Objective:To investigate the clinical effect of ultrapulse fractional carbon dioxide laser combined with stromal vascular fraction gel (SVF-Gel) transplantation in the treatment of scars.Methods:Retrospective analysis of the clinical data of patients with scars treated at the General Hospital of Jilin Chemical Industry Group from January 2018 to January 2022. Application of ultrapulse fractional carbon dioxide laser for treatment: Scaar FX mode treatment for hypertrophic scars, micro FX energy: 80-150 mJ, frequency: 250 Hz, density: 3%. Deep FX mode treatment for superficial scars and atrophic scars, micro FX energy: 30-50 mJ, frequency: 300 Hz, density: 5%. Manual fractional technology(MFT) mode treatment for hyperplastic scars, atrophic scars with scar contracture site, energy: 150-175 mJ, frequency: 40 Hz, distance between holes: 4-5 mm, treatment time 2-3 s. Superficial scar and atrophic scar were treated 2 times, hypertrophic scar was treated 3 times, and the time interval was 2 months. Transplantation of SVF-Gel for scar treatment around 30 days after the first laser treatment. Thigh fatty tissue was extracted to prepare SVF-Gel. The SVF-Gel was injected into the basal layer and deep layer of inside the scar by multi-point and multi-tunnel injection. All patients were followed up for 6 months to evaluate the therapeutic effect. Assess the Vancouver scar scale (VSS) score and the difference of transepidermal water loss (TEWL) between scar skin and adjacent normal skin was measured after treatment, compared with before treatment. The data were analyzed by SPSS 20.0, data in Mean±SD represents. Paired t-test was used to compare the difference between the VSS score and TEWL before and after treatment. P<0.05 indicates a statistically significant difference. Results:A total of 30 patients were enrolled, including 17 males and 13 females, aged (32.7 ± 11.2) years old. Among the 30 patients, 10 patients were superficial scars, 10 patients were hypertrophic scars, 10 patients were atrophic scars. The scars’ formation time was (17.5 ± 4.5) months. (1) The VSS score of superficial scars after treatment was 1.8±0.7, which was lower than 4.7±0.8 before treatment( t=9.26, P=0.001). The difference in TEWL after treatment was (2.48±0.61) g·m -2·h -1, which was lower than (6.85±1.17) g·m -2·h -1 before treatment( t=13.28, P<0.001). (2) The VSS score of hyperplastic scars after treatment was 3.9±1.1, which was lower than 10.6±1.7 before treatment( t=9.37, P=0.001). The difference in TEWL after treatment was (4.91±0.87) g·m -2·h -1, which was lower than (9.92±0.75) g·m -2·h -1 before treatment( t=18.22, P<0.001). (3) The VSS score of atrophic scars after treatment was 3.5±1.2, lower than 7.7±2.3 before treatment ( t=5.81, P=0.005). The difference in TEWL after treatment was (3.73±1.22) g·m -2·h -1, lower than (6.52±1.51) g·m -2·h -1 before treatment ( t=9.52, P=0.001). Conclusion:Ultrapulse fractional carbon dioxide laser combined with SVF-Gel transplantation is effective in the treatment of scars. It can improve the color, thickness, vascular distribution, softness, and skin barrier function of scars.

Objective:To investigate the clinical effect of ultrapulse fractional carbon dioxide laser combined with stromal vascular fraction gel (SVF-Gel) transplantation in the treatment of scars.Methods:Retrospective analysis of the clinical data of patients with scars treated at the General Hospital of Jilin Chemical Industry Group from January 2018 to January 2022. Application of ultrapulse fractional carbon dioxide laser for treatment: Scaar FX mode treatment for hypertrophic scars, micro FX energy: 80-150 mJ, frequency: 250 Hz, density: 3%. Deep FX mode treatment for superficial scars and atrophic scars, micro FX energy: 30-50 mJ, frequency: 300 Hz, density: 5%. Manual fractional technology(MFT) mode treatment for hyperplastic scars, atrophic scars with scar contracture site, energy: 150-175 mJ, frequency: 40 Hz, distance between holes: 4-5 mm, treatment time 2-3 s. Superficial scar and atrophic scar were treated 2 times, hypertrophic scar was treated 3 times, and the time interval was 2 months. Transplantation of SVF-Gel for scar treatment around 30 days after the first laser treatment. Thigh fatty tissue was extracted to prepare SVF-Gel. The SVF-Gel was injected into the basal layer and deep layer of inside the scar by multi-point and multi-tunnel injection. All patients were followed up for 6 months to evaluate the therapeutic effect. Assess the Vancouver scar scale (VSS) score and the difference of transepidermal water loss (TEWL) between scar skin and adjacent normal skin was measured after treatment, compared with before treatment. The data were analyzed by SPSS 20.0, data in Mean±SD represents. Paired t-test was used to compare the difference between the VSS score and TEWL before and after treatment. P<0.05 indicates a statistically significant difference. Results:A total of 30 patients were enrolled, including 17 males and 13 females, aged (32.7 ± 11.2) years old. Among the 30 patients, 10 patients were superficial scars, 10 patients were hypertrophic scars, 10 patients were atrophic scars. The scars’ formation time was (17.5 ± 4.5) months. (1) The VSS score of superficial scars after treatment was 1.8±0.7, which was lower than 4.7±0.8 before treatment( t=9.26, P=0.001). The difference in TEWL after treatment was (2.48±0.61) g·m -2·h -1, which was lower than (6.85±1.17) g·m -2·h -1 before treatment( t=13.28, P<0.001). (2) The VSS score of hyperplastic scars after treatment was 3.9±1.1, which was lower than 10.6±1.7 before treatment( t=9.37, P=0.001). The difference in TEWL after treatment was (4.91±0.87) g·m -2·h -1, which was lower than (9.92±0.75) g·m -2·h -1 before treatment( t=18.22, P<0.001). (3) The VSS score of atrophic scars after treatment was 3.5±1.2, lower than 7.7±2.3 before treatment ( t=5.81, P=0.005). The difference in TEWL after treatment was (3.73±1.22) g·m -2·h -1, lower than (6.52±1.51) g·m -2·h -1 before treatment ( t=9.52, P=0.001). Conclusion:Ultrapulse fractional carbon dioxide laser combined with SVF-Gel transplantation is effective in the treatment of scars. It can improve the color, thickness, vascular distribution, softness, and skin barrier function of scars.

Objective:To study the transepidermal water loss (TEWL) of scar skin in patients with superficial scars, hypertrophic scars, and atrophic scars, and to explore the correlation between TEWL and scar severity.Methods:A retrospective observational study was conducted. From February 2017 to February 2019, 120 scar patients who met the inclusion criteria were admitted to the General Hospital of Jilin Chemical Industry Group, including 78 males and 42 females, aged (35±14) years. According to the diagnosis on admission, there were 40 cases of superficial scar patients, 40 cases of hypertrophic scar patients, and 40 cases of atrophic scar patients. On admission, the Vancouver Scar Scale (VSS) was used to score the scar of each patient; the TEWL of scar skin and normal skin 1 cm from the edge of scar or the same site of the healthy side (hereinafter referred to as normal skin) of each patient was measured by water loss tester, and the difference value of TEWL between scar skin and normal skin (hereinafter referred to as the TEWL difference) was calculated. Data were statistically analyzed with chi-square test, Kruskal-Wallis rank sum test, paired sample t test, one-way analysis of variance, and Dunnett- t test for comparison, and the correlation between the difference value of TEWL and scar VSS score was analyzed with univariate linear regression analysis. Results:On admission, the scar VSS score of superficial scar patients was significantly lower than that of hypertrophic scar or atrophic scar patients ( t=4.403, 4.768, P<0.01), and the scar VSS score of atrophic scar patients was significantly lower than that of hypertrophic scar patients ( t=4.185, P<0.01). On admission, the TEWL of scar skin of superficial scar, hypertrophic scar, and atrophic scar patients were (18±4), (20±4), and (20±5) g·m -2·h -1 respectively, significantly higher than (12±3), (12±3), and (14±4) g·m -2·h -1 of normal skin ( t=6.889, 10.221, 5.870, P<0.01). The difference values of TEWL of superficial scar, hypertrophic scar, and atrophic scar patients were (5.9±1.7), (8.1±1.7), and (6.4±2.1) g·m -2·h -1 respectively. In comparison among different types of scar patients, only the TEWL difference of hypertrophic scar patients was significantly higher than that of superficial scar patients ( t=6.975, P<0.05). The TEWL difference and the scar VSS score in patients with superficial scars, hypertrophic scars, and atrophic scars were significantly positively correlated ( r=0.805, 0.872, 0.826, P<0.01). Conclusions:The TEWL of scar skin in patients with superficial scars, hypertrophic scars, and atrophic scars is increased compared with normal skin, and the degree of increase was positively correlated with the severity of scars.