Fractional CO2 laser treatment of caesarean section scars—A randomized controlled split‐scar trial with long term follow‐up assessment
- 8 November 2016
- journal article
- research article
- Published by Wiley in Lasers in Surgery and Medicine
- Vol. 49 (2) , 189-197
Abstract
Background and Objectives: Caesarean section (c‐section) scars can be pose functional and cosmetic challenges and ablative fractional laser (AFXL) treatment may offer benefit to patients. We evaluated textural and color changes over time in AFXL‐treated versus untreated control scars.Materials and Methods: A randomized, controlled, intra‐individual split‐scar trial with three sessions of AFXL‐treatments for mature c‐section scars. Settings of AFXL were adjusted to each individual scar. End‐points were blinded on‐site clinical evaluations at 1, 3, and 6 months follow‐up (Patient and Observer Scar Assessment Scale [POSAS] and Vancouver Scar Scale [VSS]), blinded photo‐evaluations, reflectance measurements, tissue histology, and patients satisfaction.Results: Eleven of 12 patients completed the study. At 1 month follow‐up, AFXL‐treated scars were significantly improved in pliability (POSAS P = 0.01 VSS P = 0.02) and smoother in surface relief (POSAS P = 0.03) compared to control scars. At 1–3 months, overall scar appearance was dominated by transient erythema and hyperpigmentation, confirmed by reflectance measurements (erythema% and pigmentation% peaked at 1 and 3 month follow‐up, respectively). At 6 months follow‐up, AFXL‐treated scars improved on POSAS‐total score though not significantly (P = 0.06). Correspondingly, blinded photo‐evaluation found AFXL‐treated scars significantly improved compared to controls (VAS P = 0.02). Histology indicated new dermal collagen and elastic fibers on AFXL‐treated scars. At 6 months follow‐up, a majority of patients (64%) favored subsequent AFXL‐treatment of their untreated control scar tissue.Conclusions: Scar remodeling is initiated 1 month after AFXL treatment, but overall scar improvement is concealed until laser‐induced color changes resolve. At 6 months follow‐up, the benefit of AFXL treatment on c‐section scars emerges. Lasers Surg. Med. 49:189–197, 2017.Keywords
Funding Information
- Lumenis Ltd
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