Plastic Surgery Research Council

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3D Mesh Releasing by the Fractional CO2 Laser -- A Retrospective Analysis of Fractional CO2 Treatment on Contracture Scars
Wenjing Xi, B.SE., M.D., Yixin Zhang, M.D., Ph.D..
Shanghai Ninth's People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Abstract
Purpose
Contracture scars located in the joint area often led to a limitation in the range of motion(ROM) of that specific joint and would cause inconvenience for the patient. Fractional CO2 treatment for scars demonstrated a growing clinical application in the past decade. However, the maximum efficacy of the modality for contracture scars has not been reported yet. The purpose of this article is to present the efficacy of this modality in terms of the improvement of ROM of the joint in question.
Method
A retrospective analysis was conducted on 10 cases of contracture scars treated by fractional CO2 laser from 2016.11 to 2018.1. The treatment was carried out every 2 months until the improvement has plateaued or the relevant joint has obtained its normal range of motion. All cases were followed-up for 6 months. The primary outcome measure was the improvement of the ROM before all intervention and at the last follow-up. In 6 cases, the immediate improvement of the ROM after the treatment as well as the ROM at the next follow-up were also recorded (the efficacy of one laser session).
Result
In the 10 cases, 11 joints were treated by the fractional CO2 laser. Patients in the series went through 2.27(SD 1.42) laser sessions. The average improvement of ROM until the last follow-up was 19.13(SD 10.25, p<0.02). In 6 treatments, we recorded that there was an improvement in the relevant ROM of 8.53(SD 5.81, p<0.02) immediately after the laser intervention, and the average improvement reached 13.58(SD 8.15, p<0.02) after 2-3 months at the next follow-up.
Conclusion
The fractional CO2 laser could improve the limited ROM in the joints affected by contracture scars and the effect maintained at least 6 months. This modality has the advantage of minimal-invasiveness and potentially could serve as a supplement to the current treatment ladder for contracture scars.





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