Effect of Ablative Fractional Carbon Dioxide Laser Combined with 1064 Nm-Nd: YAG Laser in the Treatment of Postburn Hypertrophic Scar

Overview

Journal Pak J Med Sci

Date 2025 Feb 10

PMID 39926675

Authors

Lingqiao Li

Weichang Shen

Guozhong Lyu

Affiliations

Soon will be listed here.

Abstract

Objective: To investigate the effect of ablative fractional carbon dioxide laser (AFCO2L) combined with 1064 nm-Nd: YAG laser in treating hypertrophic scars (HTS) in burn patients.

Methods: This study retrospectively analyzed the medical records of 119 patients with postburn HTS admitted to The First People's Hospital of Changzhou from March 2021 to October 2023. According to the treatment method, patients who received 1064 nm-Nd: YAG laser treatment were included in the YAG group, while patients who were treated by a combination of 1064 nm-Nd: YAG laser and AFCO2L comprised the combined group. Treatment effects, skin properties, and patients' satisfaction with aesthetics were compared between the two groups.

Results: The total efficacy of the combination group was significantly higher than that of the YAG group (<0.05). After the treatment, skin elasticity, skin moisture, and pigmentation scores of the combined group were significantly higher than those of the YAG group (<0.05). The level of satisfaction with the aesthetics was significantly higher in patients who received the combined treatment than those treated with YAG alone (<0.05).

Conclusions: A combination of AFCO2L and 1064 nm-Nd: YAG laser in the treatment of HTS is associated with a more significant effect, more significant improvement of skin properties, less pigmentation, and overall increased patient satisfaction with the aesthetics compared to the treatment with 1064 nm-Nd: YAG laser alone.

References

Tawfik A, Hanafy N, Ali R . Picosecond Nd:YAG versus Fractional CO Lasers in Management of Postburn Scars. Plast Reconstr Surg Glob Open. 2024; 12(3):e5700. PMC: 10959566. DOI: 10.1097/GOX.0000000000005700. View

Li L, Gao L, Zhao Y . Effect of vitiligo treatment by compound Glycyrrhizin combined with fractional laser and Triamcinolone Acetonide injection on T Lymphocyte subpopulation. Pak J Med Sci. 2022; 38(1):201-206. PMC: 8713234. DOI: 10.12669/pjms.38.1.4412. View

Jeschke M, van Baar M, Choudhry M, Chung K, Gibran N, Logsetty S . Burn injury. Nat Rev Dis Primers. 2020; 6(1):11. PMC: 7224101. DOI: 10.1038/s41572-020-0145-5. View

Guo X, Xie W . [Research progress on the mechanism of wound skin dys- pigmentation after burns]. Zhonghua Shao Shang Za Zhi. 2021; 37(10):1000-1004. DOI: 10.3760/cma.j.cn501120-20200714-00344. View

Chen H, Lei Y, OuYang H, Gold M, Tan J . Experimental comparative study of the effect of fractional CO laser combined with pulsed dye laser versus each laser alone on the treatment of hypertrophic scar of rabbit ears. J Cosmet Dermatol. 2022; 21(3):979-990. DOI: 10.1111/jocd.14732. View

Kim Y, Whang K, Choi W, Kim H, Hwang J, Lee J . Efficacy and safety of 1,064 nm Q-switched Nd:YAG laser treatment for removing melanocytic nevi. Ann Dermatol. 2012; 24(2):162-7. PMC: 3346906. DOI: 10.5021/ad.2012.24.2.162. View

Kivi M, Jafarzadeh A, Hosseini-Baharanchi F, Salehi S, Goodarzi A . The efficacy, satisfaction, and safety of carbon dioxide (CO2) fractional laser in combination with pulsed dye laser (PDL) versus each one alone in the treatment of hypertrophic burn scars: a single-blinded randomized controlled trial. Lasers Med Sci. 2024; 39(1):69. DOI: 10.1007/s10103-024-03976-6. View

Sipprell 3rd W, Bell D, Ibrahim S . Fractionally Ablative Er: YAG Laser Resurfacing for Thermal Burn Scars: a Split-Scar, Controlled, Prospective Cohort Study. Dermatol Surg. 2020; 46(12):1577-1582. DOI: 10.1097/DSS.0000000000002650. View

Ruchiatan K, Suhada K, Hindritiani R, Puspitosari D, Septrina R . Combination of 1064 nm Long-Pulsed and Q-Switched Nd:YAG Laser for Facial Hypertrophic Scar and Hyperpigmentation Following Burn Injury. Int Med Case Rep J. 2022; 15:23-27. PMC: 8800586. DOI: 10.2147/IMCRJ.S348091. View

10.

Betar N, Donovan M, Tyack Z, Warren J, McPhail S, Vujcich E . Recovery in patients undergoing ablative fractional carbon dioxide laser for adult hypertrophic burn scars: A longitudinal cohort study. Burns. 2024; 51(1):107300. DOI: 10.1016/j.burns.2024.107300. View

11.

Bunyaratavej S, Wanitphakdeedecha R, Ungaksornpairote C, Kobwanthanakun W, Chanyachailert P, Nokdhes Y . Randomized controlled trial comparing long-pulsed 1064-Nm neodymium: Yttrium-aluminum-garnet laser alone, topical amorolfine nail lacquer alone, and a combination for nondermatophyte onychomycosis treatment. J Cosmet Dermatol. 2020; 19(9):2333-2338. DOI: 10.1111/jocd.13291. View

12.

Madni T, Lu K, Nakonezny P, Imran J, Cunningham H, Clark A . Treating Hypertrophic Burn Scar With 2940-nm Er:YAG Laser Fractional Ablation Improves Scar Characteristics as Measured by Noninvasive Technology. J Burn Care Res. 2019; 40(4):416-421. DOI: 10.1093/jbcr/irz056. View

13.

Yan H, Sun Y, Hu Y, Wu Y . Ultrapulse carbon dioxide dot matrix laser for facial scar treatment: A meta-analysis. Int Wound J. 2023; . PMC: 10828724. DOI: 10.1111/iwj.14429. View

14.

Khedr M, Mahmoud W, Sallam F, Elmelegy N . Comparison of Nd: YAG Laser and Combined Intense Pulsed Light and Radiofrequency in the Treatment of Hypertrophic Scars: A Prospective Clinico-Histopathological Study. Ann Plast Surg. 2019; 84(5):518-524. DOI: 10.1097/SAP.0000000000002086. View

15.

Lewis C, Douglas H, Martin L, Deng Z, Melton P, Fear M . Carbon dioxide laser treatment of burn-related scarring: Results of the ELIPSE (Early Laser Intervention Promotes Scar Evolution) prospective randomized controlled trial. J Plast Reconstr Aesthet Surg. 2023; 84:368-376. DOI: 10.1016/j.bjps.2023.06.012. View

16.

Wan L, Zhou J, Li L . Effects of punctate skin grafting combined with or without irrigation on skin graft survival, redness and swelling score and pain in treatment of large-area residual burn wounds. Pak J Med Sci. 2022; 38(7):1832-1837. PMC: 9532662. DOI: 10.12669/pjms.38.7.5522. View

17.

Tawfic S, El-Tawdy A, Shalaby S, Foad A, Shaker O, Sayed S . Evaluation of Fractional CO Versus Long Pulsed Nd:YAG Lasers in Treatment of Hypertrophic Scars and Keloids: A Randomized Clinical Trial. Lasers Surg Med. 2020; 52(10):959-965. DOI: 10.1002/lsm.23249. View

18.

Kurup S, Travis T, Shafy R, Shupp J, Carney B . Treatment of burn hypertrophic scar with fractional ablative laser-assisted drug delivery can decrease levels of hyperpigmentation. Lasers Surg Med. 2023; 55(5):471-479. DOI: 10.1002/lsm.23662. View

19.

Supp D, Hahn J, Lloyd C, Combs K, Swope V, Abdel-Malek Z . Light or Dark Pigmentation of Engineered Skin Substitutes Containing Melanocytes Protects Against Ultraviolet Light-Induced DNA Damage In Vivo. J Burn Care Res. 2020; 41(4):751-760. DOI: 10.1093/jbcr/iraa029. View

20.

Asilian A, Salimi E, Faghihi G, Dehghani F, Tajmirriahi N, Hosseini S . Comparison of Q-Switched 1064-nm Nd: YAG laser and fractional CO2 laser efficacies on improvement of atrophic facial acne scar. J Res Med Sci. 2012; 16(9):1189-95. PMC: 3430044. View