Time of fractional CO2 laser intervention in post-traumatic scars: a pilot study

Post-traumatic scars may be a massive burden on psychosocial health, which affects self-esteem. Scar revision with fractional CO 2 laser aids in rebuilding the collagenous fibers of the tissues and enhances the texture, pigmentation, and appearance of the scars. Moreover, recent research has begun to focus on early scar interventions. This pilot study was conducted to preliminarily explore the optimal timing of fractional CO 2 intervention in the management of post-traumatic scars. Both histopathological and clinical assessments were done to evaluate the results objectively. Forty post-traumatic scar patients were divided into two equal groups: Group 1 started the laser sessions in the first 3 months after healing, whereas Group 2 started the laser sessions after 1 year. Vancouver Scar Scale (VSS), and patient satisfaction grading have been used for clinical evaluation before & after treatment. Biopsies have been taken before laser intervention and three months after the last session from the treated scars for histological assessment. The early fractional CO 2 laser intervention in group 1 was associated with greater improvement compared to the late intervention in group 2. There was a statistically significant reduction in the Vancouver Scar Scale following laser sessions of group 1 compared to group 2. A non-significant trend toward higher patient satisfaction was observed in Group 1 compared with Group 2. A highly statistically significant difference was observed between the two groups as regards histopathology ( P = 0.006). The early Fractional ablative CO 2 laser may be associated with superior outcomes in the treatment of post-traumatic scars compared to late intervention, though larger studies are needed to confirm these preliminary findings.