Clinical Effect Observation Of Fractional CO₂ Laser Combined With Glucocorticoid Hypodermic Injection In The Treatment Of Hypertrophic Scar

Objective To study the efficacy and safety of hypertrophic scars treatment though fractional CO2 laser combined with glucorticosteroid hypodermic injection.Method 90 cases of hypertrophic scars whose course of disease was more than half a year,were selected,According to the modified Vancouver scar scale(VSS) which was more than 7 points and the scar size which was less than 15 square centimetre, randomly divided into 3 groups, each of 30 cases;The experimental group was treated though fractional CO2 laser combined with glucorticosteroid hypodermic injection.The control group 1 was treated though glucorticosteroid hypodermic injection,and the control group 2 was treated though fractional CO2 laser.The energy range of fractional CO2 laser treatment was 40-50 mj,triamcinolone acetonide injection concentration was 10mg/ml;The experimental group was treated with fractional CO2 laser and triamcinolone acetonide hypodermic injection aternately, each treatment interval of 4 weeks;The control group 1 was treated with Triamcinolone acetonide hypodermic injection and the control group2 was treated with fractional CO2 laser.energy or concentration of the control group was the same as the experimental group, each treatment interval of 4 weeks;All the three groups received 6 treatments as a completed course treatment.Vists were conducetd one month after of 2 treatments, 4 treatments, 6 treatments, and half a year after completed course treatment to evaluate the clinical efficacy and adverse events;In the experimental group, one paient was randomly selected to carry out the pathological examination before and after treatment.Result 1.Prior to the treatment, the modified VSS score of the experimental group was 12.40±0.63, the control group was 11.83±1.91, and the control group 2 improved VSS score 12±1.72, the difference was not statistically significant(P < 0.05);Six months after the completed course treatment, the VSS score of the experimental group was 4.00±0.83, the control group1 was 6.02±0.96, and the control group2 was 5.07±2.00.The scores from the three groups experienced improvement compared with their conditions before the treatments,the difference was statistically significant(P<0.05);In the experimental group, control group 1 and control group 2, the treatment efficiency were 100%, 80% and 90%, the difference was statistically significant,In the three groups after treatment, the improvement of VSS score was8.40±1.55 、 5.82±1.69and6.93±1.69 respectively, and the difference was statistically significant(P<0.05). The effect of the experimental group was better than control group 1 and control group 2; 2.Pathological examination of hypertrophic scar in the experimental group were randomly selected,A large number of collagen fibers proliferated and arranged in disorder, and the part was nodular;After treatment, the collagen arrangement is parallel, neat, close to the normal dermal tissue, and the treatment is effective. 3.Afer triamcinolone acetonide hypodermic injection,most femal patients had menstrual disorder,a part of patients had subcutaneous tissue atrophy and none had petic ulcer in the active、erectile dysfunction and Cushing’s syndrome.And the incidence of the subcutaneous tissue atrophy was lower in the experimental group than in the control group1, the difference was statistically significant(P<0.05).Afer fractional CO2 laser therapy,patients had some level of pain,edematous erythematous plaques、pigmentation and so on. And in the incidence of the pigmentation, the experimental group was lower than in the control group 1, the difference was statistically significant(P<0.05).Coclusion Both the fractional CO2 laser therapy and glucocorticoid hypodermic injection conducted a certain effect on the treatment of hypertrophic scars,and the combind application of two achieved better effect and less adverse reaction.