Study of fractional ablative laser in surgical and post traumatic scar

Abstract

Introduction: Ablative, fractional lasers generate microscopic columns of coagulated tissue through the epidermis and dermis to evoke a wound healing response. In this study, we examined the efficacy and safety of fractional ablative 2940nm erbium: YAG laser in the treatment of surgical and post-traumatic scars. Fractional laser photothermolysis is the latest in the broad range of Er: YAG laser technique. This technique promises a novel means of providing treatments that would be as effective as traditional Er: YAG, while further reducing their down time and risk. Aim of the Work: The aim of this work is to assess the efficacy and safety of variable square pulse (VSP) fractional Er: YAG laser for the treatment of surgical and post-traumatic scars; both clinically and histopathologically. Methods: Clinical studies were conducted on a range of surgical and post-traumatic scars with a 2940nm erbium: YAG fractional ablative laser varying energy, pulse widths, treatment passes, and number of treatments: twenty subjects, with Fitzpatrick skin types III-IV, received two to five treatments at one month interval and a follow up period for 3 months. Clinical and histopathological evaluation of the results was performed. Results: Almost all patients improved both clinically and histopathologically. Clinical improvement in scars according to investigator assessment: 40% of patients had excellent improvement of 76-100% (grade 3), 50% of patients had good improvement of 50-75% (grade 2), 10% had fair improvement of 26-49% (grade 1) at three month follow up. Histologic findings demonstrated remodeling of scar tissue with renewal and reorganization of collagen fibers in the dermis was noted two weeks post-treatment. Conclusion: These data illustrate the safety and efficacy of the 2940nm erbium:YAG fractional ablative laser in the treatment of surgical and post-traumatic scars with short down time period, and almost no incidence of complication.