Early Fractional Ablative Laser for Skin Cancer Excision Scars: A Randomized Split-Scar Study

Area of Science:

• Dermatology
• Plastic Surgery
• Regenerative Medicine

Background:

• Fractional ablative laser resurfacing is recognized for improving surgical scar appearance.
• The optimal timing for initiating fractional CO2 laser treatment remains undetermined.

Purpose of the Study:

• To compare the efficacy of fractional carbon dioxide (CO2) laser treatment for surgical scars when applied on Day 0 versus Day 14 post-operatively.

Main Methods:

• A prospective, randomized, split-scar, physician-blinded study involved 30 surgical scars on limbs.
• Scars were treated with fractional CO2 laser on either Day 0 or Day 14.
• Assessments at 6 months included patient preference, physician-modified Manchester Scar Scale (MMSS) scores, and quantitative histological analysis (fractal dimension and lacunarity).

Main Results:

• No significant differences were observed in patient preference (54% Day 0 vs. 46% Day 14, p = .58) or physician assessments (MMSS: 8.4 Day 0 vs. 8.7 Day 14, p = .28).
• Quantitative histological analysis showed similar fractal dimensions (p = .80) and lacunarity (p = .44) between the two treatment timings.

Conclusions:

• Intraoperative fractional CO2 laser treatment is noninferior to treatment on Day 14 for improving surgical scar appearance.
• The timing of fractional CO2 laser application (immediate vs. delayed) does not significantly impact scar outcomes.