Moist exposed burn therapy in recovery of patients with immature, red hypertrophic scars successfully treated with a pulsed dye laser in combination with a fractional CO₂ laser

Abstract

Background The efficacy of pulsed dye laser combined (PDL) and UltraPulse fractional CO2 in treatment of hypertrophic scars is well documented. The present study investigates the efficacy of moist exposed burn ointment (MEBO)/moist exposed burn therapy (MEBT) in postlaser wound management. Methods Sixty‐one patients with immature, red hypertrophic scars were enrolled in this clinical trial. Patients were randomly divided into two groups: (a) the MEBO treatment group (n = 30) and (b) the control group (n = 31) treated with chlortetracycline hydrochloride ointment. Demographic data such as age, gender, and cause of scars were recorded. A visual analogue score (VAS) was collected to measure pain at 1, 6, 24, 72 hours, and 7 days post‐treatment. The Vancouver Scar Scale (VSS) was used to determine the response of the scars before and 3 months after the treatment. The wound healing time and pigmentation scores were also recorded. Results No significant differences were found in age, gender, and etiology of the scars in the two groups. The VAS scores in MEBO group were significantly lower than the control group within the first 3 days after treatment. The wound healing time of the MEBO group was significantly shorter than the control group. For both groups, VSS scores were significantly decreased and the scar markedly improved. However, the VSS scores were significantly lower in the MEBO group compared with the control group 3 months after treatment and pigmentation formation was dramatically lower in MEBO group compared with the control. Conclusion MEBT/MEBO treatment reduced the post‐treatment pain, shortened the wound healing duration, promoted the overall scar condition, and reduced the incidence of pigmentation.

Fractional CO2 laser combined with 595-nm PDL inhibiting hypertrophic scars via measuring BMP-7 and Fas expression in rabbit models

“…Fractional CO2 laser and 595-nm PDL in treating hypertrophic scars build on the principle of selective photothermolysis, and their e cacies have been clinically proved [9][10][11][12][13][14][35][36][37][38][39][40][41][42][43][44][45][46]. In current study, we attempted combined use of the two laser modalities in rabbit models, with BMP-7 and Fas expression detected in the HS tissues.…”

“…PDL, another laser modality with selective photothermolysis, has been clinically used for decades, and can effectively inhibit microvasculature in HSs [3,9]. Previous studies revealed that PDL can reduce abnormal mast cells, broblasts and keratinocytes in HSs [10][11][12], and particularly could produce better effects by 585-nm wavelength for post-surgery scars, and promote vascularity and pliability of skins at the HSs [9,12,[35][36][37][38][39].…”

“…Nevertheless, simple use of either FCO2L or PDL failed to achieve satisfactory prognosis in treating HSs, and there remains necessary to expand evidence and develop optimal therapeutic options, for which combined use of FCO2L and 595-nm PDL was attempted in early-stage of HSs, and the results showed that the clinical scores (VAS, VSS and POSAS) as well as disordered collagens and bers were signi cantly improved after treatment [11,13,37,39,41,[55][56][57]. This may be involved in the role of 595-nm PDL that is capable of promoting BMP-7 and Fas expression, which is con rmed in our study.…”

“…Currently, HS still remains a medical problem because of its complex physiologic wound healing cascade, though combined therapeutic strategies have been attempted in its treatment [11,13,37,39,41]. Nevertheless, the role of BMP-7 and Fas expression following by FCO 2 L combined with 595-nm PDL is rarely available.…”

“…PDL to treat hypertrophic scars is on the principle basis of selective photothermolysis [9-12, 38, 39] instead of skin resurfacing like carbon dioxide laser, since improvement of HS is to reduce the proliferation and excessive microvasculature. In addition, 595-nm PDL can create deeper penetration than 585-nm PDL, and destroy extra hemoglobin and blood vessels at the HS and other skin conditions [35][36][37][38]. The effectiveness of 595-nm PDL for HSs has been evaluated and documented in some studies [9][10][11][12][35][36][37][38][39].…”