Observation on clinical effect of botulinum toxin type A injection combined with low-energy CO2 fractional laser periocular rejuvenation treatment

Objective To investigate the clinical effect of botulinum toxin type A injection combined with low-energy CO2 fractional laser periocular rejuvenation treatment.Methods The clinical effect of botulinum type A injection alone and botulinum type A injection combined with low-energy CO2 fractional laser was compared in 96 patients who needed to receive periocular rejuvenation treatment from April 2018 to April 2019.Results After the combined low-energy CO2 fractional laser treatment was given on the basis of botulinum toxin type A injection,the follow-up global aesthetic improvement scale(GAIS)scores of the observation group were 86.78±4.67,80.31±3.66,76.94±4.03 and 40.59±4.78.The global aesthetic improvement of the dynamic and static wrinkles was obvious.The total effective rate was 93.7%.The total satisfaction rate of the patients was 95.8%,which was higher than that of the control group(P<0.05).The clinical efficacy was significant.Conclusion The application of the combined periocular rejuvenation treatment can improve the dynamic and static wrinkles simultaneously with remarkable rejuvenation effect,increase the effective rate of treatment and enhance the patients'satisfaction.

Clinical study of treatment of facial scar with ultrapulse CO2 laser and Erbium fractional laser

Objective To observe the effect of uitrapulse CO2 laser combined with Erbium fractional laser on treatment facial scars. Methods Total 70 cases with facial scars were treated with ultrapulse CO2 laser combined with Erbium fractional laser for 3 times with 2 ～ 3 months interval. Firstly,scar resurfacing was performed

CO_(2)fractional laser-assisted transdermal delivery of silk nanofiber carriers in a rabbit ear hypertrophic scar model

Background:Hypertrophic scars are skin fibrotic diseases,characterized by fibroblast hyperprolif-eration and excessive accumulation of extracellular matrix.However,topical drug application for hypertrophic scars are unsatisfactory.The purpose of this study was to explore the permeability of silk nanofiber hydrogels(SNFs)loaded with rhodamine 6G(R6G)and rhodamine 110(R110)mediated by CO_(2)fractional laser irradiation into hypertrophic scar tissues.Methods:In this work,R6G and R110 were chosen as hydrophilic and hydrophobic model molecules.They were loaded inside SNFs.In vivo rabbit ear hypertrophic scars were treated with CO_(2)fractional laser irradiation and then R6G/R110-laden SNFs were applied to the scars to evaluate their synergetic effect on drug penetration efficiency.Their permeability was quantified by fluorescence intensity and measured by confocal laser scanning microscopy on days 1,3,5 and 7.More specifically,the thermal coagulation zone(CZ)and its surrounding area(peri-CZ)caused by the thermal coagulation of the laser were discussed separately.Results:Our data indicated that the SNFs promoted the penetration of R6G but not that of R110 in the peri-CZ on day 1 when combined with laser irradiation.Interestingly,both R6G and R110 were abundant in the CZ and remained stable on days 1,3 and 5.Moreover,rapid re-epithelialization hindered the long-term permeability of both drugs.Conclusion:Combining CO_(2)fractional laser irradiation with SNF drug delivery could improve the efficiency of hydrophilic drug delivery within 24 h before total re-epithelialization.

Ablative fractional CO_(2)laser surgery improving sleep quality,pain and pruritus in adult hypertrophic scar patients:a prospective cohort study

Background:Poor sleep quality is associated with a decrease in quality of life in patients with major burn scars,combined with pruritus and pain.Few interventions have been reported to improve the sleep quality of patients with scars.In the current prospective cohort study,we investigated the efficacy of CO_(2)-ablative fractional laser(AFL)surgery vs conventional surgery in post-burn patients with hypertrophic scars with sleep quality as the primary study outcome.Methods:In total 68 consecutive patients undergoing scar surgical treatment were recruited,including a CO_(2)-AFL surgery cohort(n=35)and a conventional surgery cohort(n=33).A subgroup from the AFL cohort was selected.Sleep quality,pain and pruritus were evaluated.Multiple linear regression analyses were performed to reveal the effect of CO_(2)-AFL surgery.Results:The CO_(2)-AFL surgery cohort had significantly lower Pittsburgh sleep quality index(PSQI)global scores than the conventional surgery cohort after the last surgical treatment.In the subgroup of patients receiving hardware sleep monitoring,CO_(2)-AFL markedly increased deep sleep time,deep sleep efficiency and reduced initial sleep latency.Compared to the conventional surgery cohort,the CO_(2)-AFL cohort presented significantly lower pain and pruritus scores.Correlation analysis showed pain and pruritus were significantly associated with PSQI scores,and there were also significant correlations between pain and pruritus scores.Multiple linear regression analysis showed that surgery method was negatively linearly correlated with visual analog scale(VAS)pain score,brief pain inventory(BPI)total,VAS pruritus score,5-D itch scale total,four-item itch questionnaire(FIIQ)total and PSQI total.Conclusions:CO_(2)-AFL surgery significantly improved sleep quality and reduced pain and pruritus of hypertrophic scar patients.The alleviation of sleep disorder was associated with improvement of deep sleep quality including deep sleep time and deep sleep deficiency.Trial registration:The Chinese Clinical Trial Registry(ChiCTR200035268)approved retrospectively registration on 5 Aug 2020.

Effectiveness of fractional CO2 laser in women with stress urinary incontinence

BACKGROUND： Stress urinary incontinence （SUI） is a relatively common disorder that significantly affects the quality of life. Many conservative and surgical treatment methods have been recommended for SUI, but they have major limitations. AIMS： To assess the use of the CO2 fractional laser in the treatment of SUI. METHODS： This clinical trial included 55 patients with confirmed SUI. Patients underwent fractional CO2 laser treatment 3 times at 30-day intervals. Data on age, smoking history, sexual activity, menopause, and history of hormone replacement therapy （HRT） were collected. Response to treatment was assessed by SUI severity and the level of sexual satisfaction was assessed using the visual analog scale （VAS）. Patients were evaluated at 3 different time points： before treatment, and 45 days and 6 months after the last laser treatment. RESULTS： The mean patient age was 44.4±11.4 years （range： 28 to 68 years）. Smoking history was positive in 6 patients （9.1%）; 19 （54.3%） were menopausal on HRT. The SUI severity score at baseline （before treatment） was 8.56±0.62 and decreased to 2.28 6 months after treatment （p 〈 0.0001）. The sexual satisfaction score was 3 ± 0.94 at baseline and increased to 7.87±0.93 6 months after treatment （day 180） （p 〈 0.0001, slope = ＋ 2.2） CONCLUSION： Our findings are in line with a previous study that showed the value of transvaginal CO2 fractional laser treatment for alleviation of SUI symptoms and its potential as an alternative treatment. We also observed improved sexual satisfaction in SUI patients.

Combination of ablative fractional carbon dioxide laser and platelet-rich plasma treatment to improve hypertrophic scars:a retrospective clinical observational study

Background:Hypertrophic scars are one of the main complications that affect the quality of life of patients after burns.Many methods have been shown to be effective in the treatment of hypertrophic scars,such as ablative fractional CO_(2) laser(AFCL)and platelet-rich plasma(PRP).However,there are few studies on the effect of the combined application of these measures.The purpose of this study was to explore the therapeutic effect of AFCL combined with PRP on hypertrophic burn scars.Methods:A retrospective clinical observation study was conducted on 50 patients with hypertrophic burn scars.The AFCL+PRP group included 31 patients who received AFCL combined with PRP treatment;the AFCL group included 19 patients who received AFCL treatment only.The University of North Carolina 4P Scar Scale(UNC4P)and the Vancouver Scar Scale(VSS)scores that were collected before each treatment were used as indicators of the effectiveness of the previous treatment.The scores recorded at the second,fourth and seventh months were analysed.Results:The demographic data of the 2 groups were not significantly different.Before treatment,therewas no difference in the UNC4P and VSS scores between the 2 groups.Therewas a significant decline in the UNC4P and VSS total scores over 6 months in both groups(p<0.05)and scores in the 2 groups were comparable after 3 and 6 months(p<0.05).UNC4P scores in the AFCL+PRP group decreased from a mean of 8.26 to 2.61(p<0.05)with a concomitant drop in VSS scores from a mean of 11.74 to 6.06(p<0.01).In the AFCL group UNC4P and VSS scores decreased from 7.68 to 4.63(p<0.05)and from 10.89 to 8.16(p<0.05),respectively.The sub-items of these 2 assessments were analysed and the results suggest that AFCL combined with PRP can comprehensively improve scarring.Conclusions:This study shows that PRP is an effective adjunct for AFCL in the treatment of hypertrophic burn scars and that the combination of PRP and AFCL proved to be more useful than AFCL alone.This combination may be a new and effective clinical practice for the treatment of scars.However,larger and higher-level clinical studies are still needed to determine its efficacy and possible mechanisms.

Efficacy and safety of a dual-scan protocol for carbon dioxide laser in the treatment of split-thickness skin graft contraction in a red Duroc pig model

Background:Fractional CO_(2) laser plays an important role in scar management post split-thickness skin graft by loosening the graft contracture and restoring the smoothness of the surface.However,the optimal treatment protocol remains unknown.This study applied a dual-scan protocol to achieve both releasing and ablation of contracted skin graft.We comprehensively describe this treatment method and compare the efficacy and safety between this dual-scan method and the conventional mono-scan mode.Methods:A hypercontracted scar model after split-thickness skin grafting in red Duroc pigs was established.All scars meeting the inclusion criteria were randomly divided into four groups:high fluence–low density(HF–LD),low fluence–high density(LF–HD),combined group and control group.The energy per unit areawas similar in the HF–LD and LF–HD groups.Two laser interventions were performed at a 6-week interval.The efficacy of the treatment was evaluated by objective measures of scar area,release rate,elasticity,thickness and flatness,while the safetywas evaluated based on adverse reactions and melanin index.Collagen structurewas observed histologically.The animals were followed up for a maximum of 126 days after modeling.Results:A total of 28 contracted scars were included,7 in each group.At 18 weeks postoperatively,the HF–LD and the combined groups showed significantly increased scar release rate(p=0.000)and elasticity(p=0.036)and decreased type I/III collagen ratio(p=0.002)compared with the control and LF–HD groups.In terms of flatness,the combined group was significantly better than the HF–LD group for elevations<1mm(p=0.019).No significant skin side effects,pigmentation or scar thickness changes were observed at 18 weeks.Conclusions:Dual-scan protocol could achieve superficial ablation and deep release of contracted split-thickness skin graft in a single treatment,with similar contraction release and texture improvement compared to a single deep scan.Its main advantage is to restore a smoother scar appearance.Adequate laser penetration was necessary for the release of contracted scars.