摘要

Objectives: The aim of the study is to evaluate the efficacy of a novel approach for scar treatment in patients undergoing planned elective surgery. The treatment includes pre-operative non-ablative laser treatment using the 1570nm laser and post-operative scar treatment using a unique pattern of both 10600nm and 1570nm lasers, immediately followed by trans-epidermal delivery of Triamcinolone acetonide (TAC). This novel treatment approach was tested on women undergoing bilateral breast reduction. Introduction: Post-operative scarring is a common cause of patients' dissatisfaction. Despite precise surgical technique, scars may remain due to weak formation or inadequately replaced collagen fibers. Preparation of the skin pre-operatively using 1570nm laser is a novel treatment approach to improve the appearance of surgical scars in patients’ who are planned to undergo elective surgery. Post-operative scar treatment using a unique pattern of fractional ablative and non ablative laser creates micro zones which may be used as channels to deliver drugs and other substances to enhance scar treatment. Materials / method: 20 eligible female subjects scheduled to undergo a surgical intervention of bilateral breast reduction were enrolled into the study. Subjects’ breasts (right and left) were randomly assigned into 2 treatment arms. The incision areas amongst the patient arms were divided into segments. Pre-operatively, segments were either treated with 1570nm laser, or with no skin preparation. Post-operatively, segments were treated with a combination of 1570nm and 10600nm laser, with or without trans epidermal delivery of TAC. Patients' received 4 treatments. Follow up sessions were at 1, 3 & 6 months post. Results: Highest differences in VSS scores were observed in the segment that underwent pre-treatment with non-ablative 1570nm laser and post-operative scar treatment using both 10600nm and 1570nm lasers, followed by trans-epidermal delivery of TAC. Slightly lower differences in VSS scores were observed in the segment that underwent pre-treatment with non-ablative 1570nm laser and then post-operative scar treatments using both 10600nm and 1570nm lasers only. Differences in the VSS were significant in those that did not receive pre-treatment. Most adverse effects were mild to moderate in severity. Conclusion: Our results demonstrate that pre-operative treatment of the planned incision site using non-ablative 1570nm laser and post-operative scars treatments using both 10600nm and 1570nm lasers, immediately followed by trans-epidermal delivery of TAC is the most promising protocol to significantly improve the final scar appearance.