High-intensity laser photocoagulation and cryodestruction in the treatment of patients with skin scars

V. Yudin, I. V. Vasin, T. A. Kachanova
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Abstract

Purpose: to assess the effects of combined application of high-level laser photocoagulation and simultaneous cryodestruction at pathological scars on the skin.Material and methods. Two groups included patients of both genders aged 18 and older. Patients from the fi rst (main) group (n = 60) had simultaneous high-level laser irradiation and cryodestruction on scar tissue; patients from the second (control) group (n = 30) were treated separately with laser irradiation and cryodestruction. For laser irradiation, laser devise CO2-laser AKHIL with wavelength 10.6 μm, pulsed frequency 10–20 Hz and power 5–15 W was used. For cryodestruction, apparatus “KRIO-RM-01” was used: tip cooling speed of 220 °C/min, the temperature of 180 °C on the tip working part, exposure time – 15–20 sec. The treated patients had hypertrophic and keloid scars. Etiologically, scars were of post-traumatic, postoperative, post-eruptive types. Evaluation criteria were histological examination of biopsy material with eosinhematoxylin, patients’ quality of life, examination of scar zone.Results. The obtained results demonstrate that the combined application of two physical factors (laser + cryo) at scar tissue increases satisfactory outcomes in patients with hypertrophic scars by 75 % and by 53.4 % in the control group. Relapses were seen in both groups: 25 % in the main group and 46 % in the control group. Morphologically, one can see positive changes in degradation of rough fi brous tissue.Conclusion. A combined application of high-intensity laser photocoagulation and simultaneous cryodestruction has been proven to be effective in patients with pathological skin scars.
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高强度激光光凝与低温破坏治疗皮肤瘢痕的疗效观察
目的:探讨高强度激光光凝联合冷冻破坏治疗皮肤病理性瘢痕的效果。材料和方法。两组包括18岁及以上的男女患者。第一组(主要)患者(n = 60)同时对瘢痕组织进行高强度激光照射和冷冻破坏;第二组(对照组)30例患者分别采用激光照射和冷冻破坏治疗。激光照射采用co2激光AKHIL,波长10.6 μm,脉冲频率10 ~ 20 Hz,功率5 ~ 15 W。冷冻破坏采用“KRIO-RM-01”装置:尖端冷却速度220℃/min,尖端工作部位温度180℃,暴露时间- 15-20秒。治疗患者有增生性瘢痕和瘢痕疙瘩。病因学上,疤痕为创伤后、术后、爆发后类型。评价标准为活检材料伊红苏木精组织学检查、患者生活质量、瘢痕区检查。结果表明,在瘢痕组织中联合应用两种物理因素(激光+冷冻)可使增生性瘢痕患者的满意结果提高75%,对照组提高53.4%。两组均有复发:主组25%,对照组46%。形态学上,我们可以看到粗纤维组织退化的积极变化。高强度激光光凝和同时冷冻破坏的联合应用已被证明对病理性皮肤疤痕患者有效。
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期刊介绍: The main columns of "Chinese Journal of Laser Medicine & Surgery" include treatises, which report the latest research results in basic research and clinical trials in the field of laser medicine; comprehensive reviews of the latest research progress in laser medicine at home and abroad. In addition, there are short reports and excerpts from foreign journals, conference news and other columns. The journal has published a large number of papers on basic research on laser medicine and applied research in various clinical subjects, aiming to play a positive role in promoting the application of laser in medicine and improving the level of laser medicine research.
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