Combination of ablative fractional carbon dioxide laser and platelet-rich plasma treatment to improve hypertrophic scars: a retrospective clinical observational study

Abstract

Background Hypertrophic scars are one of the main complications that affect the quality of life of patients after burns. Many methods have been shown to be effective in the treatment of hypertrophic scars, such as ablative fractional CO2 laser (AFCL) and platelet-rich plasma (PRP). However, there are few studies on the effect of the combined application of these measures. The purpose of this study was to explore the therapeutic effect of AFCL combined with PRP on hypertrophic burn scars. Methods A retrospective clinical observation study was conducted on 50 patients with hypertrophic burn scars. The AFCL+PRP group included 31 patients who received AFCL combined with PRP treatment; the AFCL group included 19 patients who received AFCL treatment only. The University of North Carolina 4P Scar Scale (UNC4P) and the Vancouver Scar Scale (VSS) scores that were collected before each treatment were used as indicators of the effectiveness of the previous treatment. The scores recorded at the second, fourth and seventh months were analysed. Results The demographic data of the 2 groups were not significantly different. Before treatment, there was no difference in the UNC4P and VSS scores between the 2 groups. There was a significant decline in the UNC4P and VSS total scores over 6 months in both groups (p < 0.05) and scores in the 2 groups were comparable after 3 and 6 months (p < 0.05). UNC4P scores in the AFCL+PRP group decreased from a mean of 8.26 to 2.61 (p < 0.05) with a concomitant drop in VSS scores from a mean of 11.74 to 6.06 (p < 0.01). In the AFCL group UNC4P and VSS scores decreased from 7.68 to 4.63 (p < 0.05) and from 10.89 to 8.16 (p < 0.05), respectively. The sub-items of these 2 assessments were analysed and the results suggest that AFCL combined with PRP can comprehensively improve scarring. Conclusions This study shows that PRP is an effective adjunct for AFCL in the treatment of hypertrophic burn scars and that the combination of PRP and AFCL proved to be more useful than AFCL alone. This combination may be a new and effective clinical practice for the treatment of scars. However, larger and higher-level clinical studies are still needed to determine its efficacy and possible mechanisms.

Evaluating skin colour diversity in the validation of scar assessment tools

“…However, this scale has not been used frequently, and therefore very little information is available about its reliability and validity. Nevertheless, the UNC4P has been a useful tool in the subjective evaluation of dual scar treatment interventions that involve the use of laser therapy in the treatment of scars 28–30 . However, of the patients included in the aforementioned studies, the majority were Fitzpatrick levels I–IV, while none were levels V or VI, which implicates the notable deficiency in the inclusion of dark‐skinned individuals in scar scale assessment studies.…”

Safety and efficacy of CO2 dot matrix laser combined with platelet‐rich plasma on depressed scar after acne vulgaris and influencing factors of its repair effect: A retrospective analysis

“…However, there are some shortcomings in this study. First, in previous studies, CO 2 dot matrix laser and PRP have also been verified to have favorable efficacy on hypertrophic scars 45–47 . This study has only included patients with DS, so the efficacy of the combination on hypertrophic scars is not yet clear.…”

“…to have favorable efficacy on hypertrophic scars. [45][46][47] This study has only included patients with DS, so the efficacy of the combination on hypertrophic scars is not yet clear. Additionally, because of the small number of cases in this study, it cannot be excluded that the statistical calculation of some results may be accidental.…”

Study of platelet‐rich plasma application for skin and plastic surgery in recent 20 years: A bibliometric analysis

“…Hewedy et al 42 has revealed that the combination of TAC and PRP can produce better cosmetic results in the treatment of keloids and reduce the incidence of TAC‐induced side effects. Besides, Dai et al 43 has retrospectively analyzed the efficacy of ablative fractional CO 2 laser and PRP combination for the treatment of hyperplastic scars and found that combination therapy has improved efficacy over individual treatments. PRP is an emerging therapeutic in scar treatment, but its application in hypertrophic/keloid tissues is still controversial.…”