Fractional CO2 Laser to Treat Surgical Scars: A System Review and Meta-Analysis on Optimal Timing

IF 2.3 4区医学 Q2 DERMATOLOGY

Journal of Cosmetic Dermatology Pub Date : 2025-01-08 DOI:10.1111/jocd.16708

Qiang Ji, Lili Luo, Jun Ni, Xiaolan Pu, He Qiu, Dongmei Wu

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引用次数: 0

Abstract

Background

Surgical scars with textural changes can be disfiguring and uncomfortable for patients. Various laser therapies have shown promise in softening and flattening these scars. Therefore, the authors conducted a systematic review and meta-analysis on the efficacy of fractional CO₂ laser in treating surgical scars.

Objective

This study aims to present evidence from controlled trials investigating the efficacy of ablative carbon dioxide fractional laser in treating surgical scars.

Materials and Methods

A literature search of Medline (via PubMed), Ovid, Web of Science, and Embase for relevant trials was conducted before March 2024. After assessing for inclusion, data extraction was performed using Population, Intervention, Comparison, Outcomes and Study criteria (PICOS). Quality, validity, and risk of bias were assessed using the RevMan5.3 risk of bias assessment tool.

Results

A total of 14 controlled trials involving 492 participants or postsurgical scars were included in the system review and meta-analysis. Both in RCT and non-RCT settings, fractional CO₂ laser therapy exhibited the same efficacious outcomes, with MD values of −0.63 (95% CI: −1.15 to −0.12; I² = 70%; p = 0.02) and − 1.86 (95% CI: −2.65 to −1.07; I² = 85%; p < 0.001), respectively. Moreover, furthermore analysis illustrated that initiating FRACTIONAL CO2 LASER treatment sessions at or within 1 month after surgery significantly reduced postoperative scars compared to control groups and groups on treatments initiated more than 3 months after surgery (MD: -1.66; 95% CI: −2.31 to −1.01; I² = 89%; p < 0.001 and MD: -1.93; 95% CI: −2.24 to −1.62; I² = 48%; p < 0.001). However, fractional CO₂ laser treatment administered over 3 months after surgery did not significantly improve postoperative scars (MD: –0.17; 95% CI: −0.56 to 0.21; I² = 37%; p = 0.37).

Conclusion

The systematic review and meta-analysis provide robust support for the efficacy of fractional CO₂ laser in treating surgical scars, particularly when administered at or within 1 month after surgery. One treatment session within 1 month after surgery also can produce significant results, but most clinical trials support 2–3 treatment sessions or more.

Abstract Image

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分数CO2激光治疗手术疤痕：最佳时机的系统回顾和荟萃分析。

背景：手术疤痕与质地改变可以毁容和不舒服的病人。各种激光疗法已经显示出软化和平坦这些疤痕的希望。因此，作者对分数CO2激光治疗手术瘢痕的疗效进行了系统回顾和荟萃分析。目的：本研究旨在提供对照试验的证据，探讨烧蚀二氧化碳分数激光治疗手术疤痕的疗效。材料与方法：2024年3月前，检索Medline（通过PubMed）、Ovid、Web of Science和Embase进行相关试验的文献检索。评估纳入后，使用人群、干预、比较、结果和研究标准（PICOS）进行数据提取。使用RevMan5.3偏倚风险评估工具对质量、效度和偏倚风险进行评估。结果：系统回顾和荟萃分析共纳入14项对照试验，涉及492名参与者或术后疤痕。在随机对照试验和非随机对照试验中，部分CO2激光治疗显示出相同的有效结果，MD值为-0.63 (95% CI: -1.15至-0.12；i2 = 70%；p = 0.02)和- 1.86 (95% CI: -2.65至-1.07；i2 = 85%；p 2 = 89%；p 2 = 48%；术后3个月给予激光治疗对术后瘢痕无显著改善(MD: -0.17；95% CI: -0.56 ~ 0.21；i2 = 37%；p = 0.37)。结论：系统评价和荟萃分析为分数CO2激光治疗手术瘢痕的疗效提供了强有力的支持，特别是在手术后1个月内给予。手术后1个月内的一次治疗也可以产生显著的效果，但大多数临床试验支持2-3次或更多的治疗。

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来源期刊

Journal of Cosmetic Dermatology DERMATOLOGY-

CiteScore

4.30

自引率

13.00%

发文量

818

审稿时长

>12 weeks

期刊介绍： The Journal of Cosmetic Dermatology publishes high quality, peer-reviewed articles on all aspects of cosmetic dermatology with the aim to foster the highest standards of patient care in cosmetic dermatology. Published quarterly, the Journal of Cosmetic Dermatology facilitates continuing professional development and provides a forum for the exchange of scientific research and innovative techniques. The scope of coverage includes, but will not be limited to: healthy skin; skin maintenance; ageing skin; photodamage and photoprotection; rejuvenation; biochemistry, endocrinology and neuroimmunology of healthy skin; imaging; skin measurement; quality of life; skin types; sensitive skin; rosacea and acne; sebum; sweat; fat; phlebology; hair conservation, restoration and removal; nails and nail surgery; pigment; psychological and medicolegal issues; retinoids; cosmetic chemistry; dermopharmacy; cosmeceuticals; toiletries; striae; cellulite; cosmetic dermatological surgery; blepharoplasty; liposuction; surgical complications; botulinum; fillers, peels and dermabrasion; local and tumescent anaesthesia; electrosurgery; lasers, including laser physics, laser research and safety, vascular lasers, pigment lasers, hair removal lasers, tattoo removal lasers, resurfacing lasers, dermal remodelling lasers and laser complications.