Non-ablative fractional resurfacing of surgical and post-traumatic scars.
OBJECTIVE
Non-ablative, fractional lasers generate microscopic columns of coagulated tissue through the epidermis and dermis to evoke a wound healing response. In this study, the authors examined the efficacy and safety of the non-ablative 1540 nm erbium:glass fractional laser in the treatment of surgical and post-traumatic scars.


METHODS
Clinical studies were conducted on a range of surgical and post-traumatic scars with a 1540 nm erbium:glass fractional laser varying energy, pulse widths, treatment passes, and number of treatments. A histological study was conducted on a postsurgical scar to follow the time course of healing post-treatment and the impact of the fractional treatment on normalization of scar tissue, as compared to baseline histology of the scar.


RESULTS
Histologic findings demonstrated rapid re-epithelialization of the epidermis within 72 hours of treatment. Remodeling of scar tissue with renewal and reorganization of collagen fibers in the dermis was noted two weeks post-treatment. Clinical subjects, with Fitzpatrick skin types II-V, received three to seven treatments with microbeam energies up to 60 mJ/pb and five passes. Relative to baseline, 73% of treated scars improved 50% or more and 43% improved 75% or more. Side effects included mild swelling (95% of subjects), erythema (94%) and purpura (5%), which all resolved within two to three days. Downtime was minimal-to-none for all subjects.


CONCLUSIONS
These data illustrate the safety and efficacy of the 1540 nm erbium:glass fractional laser in the treatment of surgical and post-traumatic scars. Practitioners can vary energy and microbeam density in order to tailor the treatment to reflect the individual scar characteristics.
Vasily
David B
DB
Aesthetic Cosmetic and Laser Surgery Center, Bethlehem, PA 18018, USA. davidvasily@att.net
Cerino
Mary E
ME
Ziselman
Ethel M
EM
Zeina
S Tannous
ST
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002921:Cicatrix / Q000209:etiology / Q000601:surgery*; D002986:Clinical Trials as Topic; D003094:Collagen / Q000378:metabolism*; D004871:Erbium; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D011183:Postoperative Complications; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D004871:Erbium; D003094:Collagen