title: Fractionated Er:YAG laser versus fully ablative Er:YAG laser for scar revision: Results of a split scar, double blinded, prospective trial.
abstract: Ablative laser resurfacing is a common treatment for post-surgical scars. Fractional ablative laser resurfacing has been an emerging treatment option that is replacing fully ablative lasers in many applications. Data comparing fractionated and fully ablative lasers in treating post-operative scars are lacking.
  
  
  
  Twenty patients were enrolled in a split scar study following excisions from dermatologic surgery. Wounds had to be older than 8 weeks but less than 1 year. The scars were randomly divided into two halves. One half of the scar was treated with fully ablative erbium-doped yttrium aluminum garnet (Er:YAG) and the other was treated with fractionated Er:YAG. The scars were treated at monthly intervals for 3 months, then followed up at months 1 and 2 after the last treatment. POSAS was used to evaluate the scars by a panel of dermatologists blinded to the lasers in conjunction with the patients, who were also blinded.
  
  
  
  Physicians and patients both observed a superior outcome of 32.5% (P = 0.019) and 58.1% (P = 0.001), respectively, using the POSAS. There was no trend in difference in pain reported by the patient between the two lasers. Patients overwhelmingly preferred the fractionated Er:YAG laser (94%) to the fully ablative laser when asked at the end of the study.
  
  
  
  Although this study is limited by a short follow-up period, it shows a statistically significant superior outcome in fractionated Er:YAG over fully ablative Er:YAG for scar revision. It also adds quantitative values to the assessment of scar appearance when treated with fractionated lasers compared to fully ablative lasers. It was also found that the fractionated Er:YAG had increased patient satisfaction, but there was no difference in reported pain scores. These data are useful when counseling patients undergoing laser surgery. Lasers Surg. Med. 48:837-843, 2016. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Division of Dermatology, University of Louisville, 3810 Springhurst Blvd., Louisville, Kentucky, 40241. wjamestidwell@gmail.com.
authors.forename: W James
authors.initials: WJ
authors.lastname: Tidwell
authors.affiliation: Division of Dermatology, University of Louisville, 3810 Springhurst Blvd., Louisville, Kentucky, 40241.
authors.forename: Cindy E
authors.initials: CE
authors.lastname: Owen
authors.affiliation: Division of Dermatology, University of Louisville, 3810 Springhurst Blvd., Louisville, Kentucky, 40241.
authors.forename: Carol
authors.initials: C
authors.lastname: Kulp-Shorten
authors.affiliation: The Fletcher School of Law and Diplomacy, Tufts University, 160 Packard Avenue, Medford, Massachusetts, 02155.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Maity
authors.affiliation: Division of Dermatology, University of Louisville, 3810 Springhurst Blvd., Louisville, Kentucky, 40241.
authors.forename: Michael
authors.initials: M
authors.lastname: McCall
authors.affiliation: Division of Dermatology, University of Louisville, 3810 Springhurst Blvd., Louisville, Kentucky, 40241.
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Brown
mesh_terms: D000328:Adult; D000368:Aged; D002921:Cicatrix / Q000601:surgery*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: clinical trial; hypertrophic scar; laser resurfacing; patient satisfaction; wound healing