Comparison of the Effectiveness of Ablative and Non-Ablative Fractional Laser Treatments for Early Stage Thyroidectomy Scars

Background Open thyroidectomy is conventionally performed at the anterior side of neck, which is a body part with a comparatively great degree of open exposure; due to this, postoperative scarring may cause distress in patients. We aimed to compare the effects of ablative and nonablative fractional laser treatments on thyroidectomy scars. We examined medical records in a retrospective manner and analyzed scars based on their digital images by using the modified Manchester Scar Scale (mMSS).

Methods Between February 2012 and May 2013, 55 patients with thyroidectomy scars were treated with ablative (34 patients) or nonablative (21 patients) fractional laser. Each patient underwent 4 laser treatment sessions in 3–4 week intervals, 1–2 months postoperatively. Scar improvement was assessed using patient images and the mMSS scale.

Results The mean decrease in scar score was 3.91 and 3.47 in the ablative and nonablative groups, respectively; the reduction between 2 groups did not exhibit any significant difference (P=0.16). We used the scale once again to individually evaluate scar attributes. The nonablative group accounted for a considerably higher color score value (P=0.03); the ablative group accounted for a considerably higher contour score value (P<0.01). Patient satisfaction was high and no complications occurred.

Conclusions Both types of fractional laser treatments can be used successfully for thyroidectomy scar treatment with minimal complications; however, results indicate that higher effectiveness may be obtained from the use of ablative and nonablative lasers for hypertrophic scars and early erythematous scars, respectively. Therefore, the appropriate laser for scar treatment should be selected according to its specific characteristics.

Keywords

Laser therapy - Cicatrix - Thyroidectomy

Presented At The 30th Annual Meeting Of The Korean Society For Laser Medicine And Surgery On November 29, 2015 In Seoul, Korea.

Publication History

Received: 30 May 2016

Accepted: 12 October 2016

Article published online:
20 April 2022

• References

• 1 Conologue TD, Norwood C. Treatment of surgical scars with the cryogen-cooled 595 nm pulsed dye laser starting on the day of suture removal. Dermatol Surg 2006; 32: 13-20
• 2 Manstein D, Herron GS, Sink RK. et al. Fractional photothermolysis: a new concept for cutaneous remodeling using microscopic patterns of thermal injury. Lasers Surg Med 2004; 34: 426-438
• 3 Geronemus RG. Fractional photothermolysis: current and future applications. Lasers Surg Med 2006; 38: 169-176
• 4 Laubach HJ, Tannous Z, Anderson RR. et al. Skin responses to fractional photothermolysis. Lasers Surg Med 2006; 38: 142-149
• 5 Fisher GJ, Varani J, Voorhees JJ. Looking older: fibroblast collapse and therapeutic implications. Arch Dermatol 2008; 144: 666-672
• 6 Cheon YW, Lee WJ, Rah DK. Objective and quantitative evaluation of scar color using the L^*a^*b^* color coordinates. J Craniofac Surg 2010; 21: 679-684
• 7 van der Wal MB, Verhaegen PD, Middelkoop E. et al. A clinimetric overview of scar assessment scales. J Burn Care Res 2012; 33: e79-e87
• 8 Beausang E, Floyd H, Dunn KW. et al. A new quantitative scale for clinical scar assessment. Plast Reconstr Surg 1998; 102: 1954-1961
• 9 Alster T, Zaulyanov L. Laser scar revision: a review. Dermatol Surg 2007; 33: 131-140
• 10 Alster TS, Tanzi EL. Hypertrophic scars and keloids: etiology and management. Am J Clin Dermatol 2003; 4: 235-243
• 11 Anderson RR, Parrish JA. Selective photothermolysis: precise microsurgery by selective absorption of pulsed radiation. Science 1983; 220: 524-527
• 12 Rosenberg GJ, Brito Jr MA, Aportella R. et al. Long-term histologic effects of the CO2 laser. Plast Reconstr Surg 1999; 104: 2239-2244
• 13 Houk LD, Humphreys T. Masers to magic bullets: an updated history of lasers in dermatology. Clin Dermatol 2007; 25: 434-442
• 14 Nanni CA, Alster TS. Complications of carbon dioxide laser resurfacing: an evaluation of 500 patients. Dermatol Surg 1998; 24: 315-320
• 15 Tanzi EL, Alster TS. Comparison of a 1450-nm diode laser and a 1320-nm Nd:YAG laser in the treatment of atrophic facial scars: a prospective clinical and histologic study. Dermatol Surg 2004; 30: 152-157
• 16 Borges J, Cuzzi T, Mandarim-de-Lacerda CA. et al. Fractional Erbium laser in the treatment of photoaging: randomized comparative, clinical and histopathological study of ablative (2940nm) vs. non-ablative (1540nm) methods after 3 months. An Bras Dermatol 2014; 89: 250-258
• 17 Kim SG, Kim EY, Kim YJ. et al. The efficacy and safety of ablative fractional resurfacing using a 2,940-Nm Er:YAG laser for traumatic scars in the early posttraumatic period. Arch Plast Surg 2012; 39: 232-237
• 18 Chapas AM, Brightman L, Sukal S. et al. Successful treatment of acneiform scarring with CO2 ablative fractional resurfacing. Lasers Surg Med 2008; 40: 381-386
• 19 Choe JH, Park YL, Kim BJ. et al. Prevention of thyroidectomy scar using a new 1,550-nm fractional erbium-glass laser. Dermatol Surg 2009; 35: 1199-1205
• 20 Kim HS, Lee JH, Park YM. et al. Comparison of the effectiveness of nonablative fractional laser versus ablative fractional laser in thyroidectomy scar prevention: a pilot study. J Cosmet Laser Ther 2012; 14: 89-93
• 21 Cho S, Jung JY, Shin JU. et al. Non-ablative 1550 nm erbium-glass and ablative 10,600 nm carbon dioxide fractional lasers for various types of scars in Asian people: evaluation of 100 patients. Photomed Laser Surg 2014; 32: 42-46