Qiang Ji, Lili Luo, Jun Ni, Xiaolan Pu, He Qiu, Dongmei Wu
{"title":"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。","authors":"Qiang Ji, Lili Luo, Jun Ni, Xiaolan Pu, He Qiu, Dongmei Wu","doi":"10.1111/jocd.16708","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>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 CO<sub>2</sub> laser in treating surgical scars.</p>\n </section>\n \n <section>\n \n <h3> Objective</h3>\n \n <p>This study aims to present evidence from controlled trials investigating the efficacy of ablative carbon dioxide fractional laser in treating surgical scars.</p>\n </section>\n \n <section>\n \n <h3> Materials and Methods</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>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 CO<sub>2</sub> laser therapy exhibited the same efficacious outcomes, with MD values of −0.63 (95% CI: −1.15 to −0.12; I<sup>2</sup> = 70%; <i>p</i> = 0.02) and − 1.86 (95% CI: −2.65 to −1.07; I<sup>2</sup> = 85%; <i>p</i> < 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; I<sup>2</sup> = 89%; <i>p</i> < 0.001 and MD: -1.93; 95% CI: −2.24 to −1.62; I<sup>2</sup> = 48%; <i>p</i> < 0.001). However, fractional CO<sub>2</sub> laser treatment administered over 3 months after surgery did not significantly improve postoperative scars (MD: –0.17; 95% CI: −0.56 to 0.21; I<sup>2</sup> = 37%; <i>p</i> = 0.37).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>The systematic review and meta-analysis provide robust support for the efficacy of fractional CO<sub>2</sub> 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.</p>\n </section>\n </div>","PeriodicalId":15546,"journal":{"name":"Journal of Cosmetic Dermatology","volume":"24 1","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711943/pdf/","citationCount":"0","resultStr":"{\"title\":\"Fractional CO2 Laser to Treat Surgical Scars: A System Review and Meta-Analysis on Optimal Timing\",\"authors\":\"Qiang Ji, Lili Luo, Jun Ni, Xiaolan Pu, He Qiu, Dongmei Wu\",\"doi\":\"10.1111/jocd.16708\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>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 CO<sub>2</sub> laser in treating surgical scars.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>This study aims to present evidence from controlled trials investigating the efficacy of ablative carbon dioxide fractional laser in treating surgical scars.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Materials and Methods</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>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 CO<sub>2</sub> laser therapy exhibited the same efficacious outcomes, with MD values of −0.63 (95% CI: −1.15 to −0.12; I<sup>2</sup> = 70%; <i>p</i> = 0.02) and − 1.86 (95% CI: −2.65 to −1.07; I<sup>2</sup> = 85%; <i>p</i> < 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; I<sup>2</sup> = 89%; <i>p</i> < 0.001 and MD: -1.93; 95% CI: −2.24 to −1.62; I<sup>2</sup> = 48%; <i>p</i> < 0.001). However, fractional CO<sub>2</sub> laser treatment administered over 3 months after surgery did not significantly improve postoperative scars (MD: –0.17; 95% CI: −0.56 to 0.21; I<sup>2</sup> = 37%; <i>p</i> = 0.37).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>The systematic review and meta-analysis provide robust support for the efficacy of fractional CO<sub>2</sub> 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.</p>\\n </section>\\n </div>\",\"PeriodicalId\":15546,\"journal\":{\"name\":\"Journal of Cosmetic Dermatology\",\"volume\":\"24 1\",\"pages\":\"\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-01-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11711943/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Cosmetic Dermatology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/jocd.16708\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"DERMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Cosmetic Dermatology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jocd.16708","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"DERMATOLOGY","Score":null,"Total":0}
Fractional CO2 Laser to Treat Surgical Scars: A System Review and Meta-Analysis on Optimal Timing
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.
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.
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