Archives of Plastic Surgery

  • 제48권4호
  • /
  • Pages.347-352
  • /
  • 2021
  • /
  • 2234-6163(pISSN)
  • /
  • 2234-6171(eISSN)
대한성형외과학회 (Korean Society of Plastic and Reconstructive Surgeons)
권호 표지
DOI QR코드

DOI QR Code

Early postoperative treatment of mastectomy scars using a fractional carbon dioxide laser: a randomized, controlled, split-scar, blinded study

  • Shin, Hyun Woo (Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Suk, Sangwoo (Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Chae, Seoung Wan (Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Yoon, Kun Chul (Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Kim, Junekyu (Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine)
  • 투고 : 2020.12.18
  • 심사 : 2021.05.27
  • 발행 : 2021.07.15
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Background Mastectomy leaves unsightly scarring, which can be distressing to patients. Laser therapy for scar prevention has been consistently emphasized in recent studies showing that several types of lasers, including fractional ablation lasers, are effective for reducing scar formation. Nonetheless, there are few studies evaluating the therapeutic efficacy of ablative CO2 fractional lasers (ACFLs). Methods This study had a randomized, comparative, prospective, split-scar design with blinded evaluation of mastectomy scars. Fifteen patients with mastectomy scars were treated using an ACFL. Half of each scar was randomized to "A," while the other side was allocated to group "B." Laser treatment was conducted randomly. Scars were assessed using digital photographs of the scar and Vancouver scar scale (VSS) scores. Histological assessments were also done. Results The mean VSS scores were 2.20±1.28 for the treatment side and 2.96±1.40 for the control side. There was a significant difference in the VSS score between the treatment side and the control side (P=0.002). The mean visual analog scale (VAS) scores were 4.13±1.36 for the treatment side and 4.67±1.53 for the control side. There was a significant difference in VAS score between the treatment side and the control side (P=0.02). Conclusions This study demonstrated that early scar treatment using an ACFL significantly improved the clinical results of the treatment compared to the untreated scar, and this difference was associated with patient satisfaction.

키워드

참고문헌

  1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2017. CA Cancer J Clin 2017;67:7-30. https://doi.org/10.3322/caac.21387
  2. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68:394-424. https://doi.org/10.3322/caac.21492
  3. Kang SY, Kim YS, Kim Z, et al. Basic findings regarding breast cancer in Korea in 2015: data from a breast cancer registry. J Breast Cancer 2018;21:1-10. https://doi.org/10.4048/jbc.2018.21.1.1
  4. Sabino J, Lucas DJ, Shriver CD, et al. NSQIP analysis: increased immediate reconstruction in the treatment of breast cancer. Am Surg 2016;82:540-5. https://doi.org/10.1177/000313481608200616
  5. Bayat A, McGrouther DA, Ferguson MW. Skin scarring. BMJ 2003;326:88-92. https://doi.org/10.1136/bmj.326.7380.88
  6. Sobanko JF, Vachiramon V, Rattanaumpawan P, et al. Early postoperative single treatment ablative fractional lasing of Mohs micrographic surgery facial scars: a split-scar, evaluator-blinded study. Lasers Surg Med 2015;47:1-5.
  7. Karmisholt KE, Haerskjold A, Karlsmark T, et al. Early laser intervention to reduce scar formation: a systematic review. J Eur Acad Dermatol Venereol 2018;32:1099-110. https://doi.org/10.1111/jdv.14856
  8. Jang JU, Kim SY, Yoon ES, et al. Comparison of the effectiveness of ablative and non-ablative fractional laser treatments for early stage thyroidectomy scars. Arch Plast Surg 2016;43:575-81. https://doi.org/10.5999/aps.2016.43.6.575
  9. Manstein D, Herron GS, Sink RK, et al. Fractional photothermolysis: a new concept for cutaneous remodeling using microscopic patterns of thermal injury. Lasers Surg Med 2004;34:426-38. https://doi.org/10.1002/lsm.20048
  10. Brown BC, McKenna SP, Siddhi K, et al. The hidden cost of skin scars: quality of life after skin scarring. J Plast Reconstr Aesthet Surg 2008;61:1049-58. https://doi.org/10.1016/j.bjps.2008.03.020
  11. Tierney E, Mahmoud BH, Srivastava D, et al. Treatment of surgical scars with nonablative fractional laser versus pulsed dye laser: a randomized controlled trial. Dermatol Surg 2009;35:1172-80. https://doi.org/10.1111/j.1524-4725.2009.01085.x
  12. Park SH, Kim DW, Jeong T. Skin-tightening effect of fractional lasers: comparison of non-ablative and ablative fractional lasers in animal models. J Plast Reconstr Aesthet Surg 2012;65:1305-11. https://doi.org/10.1016/j.bjps.2012.04.028
  13. Kim HS, Lee JH, Park YM, et al. Comparison of the effectiveness of nonablative fractional laser versus ablative fractional laser in thyroidectomy scar prevention: a pilot study. J Cosmet Laser Ther 2012;14:89-93. https://doi.org/10.3109/14764172.2012.672746
  14. Magnani LR, Schweiger ES. Fractional CO2 lasers for the treatment of atrophic acne scars: a review of the literature. J Cosmet Laser Ther 2014;16:48-56. https://doi.org/10.3109/14764172.2013.854639
  15. Safra T, Shehadeh W, Koren A, et al. Early intervention with pulse dye and CO2 ablative fractional lasers to improve cutaneous scarring post-lumpectomy: a randomized controlled trial on the impact of intervention on final cosmesis. Lasers Med Sci 2019;34:1881-7. https://doi.org/10.1007/s10103-019-02788-3
  16. Karmisholt KE, Taudorf EH, Wulff CB, et al. Fractional CO2 laser treatment of caesarean section scars: a randomized controlled split-scar trial with long term follow-up assessment. Lasers Surg Med 2017;49:189-97. https://doi.org/10.1002/lsm.22606