High-intensity laser photocoagulation and cryodestruction in the treatment of patients with skin scars
https://doi.org/10.37895/2071-8004-2021-25-4-23-34
Abstract
Purpose: to assess the effects of combined application of high-level laser photocoagulation and simultaneous cryodestruction at pathological scars on the skin.
Material and methods. Two groups included patients of both genders aged 18 and older. Patients from the fi rst (main) group (n = 60) had simultaneous high-level laser irradiation and cryodestruction on scar tissue; patients from the second (control) group (n = 30) were treated separately with laser irradiation and cryodestruction. For laser irradiation, laser devise CO2-laser AKHIL with wavelength 10.6 μm, pulsed frequency 10–20 Hz and power 5–15 W was used. For cryodestruction, apparatus “KRIO-RM-01” was used: tip cooling speed of 220 °C/min, the temperature of 180 °C on the tip working part, exposure time – 15–20 sec. The treated patients had hypertrophic and keloid scars. Etiologically, scars were of post-traumatic, postoperative, post-eruptive types. Evaluation criteria were histological examination of biopsy material with eosinhematoxylin, patients’ quality of life, examination of scar zone.
Results. The obtained results demonstrate that the combined application of two physical factors (laser + cryo) at scar tissue increases satisfactory outcomes in patients with hypertrophic scars by 75 % and by 53.4 % in the control group. Relapses were seen in both groups: 25 % in the main group and 46 % in the control group. Morphologically, one can see positive changes in degradation of rough fi brous tissue.
Conclusion. A combined application of high-intensity laser photocoagulation and simultaneous cryodestruction has been proven to be effective in patients with pathological skin scars.
About the Authors
V. A. Yudin
I.P. Pavlov Ryazan State Medical University; Regional Clinical Hospital
Russian Federation
Russian Federation
Yudin Vladimir – Dr. Sc. (Med.), Professor at the Department of Surgery, Obstetrics and Gynecology; consultant surgeon
Ryazan
I. V. Vasin
Regional Clinical Hospital
Russian Federation
Russian Federation
Vasin Igor – Cand. Sc. (Med.), Pathologist
Ryazan
T. A. Kachanova
Mediaesthetic International Group of Clinics
Russian Federation
Russian Federation
Kachanova Tatyana – Surgeon
Saint Petersburg
References
1. Shafranov V.V., Borkhunova E.N., Taganov A.V., et al. Keloid scars. Moscow; 2003. [In Russ.].
2. Stepankina E.S., Barmin E.V., Stepankin S.N., Trofi mov E.I. Causes and pathogenesis of the formation of pathological skin scars (a review). Bulletin of Rehabilitation Medicine. 2017; 1 (77): 103–110. [In Russ.].
3. Andreeva V.V., Kuzmina E.N. Modern view at the classifi cation of cicatricial deformities of the skin. Medical Technologies. Assessment and Choice. 2018; 4(34): 83–86. [In Russ.]. DOI: 10.31556/2219-0678.2018.34.4.083-086
4. Seo B.F., Jung S.N. The immunomodulatory effects of mesenchymal stem cells in prevention or treatment of excessive scars. Stem Cells Int. 2016; 2016: 6937976. DOI: 10.1155/2016/6937976
5. Andreeva V.V. Cryolaser treatment of hypertrophic and keloid scars of the skin in the head and neck. Issues of Reconstructive and Plastic Surgery. 2020; 3 (74): 7–14. [In Russ.]. DOI: 10.17223/1814147/74/01
6. Ortiz A., Elkeeb L., Truitt A., et al. Evaluation of a novel fractional resurfacing device for the treatment of acne scarring. Lasers Surg Med. 2019; 41 (2): 122–127. DOI: 10.1002/lsm.20725
7. Al-Attar A., Mess S., Thomassen J.M., et al. Keloid pathogenesis and treatment. Plast Reconstr Surg. 2016; 117 (1): 286–300. DOI: 10.1097/01.prs.0000195073.73580.46
8. Glass D.A. 2nd. Current understanding of the genetic causes of keloid formation. J Investig Dermatol Symp Proc. 2017; 18 (2): S50–S53. DOI: 10.1016/j.jisp.2016.10.024
9. Kurganskaya I.G. Modern combined technologies of highintensity laser therapy of pathological skin scars. Russian Military Medical Academy Reports. 2020; 39 (S 3-5): 66–70. [In Russ.].
10. Sharoboro V.I., Ivanov Yu.V., Panchenkov D.N., et al. Evaluation of the possibilities of carbon dioxide laser in the treatment of cicatricial deformities. Pirogov Russian Journal of Surgery (Khirurgiya. Zurnal im. N.I. Pirogova). 2018; (5): 67–74. [In Russ.]. DOI: 10.17116/hirurgia2018567-74
11. Yudin V.A., Kachanova T.A. Method of keloid and hypertrophic skin cicatrix’s treatment: Patent N 2350364 of the Russian Federation. 2009; (9). [In Russ.].
Review
For citations:
Yudin V.A., Vasin I.V., Kachanova T.A. High-intensity laser photocoagulation and cryodestruction in the treatment of patients with skin scars. Laser Medicine. 2021;25(4):23-28. (In Russ.) https://doi.org/10.37895/2071-8004-2021-25-4-23-34
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