpretation of Chinese expert consensus report on clinical prevention and treatment of scar[J]. Chinese Journal of Plastic Surgery, 2018, 34(12): 985-990. doi: 10.3760/cma.j.issn.1009-4598.2018.12.001
    [18]
    邢福席, 付全有, 章祥洲, 等. 剥脱性点阵CO2激光治疗儿童烧伤后增生性瘢痕的临床效果研究[J]. 中华整形外科杂志, 2022, 38(2): 143-151. doi: 10.3760/cma.j.cn114453-20210523-00225

    XING F X, FU Q Y, ZHANG X Z, et al. Study on the clinical effect of ablative fractional CO2 laser in the treatment of hypertrophic scars after burns in children[J]. Chinese Journal of Plastic Surgery, 2022, 38(2): 143-151. doi: 10.3760/cma.j.cn114453-20210523-00225
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(1)  / Tables(5)

    Article Metrics

    Article views (191) PDF downloads(4) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return