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Efficacy and safety of pulsed dye laser for the treatment of surgical scars: a systematic review and meta-analysis

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Abstract

Various clinical trials have explored whether the pulsed dye laser (PDL) method is safe to treat scars, especially surgical scars. However, comprehensive evidence confirming the exact outcomes of PDL for treating surgical scars is lacking. The efficacy and safety of PDL in the treatment of surgical scars were determined through a review of several studies. The PubMed, Embase, Cochrane Library, and Web of Science databases were searched, and the main clinical outcomes were Vancouver Scar Scale (VSS) scores in terms of pigmentation, vascularity, pliability, and height. Review Manager 5.4 software was used for statistical analyses of the data; we chose a standardized mean difference (SMZ) to present the results with 95% confidence interval (CI). Overall, seven randomized controlled trials were used for this meta-analysis, all of these papers used 585 nm or 595 nm PDL with 7 mm or 10 mm spot size and a fluence of 3.5 to 10 J/cm2 for treating surgical scars; besides, the pulse duration ranged from 450 μs to 10 ms. We found that PDL significantly resulted in decreased VSS scores (P = 0.02) in four aspects: pigmentation (P = 0.0002), vascularity (P < 0.00001), pliability (P = 0.0002), and height (P = 0.0002). Moreover, scar improvement was similar when using 585 nm and 595 nm PDL in terms of pigmentation (P = 0.76), vascularity (P = 0.34), pliability (P = 0.64), and height (P = 0.57). Furthermore, our review indicated that PDL has no obvious adverse effects for most people, except transitory erythema and purpura. The meta-analysis showed that both 585 nm and 595 nm PDL therapy can effectively reduce the VSS score, suggesting that PDL can be a safe and effective method for the treatment of surgical scars.

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Funding

WX received a research grant (No. 2020364003) from the Zhejiang Medical and Health Science and Technology Program, China (http://www.msttp.com/). The funder had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. This work was supported by the National Natural Science Foundation of China (81872517). These fundings were used in the study design, data collection and analysis, fellow’s service fees, and preparation of the manuscript.

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Authors and Affiliations

  1. Department of Dermatology, Hangzhou Third People’s Hospital, Zhejiang Chinese Medical University, Hangzhou, China

    Yujia Cai, Jieya Ying, Yuan Zhu & Yu Qiu

  2. Department of Dermatology, Hangzhou Third People’s Hospital, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, Hangzhou, China

    Xiaofang Zeng & Wenzhong Xiang

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  1. Yujia Cai
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  2. Xiaofang Zeng
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  3. Jieya Ying
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Correspondence to Wenzhong Xiang.

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Cai, Y., Zeng, X., Ying, J. et al. Efficacy and safety of pulsed dye laser for the treatment of surgical scars: a systematic review and meta-analysis. Lasers Med Sci 37, 1273–1282 (2022). https://doi.org/10.1007/s10103-021-03385-z

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  • DOI: https://doi.org/10.1007/s10103-021-03385-z

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