Treatment of Post-Surgical Scars With Traditional Ablative Er:YAG Versus Fractional Ablative Er:YAG
Condition: Post-Surgical Scars
MeSH terms: Cicatrix
Study type: Interventional

Summary: 
      The investigators will compare the efficacy of Traditional Ablative Er:YAG Versus Fractional
      Ablative Er:YAG in a split scar study. The patient will receive a month treatment for 3
      months. Then follow up for the next 2 months.
    

Detailed description: 
      Background: Scars are a common complaint of patients at presentation to a dermatology office.
      To optimize cosmetic results, the investigators propose to compare erbium-doped yttrium
      aluminium garnet (Er:YAG) laser therapy on two different settings: traditional ablative
      versus fractional ablative. A side to side comparison of split scars will be done to evaluate
      the two settings. Fractionated photothermolysis (fractional setting) has improved the field
      of laser surgery by allowing the surgery to target microscopic treatment zones (MTZ). MTZ's
      allow for cylinders of damage created by laser surgery to be surrounded by normal, unaffected
      skin. This acts as a reservoir for healing and allows for the microwounds created by laser
      treatment to heal quickly and with minimal discomfort.

      Objective: To compare efficacy and cosmetic appearance of scars treated with Er:YAG ablative
      laser on traditional ablative resurfacing setting versus fractional ablative resurfacing
      setting.

      Methods: Enroll 20 patients for nonsurgical treatment of surgical scars. Half of each scar
      will be treated with the Er:YAG laser on the traditional ablative setting and the other half
      of the scar will receive Er:YAG treatment with the fractional ablative setting. The patients
      will receive 3 treatments at monthly intervals. They will follow up at 1 and 2 months after
      the treatment. Pictures of the scar will be taken at a 45 degree and 90 degree angle at
      baseline, before each treatment, after each treatment, and at all follow up appointments. The
      patients will be blinded as to which side is treated with which laser setting. At the end of
      the trial, they will be offered the chance to have the side they felt had less improvement
      treated with the laser device that had been used on the contralateral side of the scar.

      Results: A panel of three blinded dermatologists will evaluate the scar on a well-established
      five point grading scale for erythema, height and texture, and overall cosmetic outcome. The
      mean, standard deviation, and kappa values will be calculated. Patients will be asked the
      same scar evaluation questions as the panel as well as their overall satisfaction, how much
      pain was associated with the procedure, which laser they preferred, and would they recommend
      treatment to a friend or family member.
    

Intervention name(s): Er:YAG laser, traditional and fractional settings
Intervention type(s): Device
Intervention description(s): Half the scar will be treated with traditional ablative setting and the other half will be treated with the fractional ablative setting
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: scar; ICD-10 CM:L90.5