الفهرس 
NORMAL WOUND HEALINGOnly 14 pages are availabe for public view
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Abstract
H
ypertrophic Scars result of abnormal wound healing due to an inflammatory process within the wound and are mainly constituted of fibroblasts formation, neoangiogensis and substantial deposition of collagen. HS likely arise during a few months in high tension area and can persist along the margins of the original wound. Hypertrophic scars arise after various injury mechanisms such as traumatic skin injury, skin burns, surgical wounds, skin injections and dermatitis. from which, surgeries are considered to be one of the major causes of hypertrophic scars.
The aim of this study was to evaluate the efficacy of low energy carbon dioxide laser therapy in management of hypertrophic surgical scars in comparison to the standardized high energy modes in regards of scar ablation and patient satisfaction.
This study is a prospective and a comparative that compared traditional High energy with Low Energy fractional CO2 laser in treatment of Hypertrophic post-surgical scars. This study was conducted between April 2021 to March 2022 at the Laser Unit attached to plastic, Burn and Maxillofacial Surgery Department at Faculty of Medicine, Ain Shams University.
The study included 40 patients (N=40), all of which were complaining of post Abdominoplasty Hypertrophic scars and were divided blindly into 2 groups. In group I (n=20), they were treated by standard high energy fractional CO2 laser therapy Light FX: Energy (70-150mJ), density (5-10%), and frequency (150-250Hz), Deep FX: Energy (15.5-25.5mJ), density (5-15%) and frequency (300-600Hz), Active FX: Energy (100-150mJ), density (5%) and frequency (200-250Hz).
In group II (n=20), they were treated by lower energy modes than group I, Light FX: Energy (50-120mJ), density (5%), and frequency (100-200Hz), Deep FX: Energy (12.5-22.5mJ), density (3-10%) and frequency (200-400Hz), Active FX: (80- 125mJ), density (3%) and frequency (100-150Hz). Both groups were treated by Syneron/CANDELA CO2RE® laser machine and both groups were evaluated by, 3different observers using the VSS score once before starting sessions and twice on two separate occasions after completion of sessions. Patients in both groups also evaluated themselves using the POSAS score. Results of both groups were compared in regards to mean age, history of Abdominoplasty, history of massive weight loss, post session complication, skin quality, mean POSAS score before and after, and mean VSS before and after.
After review of both groups; we have concluded that high frequency fractional CO2 laser offers greater results in regards to scar ablation which could be notably measured by the VSS variables at the cost of longer recovery times and potentially more irritating to the patients. On the other hand, the low frequency fractional CO2 laser scar ablation is likely to offer moderate results, and an easier and shorter recovery times thus may contribute to greater patient satisfaction. Overall, this selection of frequencies allows the physician options to customize the appropriate care for their patients according to their patients’ needs and circumstances.
CONCLUSION
A
fter review of both groups; we have concluded that high frequency fractional CO2 laser offers greater results in regards to scar ablation which could be notably measured by the VSS variables at the cost of longer recovery times and potentially more irritating to the patients. On the other hand, the low frequency fractional CO2 laser scar ablation is likely to offer moderate results, and an easier and shorter recovery times thus may contribute to greater patient satisfaction. Overall, this selection of frequencies allows the physician options to customize the appropriate care for their patients according to their patients’ needs and circumstances.
LIMITATIONS
T
he study was performed on one type of surgical wound scars, Abdominoplasty scar, within the first six months post operatively which is relatively a recent scar. Also the study has evaluated the scars by only two variables; the patient self-rating (POSAS) and observers’ evaluation by the (VSS). Thus, the study needs to be performed on different types of scars whether surgical or traumatic and to include older than six months scars. It will be of greater benefit if histological assessment could be added to the measured variables in the study.