title: Treatment of surgical scars with the cryogen-cooled 595 nm pulsed dye laser starting on the day of suture removal.
abstract: BACKGROUND
  Cosmetic results after skin surgery are a key component of patient satisfaction and self-image. Various lasers have been used to attempt scar improvement, without consistent results. The optimal time to initiate laser treatment has not been determined. A recent study using a noncooled 585 nm pulsed dye laser starting on the day of suture removal demonstrated substantial improvement in scar appearance.
  
  
  OBJECTIVE
  To determine the efficacy of the 595 nm cryogen-cooled pulsed dye laser in the treatment of surgical scars starting on the day of suture removal.
  
  
  METHODS
  Sixteen patients with postoperative linear scars of greater than 2 cm were treated three times at 4- to 8-week intervals with a 595 nm cryogen-cooled pulsed dye laser. All patients had Fitzpatrick skin types I to IV. Each scar was divided at the midline into two fields, with half receiving treatment using a 7 mm spot size at 1.5 ms with 8 J/cm2 and a 30 ms spray duration with a 10 ms delay. The other half was not treated. Scars were evaluated for pigmentation, vascularity, pliability, and height by a blinded examiner using the Vancouver Scar Scale (VSS). In addition, the same blinded examiner evaluated the cosmetic appearance using a scale from 0 (worst) to 10 (best) prior to the second treatment and 1 month after the final treatment.
  
  
  RESULTS
  SThe average sum of all parameters in the VSS showed significant improvement from 1-month post-treatment to the final evaluation of 60% compared with the control of -3%. Also, scars in the treated portions scored an average of 2 points higher in the overall cosmetic appearance by the same blinded examiner based on a scale of 0 (worst) to 10 (best). Among the individual parameters in the VSS, the most significant improvements were found in vascularity and pliability.
  
  
  CONCLUSIONS
  The cryogen-cooled 595 nm pulsed dye laser is a safe and effective option to improve the cosmetic appearance of surgical scars in skin types I to IV starting on the day of suture removal.
authors.affiliation: Department of Dermatology, Walter Reed Army Medical Center, 6900 Georgia Avenue, Washington, DC 20007, USA. tconologue@msn.com
authors.forename: Theresa Dressler
authors.initials: TD
authors.lastname: Conologue
authors.forename: Christopher
authors.initials: C
authors.lastname: Norwood
mesh_terms: D000328:Adult; D000368:Aged; D002921:Cicatrix / Q000209:etiology / Q000473:pathology / Q000532:radiotherapy*; D062109:Dermatologic Surgical Procedures; D020878:Device Removal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D028022:Low-Level Light Therapy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D016037:Single-Blind Method; D013536:Suture Techniques; D016896:Treatment Outcome