点阵激光联合肉毒毒素早期干预治疗手术后瘢痕

Early Carbon Dioxide Fractional Laser Combined With Botulinum Toxin Intervention For Improved Appearance Of Surgical Scars

目的探讨二氧化碳点阵激光联合肉毒毒素早期干预手术后瘢痕的临床效果。方法收集我院2020年1月至2021年12月20例(面颊部9例,鼻部3例,口周3例,下颏2例,额部2例,颈部1例,其中外伤后陈旧性瘢痕行手术治疗9例,整形治疗术后11例)患者,进行手术后瘢痕早期干预治疗,术后拆线1周针对手术后瘢痕组织进行二氧化碳点阵激光的治疗,治疗6次,每次间隔1个月。肉毒毒素总剂量10-30U/次,注射于疤痕周围及周边肌肉牵扯部位。采用温哥华瘢痕量表(Vancouver Scar Scale,VSS)及患者满意度作为评分标准评估治疗前后6个月瘢痕的治疗情况。结果点阵激光联合肉毒毒素治疗后,VSS分值较治疗前降低,差异有统计学意义(P<0.05);19例患者完成上述治疗并随访至6个月,其中1例患者因工作因素未完成点阵激光治疗,治疗后,17例患者对疗效满意,总体满意度达到89.4%。结论手术后瘢痕早期联合点阵激光及肉毒毒素注射治疗能够有效预防瘢痕增生,改善瘢痕愈后,且患者满意度高,可临床推广应用。

Objective To investigate the clinical effect of carbon dioxide fractional laser combined with botulinum toxin in early intervention on postoperative scar.Methods A total of 20 cases in our hospital from January 2020 to December 2021 (9 cases in the cheek,3 cases in the nose,3 cases in the mouth,2 cases in the chin,2 cases in the forehead,and 1 case in the neck) were collected.9 cases of old scars were treated with surgery,11 cases after plastic surgery),early intervention treatment of postoperative scars,1 week after suture removal,carbon dioxide fractional laser treatment for scar tissue (CO_(2)FL),a total of 6 treatments,each time interval 1 month.The total dose of botulinum toxin is 10-30U,and it is injected around the scar and the surrounding muscles involved.The Vancouver Scar Scale (VSS) and patient satisfaction were used as scoring criteria to evaluate the scar treatment conditions before and after treatment for 6 months.Results After fractional laser combined with botulinum toxin treatment,the VSS score was lower than that before treatment,and the difference was statistically significant (P<0.05).Fractional laser treatment was not completed.After treatment,17 patients were satisfied with the curative effect,and the overall satisfaction rate reached 89.4%.Conclusion Early postoperative scar treatment combined with fractional laser and botulinum toxin injection can effectively prevent scar hyperplasia,improve scar recovery,and has high patient satisfaction,which can be clinically popularized and applied.