Laser Treatment of Traumatic Scars and Contractures: 2020 International Consensus Recommendations

Seago, Meghan; Shumaker, Peter R.; Spring, Leah K.; Alam, Murad; Al‐Niaimi, Firas; Anderson, R. R.; Artzi, Ofir; Bayat, Ardeshir; Cassuto, Daniel; Chan, Henry H.; Dierickx, Christine; Donelan, Matthias B.; Gauglitz, Gerd G.; Goo, Boncheol; Goodman, Greg; Gurtner, Geoffrey C.; Hædersdal, Merete; Krakowski, Andrew C.; Manuskiatti, Woraphong; Norbury, William B.; Ogawa, Rei; Ozog, David M.; Paasch, Uwe; Ross, E. Victor; Clementoni, Matteo Tretti; Waibel, Jill

doi:10.1002/lsm.23201

Cited by 118 publications

(133 citation statements)

References 88 publications

(131 reference statements)

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“…Laser energy was delivered through a specific type of optical bare fibre with 300-micron diameter. The fibre, with directional laser irradiation, enables penetration through tissue to a depth of 2–3 mm, enabling deeper penetration of the non-ablative fractional laser when treating thicker scars, an issue inherent with this type of laser in comparison to longer wavelength ablative fractional lasers 28 . The heat produced from this laser is emitted in a narrow field, so water quickly vaporizes in the surrounding tissue, resulting in selected tissue ablation and coagulation, with localised cell lysis and tissue necrosis.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, to treat scars that protrude the skin more than 2 mm multiple passes and treatments are necessary. Consequently, this laser method may be combined with other lasers or agents 28 , 43 – 46 .…”

Section: Discussionmentioning

confidence: 99%

“…Future studies should address the optimal timing of treatment, the optimal laser parameters and settings and the combination of complimentary therapies to achieve higher satisfactory and long-term results 28 .…”

Section: Discussionmentioning

confidence: 99%

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Treatment of hypertrophic scars and keloids using an intralesional 1470 nm bare-fibre diode laser: a novel efficient minimally-invasive technique

Nicoli

Cui

et al. 2020

Sci Rep

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Hypertrophic and keloid scars result from abnormal wound healing and can have a variable response to a number of available treatment modalities. The evolution of laser treatments in recent years has shown a wide range of clinical applications including their use in the treatment of scars. We investigated the effectiveness of a 1470 nm diode laser using an intralesional optical fibre delivery device in the treatment of hypertrophic and keloid scars. We evaluated its safety and efficacy as a novel and minimally invasive treatment alternative for scar modulation and volume reduction. A prospective cohort study was performed involving 21 patients with hypertrophic scars (HS) (n = 9) and keloids (n = 12) resulting from various aetiology. Patients were treated with one to three treatment sessions. Comprehensive evaluations were performed using the Vancouver Scar Scale, Doppler ultrasound, Cutometer, Mexameter and PeriCam PSI. Scar thickness was reduced by an average of 0.308 ± 0.138 cm (p < 0.001). In particular the two subgroups showed a significant 27.7% and 28.2% reduction in scar thickness of HS and Keloids, respectively. Scar firmness showed a significant improvement of 1.2% (p < 0.05) for HS, though for keloids this was 0.4% (p = 0.26). Keloids had a significant reduction in pigmentation at 21.3%. Blood perfusion had a significant reduction of 29.6% in HS and 22.7% in Keloids. Overall VSS total score improvement of 42% in the HS and at 37.9% in the Keloid subgroup. No adverse events such as hypo/hyperpigmentation, skin infection, or recurrence were reported. This study shows that the intralesional 1470 nm bare-fibre diode laser significantly improved hypertrophic and keloid scars based on both subjective and objective analyses and supports this type of laser therapy as a safe and effective minimally-invasive treatment option.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Treatment of hypertrophic scars and keloids using an intralesional 1470 nm bare-fibre diode laser: a novel efficient minimally-invasive technique

Nicoli

Cui

et al. 2020

Sci Rep

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“…Lasers that target chromophores of the skin can be used, including the pulsed-dye laser (hemoglobin, 595 nm); other vascular lasers including the KTP, diode, ruby, alexandrite, and Nd:YAG lasers (melanin and pigment; 532, 694, 755, and 1,064 nm); non-ablative fractional lasers (water, 1,540 and 1,565 nm); ablative fractional lasers (water, 2,940 and 10,600 nm); and ablative lasers (water, 10,600 nm). 34 Laser therapy is often combined with other adjuncts, such as silicone-based therapy and steroid injections, to fully manage scarring, and it is recommended after the patient fails a 1-month trial of silicone-based or onion extract gel therapy. 22…”

Section: Lasermentioning

confidence: 99%

Management of Complications from Skin Cancer Reconstruction

Vila

Thomas

2020

Facial Plast Surg

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Reconstruction of facial cutaneous defects from skin cancer surgery is a commonly done procedure in the hands of many facial plastic surgeons. Excellent surgical technique should always be employed to reduce the risk of a poor result. However, complications do occur and can be devastating for both the patient and surgeon. We review a range of postoperative management options, and the evidence for each modality, so that reconstructive surgeons can stay up to date on current literature.

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“…Laser modalities have proven to be cosmetically and clinically efficient in the treatment of scars [5–9]. Some lasers are effective not only in the treatment of scars but also in the prevention of hypertrophic scars [10–15].…”

Section: Introductionmentioning

confidence: 99%

The Outcome of Early Ablative Fractional Laser Treatment for Thyroidectomy Scars

et al. 2020

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Background and Objectives Ablative fractional laser (AFL) systems are commonly used to treat various scars, and recent research has indicated that early treatment with AFL may have a preventive effect on scars. This study was designed to evaluate the efficacy of early treatment with a 10,600 nm carbon dioxide (CO2) AFL on thyroidectomy scars and compare it to late (conventional) treatment for the same and untreated controls. Study Design/Materials and Methods We performed a prospective, evaluator‐blinded, split‐scar study on fresh thyroidectomy scars between July 2014 and July 2017. Scars were divided into two equal portions. Early AFL treatment had begun 1 month after surgery; five sessions on the right half of the scar was performed at 1‐month intervals. Late AFL treatment followed for 1 month after the final early treatment session on the left half of the scar at the same interval. The scars were evaluated at 6 and 11 months postoperatively using scar analysis scales and patient questionnaires. Results Twenty‐four out of 28 patients completed the study. The mean decrease in Vancouver Scar Scale (VSS) scores was significantly higher for the early treated right halves of the scars both at the 6th month (vs. untreated controls) and at the 11th month (vs. late treated controls). The VSS subset analysis showed that the early treated sides had significantly greater improvement in pliability and height than the control sides at each point of evaluation. Conclusions Early postoperative AFL treatment is safe and effective in improving linear surgical scars, such as thyroidectomy scars, and may be a promising option for scar prevention. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.

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Laser Treatment of Traumatic Scars and Contractures: 2020 International Consensus Recommendations

Cited by 118 publications

References 88 publications

Treatment of hypertrophic scars and keloids using an intralesional 1470 nm bare-fibre diode laser: a novel efficient minimally-invasive technique

Treatment of hypertrophic scars and keloids using an intralesional 1470 nm bare-fibre diode laser: a novel efficient minimally-invasive technique

Management of Complications from Skin Cancer Reconstruction

The Outcome of Early Ablative Fractional Laser Treatment for Thyroidectomy Scars

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