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Post-Surgical Repair of Cleft Scar Using Fractional CO2 Laser.
Open Access Maced J Med Sci 2018; 6(7):1231-1234OA

Abstract

BACKGROUND

Postoperative scarring is a common cause of patients dissatisfaction. Several modalities have been developed to overcome such a problem following surgical repair. Despite precise surgical technique, still, some scars would remain over the time, mostly due to the weak formation or inadequately replaced collagen fibres in the underneath dermis especially those following unilateral or bilateral cleft lip repair surgery.

AIM

of this study is to evaluate whether a 10,600 nm fractional ablative carbon dioxide (CO2) used early during the healing period would result in better postoperative scars.

METHODS

In the present study six patients complained from cleft lip scars resulting from lip revision surgery. Each patient had six fractional ablative CO2 laser sessions for treatment along six months to obtain a complete collagen cycle. Vancouver Scar Scale VSS was used as a method of evaluation of the scar using 4 points scale evaluating vascularity, pliability, thickness & colour of the skin and Visual Analogue Scale VAS from (0-10) was used to assess the severity of pain as well as a survey questionnaire for the rate of patient's satisfaction. Also, digital clinical photos assessment before&after were compared.

RESULTS

Patients expressed a significantly greater degree of satisfaction with the treatment using a subjective 4-point scale. All patients observed dramatic improvement in their lip scars after FCO2 laser sessions following their surgeries with the better psychological state. The assessment was done by clinical observation according to VSS before (9.17 ± 2.2) while after (3.33 ± 1.9) with a highly significant P value <0.001 and VAS for the rate of pain & satisfaction that ranged from (8.0 ± 0.9) as well as series of photos taken before and after the procedure. No long-term complications were noted however patients complained of annoying pain during the session as well as crust formation that lasted up to 5 days after surgery. In the present study, we introduce the effectiveness of ablative fractional 10,600 nm CO2 laser for treatment of postoperative cleft lip scar after secondary surgical cleft repair rather than ablative CO2 due to its reported complications such as postoperative infection, erythema and pigmentary changes along with prolonged downtime healing. In the current study, we chose early laser treatment within the first six months before complete collagen organisation which will be easier to manage the older scars. Patients mostly complained about the pain during the session as well as dark-coloured crust formation post session that stayed from 3-5 days however they all observed a massive improvement of their scars following treatment protocol.

CONCLUSION

Facial wounds sutured in layers heal in a good manner. Patients prefer early treatment with a fractional CO2 ablative laser for postoperative surgical scars. The use of a CO2 fractional laser is safe and effective also causes high patients satisfaction.

Authors+Show Affiliations

National Research Center, Cairo, Egypt.National Research Center, Cairo, Egypt.National Research Center, Cairo, Egypt.Al Azhar University, Cairo, Egypt.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30087726

Citation

Mossaad, Aida, et al. "Post-Surgical Repair of Cleft Scar Using Fractional CO2 Laser." Open Access Macedonian Journal of Medical Sciences, vol. 6, no. 7, 2018, pp. 1231-1234.
Mossaad A, Kotb A, Abdelrahaman M, et al. Post-Surgical Repair of Cleft Scar Using Fractional CO2 Laser. Open Access Maced J Med Sci. 2018;6(7):1231-1234.
Mossaad, A., Kotb, A., Abdelrahaman, M., & Ahmady, H. A. (2018). Post-Surgical Repair of Cleft Scar Using Fractional CO2 Laser. Open Access Macedonian Journal of Medical Sciences, 6(7), pp. 1231-1234. doi:10.3889/oamjms.2018.250.
Mossaad A, et al. Post-Surgical Repair of Cleft Scar Using Fractional CO2 Laser. Open Access Maced J Med Sci. 2018 Jul 20;6(7):1231-1234. PubMed PMID: 30087726.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Post-Surgical Repair of Cleft Scar Using Fractional CO2 Laser. AU - Mossaad,Aida, AU - Kotb,Amr, AU - Abdelrahaman,Moustapha, AU - Ahmady,Hatem Al, Y1 - 2018/06/22/ PY - 2018/02/16/received PY - 2018/05/24/revised PY - 2018/05/30/accepted PY - 2018/8/9/entrez PY - 2018/8/9/pubmed PY - 2018/8/9/medline KW - Cleft lip KW - Fractional laser KW - Scar SP - 1231 EP - 1234 JF - Open access Macedonian journal of medical sciences JO - Open Access Maced J Med Sci VL - 6 IS - 7 N2 - BACKGROUND: Postoperative scarring is a common cause of patients dissatisfaction. Several modalities have been developed to overcome such a problem following surgical repair. Despite precise surgical technique, still, some scars would remain over the time, mostly due to the weak formation or inadequately replaced collagen fibres in the underneath dermis especially those following unilateral or bilateral cleft lip repair surgery. AIM: of this study is to evaluate whether a 10,600 nm fractional ablative carbon dioxide (CO2) used early during the healing period would result in better postoperative scars. METHODS: In the present study six patients complained from cleft lip scars resulting from lip revision surgery. Each patient had six fractional ablative CO2 laser sessions for treatment along six months to obtain a complete collagen cycle. Vancouver Scar Scale VSS was used as a method of evaluation of the scar using 4 points scale evaluating vascularity, pliability, thickness & colour of the skin and Visual Analogue Scale VAS from (0-10) was used to assess the severity of pain as well as a survey questionnaire for the rate of patient's satisfaction. Also, digital clinical photos assessment before&after were compared. RESULTS: Patients expressed a significantly greater degree of satisfaction with the treatment using a subjective 4-point scale. All patients observed dramatic improvement in their lip scars after FCO2 laser sessions following their surgeries with the better psychological state. The assessment was done by clinical observation according to VSS before (9.17 ± 2.2) while after (3.33 ± 1.9) with a highly significant P value <0.001 and VAS for the rate of pain & satisfaction that ranged from (8.0 ± 0.9) as well as series of photos taken before and after the procedure. No long-term complications were noted however patients complained of annoying pain during the session as well as crust formation that lasted up to 5 days after surgery. In the present study, we introduce the effectiveness of ablative fractional 10,600 nm CO2 laser for treatment of postoperative cleft lip scar after secondary surgical cleft repair rather than ablative CO2 due to its reported complications such as postoperative infection, erythema and pigmentary changes along with prolonged downtime healing. In the current study, we chose early laser treatment within the first six months before complete collagen organisation which will be easier to manage the older scars. Patients mostly complained about the pain during the session as well as dark-coloured crust formation post session that stayed from 3-5 days however they all observed a massive improvement of their scars following treatment protocol. CONCLUSION: Facial wounds sutured in layers heal in a good manner. Patients prefer early treatment with a fractional CO2 ablative laser for postoperative surgical scars. The use of a CO2 fractional laser is safe and effective also causes high patients satisfaction. SN - 1857-9655 UR - https://www.unboundmedicine.com/medline/citation/30087726/Post_Surgical_Repair_of_Cleft_Scar_Using_Fractional_CO2_Laser_ L2 - https://doi.org/10.3889/oamjms.2018.250 DB - PRIME DP - Unbound Medicine ER -