Optimal Timing of Fractional CO2 Laser on Cleft Lip Scars: A Single-Blind Randomized Controlled Cohort Study

Chi, Haoshu; Zhao, Xinran; Shen, Lingyue; Liu, Yiyun; Cai, Ming

doi:10.1097/dss.0000000000003688

Cited by 7 publications

(15 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…34 The optimal timing of laser treatment is another area of investigation, and whether it is better to intervene early or wait for scar maturation. Chi et al 35 conducted a 2023 study treating 42 patients with a linear cleft lip scar in a singleblind, randomized controlled trial to compare fractionated CO 2 to no intervention. Thirty of these patients in the treatment arm underwent laser treatment at either 1, 3, 6, or 12 months.…”

Section: Ablative Laser Outcomesmentioning

confidence: 99%

“…Using the VSS, the study found that the laser treatment arm had significantly improved scar appearance, and that those in the 1-month postoperative laser treatment group had better outcomes, suggesting that early laser intervention may portend better scar appearance. 35 While the results of these studies are promising and show that laser does play a role in adjuvant scar treatment, some studies have failed to demonstrate efficacy. A 2023 split-scar prospective study by Lin et al 36 performed fractional CO 2 laser treatment on 30 incisions after skin cancer resection on the limbs.…”

Section: Ablative Laser Outcomesmentioning

confidence: 99%

See 1 more Smart Citation

The Measure of a Scar: Patient Perceptions and Scar Optimization after Skin Cancer Reconstruction

Drake

Moyer

2023

Facial Plast Surg

View full text Add to dashboard Cite

In facial reconstruction after skin cancer resection, management and optimization of postoperative scar is a complex paradigm. Every scar is unique and presents a different challenge—whether due to anatomic, aesthetic, or patient-specific factors. This necessitates a comprehensive evaluation and an understanding of the tools at hand to improve its appearance. How a scar looks is meaningful to patients, and the facial plastic and reconstructive surgeon is tasked with its optimization. Clear documentation of a scar is critical to assess and determine optimal care. Scar scales such as the Vancouver Scar Scale, the Manchester Scar Scale, the Patient and Observer Assessment Scale, the Scar Cosmesis Assessment and Rating “SCAR” Scale, and FACE-Q, among others, are reviewed here in the context of evaluating postoperative or traumatic scar. Measurement tools objectively describe a scar and may also incorporate the patient's assessment of their own scar. In addition to physical exam, these scales quantify scars that are symptomatic or visually unpleasant and would be best served by adjuvant treatment. The current literature regarding the role of postoperative laser treatment is also reviewed. While lasers are an excellent tool to assist in blending of scar and decreasing pigmentation, studies have failed to evaluate laser in a consistent, standardized way that allows for quantifiable and predictable improvement. Regardless, patients may derive benefit from laser treatment given the finding of subjective improvement in their own perception of scar, even when there is not a significant change to the clinician's eye. This article also discusses recent eye fixation studies which demonstrate the importance of careful repair of large and central defects of the face, and that patients value the quality of the reconstruction.

show abstract

Section: Ablative Laser Outcomesmentioning

confidence: 99%

Section: Ablative Laser Outcomesmentioning

confidence: 99%

The Measure of a Scar: Patient Perceptions and Scar Optimization after Skin Cancer Reconstruction

Drake

Moyer

2023

Facial Plast Surg

View full text Add to dashboard Cite

show abstract

“…In terms of treatment timing, some scholars advocate early laser intervention for scar, such as 1-4 weeks after surgery (32,33) because it can promote the reduction of scar hyperplasia index, and the duration of scar hyperplasia is also signi cantly shortened, with no obvious postoperative adverse reactions (34). A study published in 2023 showed that early treatment with CO 2 laser was more effective than later treatment within a month after surgery (11). However, it is also believed that scar at maturity (3 months to 1 year after scar formation) is more convenient to treat, so scar boundaries are clearer and its properties are more stable, and it is di cult to transform into other tissues (35).…”

Section: Strengths and Limitations Of The Reviewmentioning

confidence: 99%

“…Timely and accurate surgical treatment including plastic surgery and oralmaxillofacial surgery(8) as well as special postoperative care is of great signi cance for children with cleft lip and/or palate (9). Regrettably, the mechanical tension caused by a child's inevitable facial muscle movements (such as crying and sucking) has an adverse effect on postoperative wound healing, which can lead to enlarged scars and long-term development that can affect the patients' physical and mental health (10,11). So far, great progress has been made in the treatment of scar after cleft lip surgery.…”

mentioning

confidence: 99%

Laser treatment for scars after cleft lip surgery: A systematic review and meta-analysis

Pang,

Chi,

Zhan

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

Background Current studies are controversial on the optimal treatment of postoperative scar treatment by cleft lip. Our objective is to elucidate the therapeutic effect of laser on postoperative cleft lip scar treatment. Methods A systematic review was performed and reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We searched five electronic databases (EMBASE, PubMed, Web of Science, Cochrane Library and CNKI, from their inceptions until August 8, 2023) and independently assessed the methodological quality and bias risk of the included studies by two investigators using the Cochrane Handbook for Systematic Reviews. Quality assessment of the certainty of evidence was performed based on the Grading of Recommendations Assessment, Development, and Evaluation guidelines. Weighted mean difference of Vancouver Scar Scale were calculated to conduct meta-analysis by Stata statistical software version 14. We also estimated the pool sensitivity as well as testing the possibility of publication bias. Results Five studies were included in this meta-analysis involving 255 subjects. Meta-analysis showed that compared with the control group, laser was more effective in treating post-cleft lip scars (WMD = 4.39, 95%CI = 0.54–8.23; Five studies with 255 participants; Low evidentiary certainty, I2 = 99.4%). Conclusions Patients treated with laser therapy for postoperative cleft lip scar treatment tend to have lower Vancouver Scar Scale scores, indicating a significant therapeutic effect. However, our results should be interpreted with caution due to the limitations. Trial registration identifier CRD42023397042 (18/02/2023) [https://www.crd.york.ac.uk/prospero/].

show abstract

“…Ultimately, 18 eligible articles were obtained. Thirteen RCTs focused on the effects of the interventions to prevent surgical scars and reported VSS measurements(3,5,(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). The other 7 RCTs were conducted on effects of the interventions to prevent surgical scars and depicted the OSAS measurements(3,17,(23)(24)(25)(26)(27).…”

mentioning

confidence: 99%

Effect of Laser and Energy-based Device Therapies to Minimize Surgical Scar Formation: A Systematic Review and Network Meta-analysis

Yenyuwadee,

Achavanuntakul,

Phisalprapa

et al. 2024

Acta Derm Venereol

View full text Add to dashboard Cite

Utilization of lasers and energy-based devices for surgical scar minimization has been substantially evaluated in placebo-controlled trials. The aim of this study was to compare reported measures of efficacy of lasers and energy-based devices in clinical trials in preventing surgical scar formation in a systematic review and network meta-analyses. Five electronic databases, PubMed, Scopus, Embase, ClinicalTrials.gov, and the Cochrane Library, were searched to retrieve relevant articles. The search was limited to randomized controlled trials that reported on clinical outcomes of surgical scars with treatment initiation no later than 6 months after surgery and a follow-up period of at least 3 months. A total of 18 randomized controlled trials involving 482 participants and 671 postsurgical wounds were included in the network meta-analyses. The results showed that the most efficacious treatments were achieved using low-level laser therapy) (weighted mean difference –3.78; 95% confidence interval (95% CI) –6.32, –1.24) and pulsed dye laser (weighted mean difference –2.46; 95% CI –4.53, –0.38). Nevertheless, low-level laser therapy and pulsed dye laser demonstrated comparable outcomes in surgical scar minimization (weighted mean difference –1.32, 95% CI –3.53, 0.89). The findings of this network meta-analyses suggest that low-level laser therapy and pulsed dye laser are both effective treatments for minimization of scar formation following primary closure of surgical wounds with comparable treatment outcomes.

show abstract

Optimal Timing of Fractional CO2 Laser on Cleft Lip Scars: A Single-Blind Randomized Controlled Cohort Study

Cited by 7 publications

References 27 publications

The Measure of a Scar: Patient Perceptions and Scar Optimization after Skin Cancer Reconstruction

The Measure of a Scar: Patient Perceptions and Scar Optimization after Skin Cancer Reconstruction

Laser treatment for scars after cleft lip surgery: A systematic review and meta-analysis

Effect of Laser and Energy-based Device Therapies to Minimize Surgical Scar Formation: A Systematic Review and Network Meta-analysis

Contact Info

Product

Resources

About