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Evaluating evidence for atrophic scarring treatment modalities
Lopa Patel1, Duncan McGrouther1, Kaushik Chakrabarty1
1Department of Plastic Surgery and Burns Care, University Hospitals of South Manchester, Wythenshawe, Manchester M23 9LT, UK.
JRSM Open
|October 30, 2014
Summary
This systematic review found limited high-quality evidence for atrophic scar treatments. While laser, surgery, and chemical peels show promise, more rigorous studies are needed to guide clinical choices for effective atrophic scar management.
Area of Science:
- Dermatology
- Evidence-Based Medicine
- Medical Research
Background:
- Atrophic scars significantly impact patient well-being.
- Existing treatment evidence lacks comprehensive systematic analysis.
- A need exists for evidence-based guidance on atrophic scar treatments.
Purpose of the Study:
- To systematically review and evaluate evidence for atrophic scar treatments.
- To assess treatment efficacy using the Clinical Evidence GRADE scoring system.
- To facilitate evidence-based clinical decision-making for atrophic scar management.
Main Methods:
- Comprehensive literature searches in Medline, EMBASE, CINAHL, and Cochrane databases.
- Inclusion of English-language studies on adult atrophic scar treatments (excluding letters).
- Application of the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system to categorize evidence quality (high, moderate, low, very low).
Main Results:
- 41 studies were analyzed, including RCTs, observational studies, and case reports.
- Evidence quality was predominantly very low (75%), with only 7% high-quality and 10% moderate-quality.
- Treatments evaluated included various lasers, fat transfer, dermabrasion, chemical peels, injectables, subcision, and combination therapies.
Conclusions:
- A significant lack of high-quality clinical evidence exists for atrophic scar treatment modalities.
- Evidence suggests potential efficacy for laser therapy, surgical interventions, and chemical peels.
- Further biomolecular research and more randomized controlled trials are crucial to strengthen the evidence base for atrophic scar treatments.
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