Prevention of thyroidectomy scar using a new 1,550-nm fractional erbium-glass laser.
BACKGROUND
Surgical scars are a common cosmetic problem that occurs in various surgical fields including dermatology. Diverse trials have been made to prevent this annoying scar formation. Recently, 585- and 595-nm pulsed dye laser irradiation presented satisfactory cosmetic outcome for the treatment of surgical scars. Other fractionated lasers or light devices were also applied for scar treatment.


OBJECTIVE
To determine the effectiveness and safety of a newly developed 1,550-nm fractional erbium-glass laser in the prevention of scar formation after total thyroidectomy.


METHODS
Twenty-seven ethnic South Korean patients with linear surgical suture lines after total thyroidectomy operation were treated with a 1,550-nm fractional erbium-glass laser. The same surgeon performed all of the operations using the same surgical techniques. Each patient was treated four times at 1-month intervals using the same parameters (5- x 10-mm spot size, 10 mJ, 1,500 spot/cm(2), static mode). Initiation of the first irradiation was made approximately 2 to 3 weeks after the thyroidectomy. The scar prevention effects were evaluated each month for 6 months after thyroidectomy. Two kinds of assessment methods were applied in this evaluation. First, the Vancouver Scar Scale (VSS) was used. Second, three independent physicians gave a global assessment valuation to the final cosmetic results: poor (1), fair (2), good (3), or excellent (4). These results were compared with the surgical scars of a control group (patients who denied laser treatments and had no other treatments during the 6 months after total thyroidectomy by the same surgeon).


RESULTS
The average VSS score was lower in the laser treatment group. The global assessment also presented better cosmetic outcomes in the treatment group than in the controls.


CONCLUSIONS
A new 1,550-nm fractional erbium-glass laser may efficiently repress the formation and hypertrophy of thyroidectomy scars on the neck, and it can be safely applied in relatively dark Asian skin without noticeable adverse effects.
Choe
Jun-Ho
JH
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Jongno-Ku, Seoul, Korea.
Park
Yong-Lai
YL
Kim
Beom Joon
BJ
Kim
Myeung Nam
MN
Rho
Nark Kyoung
NK
Park
Byung-Soon
BS
Choi
Young-Jun
YJ
Kim
Kea Jeung
KJ
Kim
Won-Serk
WS
D000328:Adult; D002921:Cicatrix / Q000517:prevention & control*; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013965:Thyroidectomy; D016896:Treatment Outcome