• Bianca Y Kang, Sarah A Ibrahim, Alexandra Weil, Kelly A Reynolds, Tyler Johnson, Sarah Wilson, Ming H Lee, KimJohn Y SJYSDivision of Plastic and Reconstructive Surgery, Department of Surgery, Northwestern Feinberg School of Medicine, Chicago, IL., McKenzie A Dirr, Emily Poon, and Murad Alam.
• Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL.
• Ann. Surg. 2022 Dec 1; 276 (6): 975980975-980.

ObjectiveTo assess the effectiveness and safety of combined pulsed-dye laser (PDL) and NAFL for treatment of surgical scars.Summary Background DataPDL and NAFL have not been compared to healing by time alone.MethodsRandomized controlled, single-blinded clinical trial at an urban, university hospital. Healthy adults' status post skin surgery with primary closure were randomized to either 3 sessions of combination PDL and NAFL every 2 to 8 weeks, or control of no treatment. At baseline and 36-week follow-up, Patient and observer Scar Assessment Scale and Scar Cosmesis Assessment and Rating were completed by participants and blinded physicians. The primary outcome was scar improvement, as measured by the score difference over time.ResultsOf 76 participants, 52 completed the study (July 2017 to June 2019). No severe adverse events were reported. Patient and observer Scar Assessment Scale assessments demonstrated improvement in total score in the laser group compared to controls, as reported by patients [mean difference (standard deviation), laser: 12.86 (6.91) vs control: 7.25 (6.34); P = 0.004] and blinded physicians [18.32 (8.69) vs 13.08 (9.63); P = 0.044]. Patients observed a greater improvement in scar thickness [3.68 (2.04) vs 1.88 (1.85); P = 0.002] and stiffness [3.57 (2.78) vs 1.50 (2.11); P = 0.004] with lasers, and physicians reported greater improvement in vascularity [3.71 (1.98) vs 1.71 (1.52); P = 0.0002]. The live Scar Cosmesis Assessment and Rating subscore for erythema improved significantly with lasers [1.04 (0.79) vs 0.42 (0.50); P = 0.001].Conclusions And RelevanceCombined PDL and NAFL resulted in scar improvement. Scar thickness, stiffness, and erythema were improved.Trial RegistrationClinicalTrials.gov (NCT03057964).Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

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