| Background and ObjectiveScar is a natural product of the body’s repair process after trauma.It is a general term for the appearance and histopathological irregular changes of normal skin tissue caused by various traumas.At present,there is no uniform method for the classification of scars in the world.According to the pathophysiological characteristics of scar formation,it can be divided into immature scar and mature scar.Scars with a time of less than 6 months are mostly immature scars.Their salient features are red appearance,abundant capillaries inside,local itching and pain symptoms,and progressive increase in scar thickness.Studies have shown that the degree of scar congestion and hyperplasia has a significant correlation with the number of capillaries.The more capillaries are,the more severe the scar hyperplasia.Scars older than 6 months will gradually become mature scars.The main characteristics of the scar are reduced capillaries,darkened and lighter color,disappearance of clinical symptoms(pain,itching),mild alkalinity,and slower changes in scar thickness.Related research surveys show that there are 250 million more patients with surgical incisions in the world every year.Surgical incisions form scars during the tissue repair and healing process.Most of the patients need to repeat the pain,itching,poor appearance and even dysfunction caused by postoperative scars.Treatment has greatly reduced the quality of life of patients.In severe cases,anxiety,world-weariness,depression,and inability to live a normal life may even occur,leading to serious consequences such as suicide.It is estimated that about 100 million people in developed countries suffer from scars each year due to surgery,burns and other injuries.According to data from 2006,the cost of rehabilitation care is estimated to be about 240 billion euros(US$297 billion),which is approximately 4.4 times the estimated cost of emergency care,and the loss of productivity can even lead to greater social costs.In recent years,various optoelectronic technologies have been continuously developed and improved.They have the advantages of limited damage,rapid recovery,and affirmative effects.They have played an important role in scar treatment and functional improvement as well as cosmetic repair.Photoelectric technology has been used in the treatment of scars for many years.The commonly used photoelectric technologies for scar treatment mainly include laser,radio frequency,photon and other technologies.With the continuous development and advancement of optoelectronic technology,different types of optoelectronic technologies are used alone or in combination in scar treatment,and their efficacy has been widely recognized.The international and domestic expert consensus on scar prevention and treatment has given clear affirmation and recommended clinical applications.In this study,different photoelectric technologies were used for individual or sequential treatment of scars at different stages.Through the observation and analysis of clinical efficacy,this study provided more clinical evidence for the rational application of different photoelectric technologies to treat scars.MethodsCollected patients with scars who received three treatments with photoelectric technology in the plastic surgery department of the First Affiliated Hospital of Zhengzhou University in June 2018～June 2020.1.Randomly divide the scars within 6 months into A1 group(n=30),A2 group(n=30)and A3 group(n=30).Group A1 was treated with a dye pulsed light therapy(DPL)treatment,all treatments were 3 times at an interval of 1 month;Group A2 was treated with ultra-pulse CO2 fractional laser treatment,treatments were all 3 times at an interval of 1 month;Group A3 was given sequential treatment with DPL combined with ultra-pulse CO2 fractional laser.DPL was treated 2 times with an interval of 1 month each time,and the ultra-pulse CO2 fractional laser treatment was treated once with an interval of 1 month.Scores of VSS and POSAS were performed before treatment and 6 months after the last laser treatment to evaluate the scar.2.The hypertrophic scars over 6 months were randomly divided into group B1(n=20)and group B2(n=20).Group B1 was treated with ultra-pulse CO2 fractional laser treatment,and group B2 was treated with micro-plasma radio frequency technology(FMRT)treatment.Both groups B1 and B2 were treated for 3 times,with an interval of 1 month each time.Scores of VSS and POSAS were performed before treatment and 6 months after the last treatment to assess the scar.3.Atrophic scars over 6 months were randomly divided into C1 group(n=20),C2 group(n=20),C1 group was given ultra-pulse CO2 fractional laser,and C2 group was given micro-plasma radio frequency technology(FMRT))treatment.Both groups C1 and C2 were treated for 3 times,with an interval of 1 month each time.Scores of VSS and POSAS were performed before treatment and 6 months after the last treatment to assess the scar.Results1 Comparison of the curative effect of photoelectric therapy for scars less than 6 months old1.1 Comparing the scores of VSS and POSAS 6 months after the last treatment follow-up in the A1,A2,and A3 groups,the difference was statistically significant(P<0.05).Through the comparison of the three groups,combined with the mean value graph,it is found that the average scar score of the A3 group is the smallest and the effect is the best,followed by the A1 group,and finally the A2 group.The VSS and POSAS scores of groups A1,A2,and A3 were compared before treatment and 6 months after the last treatment follow-up,and the differences were statistically significant(P<0.05).The scar texture has been improved significantly,the pigmented area is reduced,the scar is lightened,the color is improved,the skin color is roughly similar to the surrounding normal skin,the thickness of the scar is significantly reduced,and the overall appearance is improved.1.2 The overall satisfaction rate of group A1=86.67%(26/30),the overall satisfaction rate of group A2=73.33%(22/30),the overall satisfaction rate of group A3=93.33%(28/30),group A3 has the highest satisfaction rate.No obvious adverse reactions were seen in all patients.2 Comparison of photoelectric effect of hypertrophic scar2.1 Comparing the scores of VSS and POSAS 6 months after the last follow-up in the B1 and B2 groups,the difference was statistically significant(P<0.05).In the early stage,the scar texture is improved significantly,the pigmented area is reduced,the scar is lightened,the color is improved,the skin color is roughly similar to the surrounding normal skin,the thickness of the scar is significantly reduced,and the overall appearance is improved.2.2 The overall satisfaction rate of group B1=90.00%(18/20),the overall satisfaction rate of group B2=85.00%(17/20).No obvious adverse reactions were seen in all patients.3 Comparison of photoelectric effect of atrophic scar3.1 Comparing the scores of VSS and POSAS 6 months after the last follow-up in the C1 and C2 groups,the difference was statistically significant(P<0.05).The skin of the scar treated area is uniform,the pits become lighter,flatter than before,the scar is obviously lightened,the color is similar to normal skin,and the overall appearance is improved.3.2 The overall satisfaction rate of group C1=85.00%(17/20),the overall satisfaction rate of group C2=90.00%(18/20).No obvious adverse reactions were seen in all patients.Conclusions1.For scars less than 6 months old,dye pulsed light(DPL),ultra-pulse CO2 fractional laser and the combination of the two lasers are effective,and the combined treatment effect is significantly better than that of a single laser treatment.2.For scars older than 6 months,ultra-pulse CO2 fractional laser has a better treatment effect on hypertrophic scars,and micro-plasma radio frequency technology(FMRT)has a more significant treatment effect on atrophic scars.3.According to the different periods of scars,the selection of appropriate photoelectric treatment technology can help promote the repair of scars and shorten the period of scar treatment. |
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