Clinical effect of intense pulsed light combined with long-pulse 1064 nm Nd:YAG laser in the treatment of early hypertrophic burn scars
Objective To investigate the efficacy and safety of long-pulse 1064 nm Nd:YAG laser combined with intense pulsed light(IPL)in the treatment of early hypertrophic burn scars.Methods A total of 90 patients with burn scar repair who were admitted to the Department of Burn Surgery,Baogang Hospital from January 2021 to January 2022 were enrolled as the prospective research subjects.According to the random number table,all patients were randomly divided into three groups,with 30 cases in each group.The patients in IPL group were treated with IPL for 3 months,with an interval of 4 weeks and a total of 3 treatments.The patients in long pulse laser group were treated with a long pulse width of 1064 nm Nd:YAG laser for 3 months,with a treatment interval of 2 weeks,and a total of 6 treatments.The patients in combination group were treated with a long pulse width of 1064 nm Nd:YAG laser and IPL treatment alternately,with an interval of 2 weeks between each treatment,and a total of 6 treatments.The clinical efficacy,visual analogue score(VAS),Vancouver scar scale(VSS),patient satisfaction,adverse reactions and recurrence were observed and compared among the three groups.The data were analyzed by the chi-square test,Fisher's exact probability method,the two-way repeated measures ANOVA analysis,the Lsd-t test,the Kruskal-Wallis test and the Mann-Whitney test.Results The total clinical effective rate of combination group was 96.7%(29/30),which was higher than that of IPL group[93.3%(28/30)]and long pulse laser group[73.3%(22/30),P＜0.05].There were statistically significant differences in VAS scores among the three groups at 1,2,3 months of treatment,and so as compared with VAS scores before the treatment.The VSS scores of the three groups were lower than those before treatment(P＜0.05),and the differences were statistically significant among the three groups at 1,2,3 months after the treatment(P＜0.05).After treatment,the scar pigment,blood supply,flexibility,thickness and total score of the three groups decreased,and those above indexes of patients in combination group were lower than the other two groups(P＜0.05).During the treatment period,the incidence of adverse reactions in combination group and IPL group were 0,lower than that in long pulse laser group.The recurrence rate of combination group was 0,lower than that of IPL group(3.3%)and long pulse group(26.7%),and the difference was statistically significant(P＜0.05).The satisfaction rate of combination group was 80.0%,which was higher than that of long pulse laser group(53.3%)and the difference was statistically significant(P＜0.05).Conclusion The long pulse width of 1064 nm Nd:YAG laser combined with IPL has a reliable effect in the treatment of early burn scar repair,which can significantly improve the color and softness of the scar,and make it better for look,which is superior to the single therapy,and is worthy of clinical application.
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