Preliminary exploration of sequential DPL and CO2 laser versus CO2 laser monotherapy for the prophylactic management of early postoperative linear scars: A retrospective cohort study

Background and Objectives. Prophylactic management of early postoperative linear scars remains a clinical challenge. This study aimed to evaluate the clinical outcomes of sequential dye pulsed light (DPL) and fractional CO 2 laser (CO 2 laser) versus CO 2 laser monotherapy in the prevention of scar hypertrophy, and to explore potential simplified early interventions. Patients and Methods. In this exploratory retrospective study, 38 patients with early postoperative linear scars were enrolled. They were divided into a sequential DPL-CO 2 laser group and a CO 2 laser monotherapy group (19 patients each). All received six monthly prophylactic treatments. Efficacy was assessed by two independent surgeons using the Patient and Observer Scar Assessment Scale (POSAS). Results. After six treatments, no statistically significant difference was detected in the total POSAS score between the two groups ( p = 0.988, mean difference = -0.26, 95% CI: -1.66 to 1.14). Similarly, no significant differences were found in the patient (PSAS) or observer (OSAS) component scores. However, compared to baseline, both groups showed significant improvement in several key scar parameters, including vascularization, thickness, color, stiffness, and irregularity. One case of transient reactive hyperplasia in the CO 2 group was resolved with conservative management. Conclusions. Both sequential DPL-CO 2 laser therapy and CO 2 laser monotherapy were associated with favorable clinical trajectories in early postoperative linear scars over 6 months. In this exploratory, underpowered retrospective cohort, no definitive comparative conclusions could be drawn between the two regimens. Spontaneous maturation likely contributed to these outcomes. The observed parallel trends generate a hypothesis requiring proper prospective randomized evaluation to determine the true utility of CO2 laser alone as a simplified early intervention.