Efficacy and safety of a dual-scan protocol for carbon dioxide laser in the treatment of split-thickness skin graft contraction in a red Duroc pig model
- Burns & Trauma Vol. 9, Issue 1, (2021)
- 作者机构：
1. Department of Plastic and Reconstructive Surgery
2. Shanghai Jiao Tong University School of Medicine
3. Department of Plastic Surgery
4. Victorian Adult Burns Service, Alfred Health
- 作者简介：
- 基金信息：
DOI：10.1093/burnst/tkab048
CLC：Published：2021，
Published Online：31 December 2021，
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Jie Li, Sally Kiu-Huen Ng, Wenjing Xi, Zheng Zhang, Xiaodian Wang, Hua Li, Weijie Su, Jingyan Wang, Yixin Zhang, Efficacy and safety of a dual-scan protocol for carbon dioxide laser in the treatment of split-thickness skin graft contraction in a red Duroc pig model, Burns & Trauma, Volume 9, 2021, tkab048, https://doi.org/10.1093/burnst/tkab048
Jie Li, Sally Kiu-Huen Ng, Wenjing Xi, Zheng Zhang, Xiaodian Wang, Hua Li, Weijie Su, Jingyan Wang, Yixin Zhang, Efficacy and safety of a dual-scan protocol for carbon dioxide laser in the treatment of split-thickness skin graft contraction in a red Duroc pig model, Burns & Trauma, Volume 9, 2021, tkab048, https://doi.org/10.1093/burnst/tkab048 DOI：
摘要
Abstract
BackgroundFractional CO2 laser plays an important role in scar management post split-thickness skin graft by loosening the graft contracture and restoring the smoothness of the surface. However
the optimal treatment protocol remains unknown. This study applied a dual-scan protocol to achieve both releasing and ablation of contracted skin graft. We comprehensively describe this treatment method and compare the efficacy and safety between this dual-scan method and the conventional mono-scan mode.MethodsA hypercontracted scar model after split-thickness skin grafting in red Duroc pigs was established. All scars meeting the inclusion criteria were randomly divided into four groups: high fluence–low density (HF–LD)
low fluence–high density (LF–HD)
combined group and control group. The energy per unit area was similar in the HF–LD and LF–HD groups. Two laser interventions were performed at a 6-week interval. The efficacy of the treatment was evaluated by objective measures of scar area
release rate
elasticity
thickness and flatness
while the safety was evaluated based on adverse reactions and melanin index. Collagen structure was observed histologically. The animals were followed up for a maximum of 126 days after modeling.ResultsA total of 28 contracted scars were included
7 in each group. At 18 weeks postoperatively
the HF–LD and the combined groups showed significantly increased scar release rate (p = 0.000) and elasticity (p = 0.036) and decreased type I/III collagen ratio (p = 0.002) compared with the control and LF–HD groups. In terms of flatness
the combined group was significantly better than the HF–LD group for elevations <1 mm (p = 0.019). No significant skin side effects
pigmentation or scar thickness changes were observed at 18 weeks.ConclusionsDual-scan protocol could achieve superficial ablation and deep release of contracted split-thickness skin graft in a single treatment
with similar contraction release and texture improvement compared to a single deep scan. Its main advantage is to restore a smoother scar appearance. Adequate laser penetration was necessary for the release of contracted scars.
关键词
Keywords
Skin graft contractionScarLaser treatmentFractional carbon dioxide laser
references
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