Defining the Treatment Window: Early Versus Late Pulsed Dye Laser Therapy for Posttraumatic and Surgical Scars in Asian Patients

• Published in: Lasers in surgery and medicine Vol. 57; no. 1; pp. 71 - 79
• Main Authors: Chang, Han‐Yuan, Wu, Bing‐Qi, Chang, Chang‐Cheng, Chen, Yu‐Tsung, Wang, Yen‐Jen
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.01.2025
• Subjects: Adolescent; Adult; Aged; Asian People; Cicatrix - etiology; Cicatrix - radiotherapy; Correlation coefficients; Dye lasers; Dyes; Female; Health services; Humans; Lasers; Lasers, Dye - therapeutic use; Low-Level Light Therapy - methods; Male; Medical records; Middle Aged; Patients; Postoperative Complications - radiotherapy; pulsed dye laser; Retrospective Studies; scar management; Scars; Skin diseases; surgical scar; Time Factors; time window; Time-to-Treatment; traumatic scar; Treatment Outcome; Wound Healing; Young Adult; scar management; surgical scar; traumatic scar; time window; pulsed dye laser
• ISSN: 0196-8092; 1096-9101; 1096-9101
• DOI: 10.1002/lsm.23844

ABSTRACT Objectives This retrospective study evaluates the effectiveness of pulsed dye laser (PDL) treatment in early versus late treatment groups for traumatic or postoperative scars. The study aims to determine the threshold between early and late treatment. Additionally, it investigates factors that may influence wound healing outcomes. Methods The medical records of 147 patients who underwent PDL treatment at our institution between January 2018 and December 2022 were retrospectively reviewed. Inclusion criteria were patients receiving PDL treatment for traumatic or postoperative scars. Out of these patients, we selected those who were willing to receive telephone interviews or re‐visit at a scheduled time. Eventually, 52 participants were included in our study. A standardized questionnaire was administered to all participants during telephone interviews, encompassing inquiries regarding their medical history, treatment experiences, and the patient component of the Patient and Observer Scar Assessment Scale. Among the enrolled patients, 38 were contacted and interviewed via telephone, while the remaining 14 patients attended follow‐up visits where photographs of their current skin condition were captured. The pretreatment and latest follow‐up photographs obtained from the clinical database were independently scored in a blinded manner by two dermatologist reviewers using both the Vancouver Scar Scale and the Manchester Scar Scale. Results Among the 52 patients, 43 (82.7%) were successfully treated with good response. The correlation coefficients between week‐to‐treatment initiation and posttreatment MSS and VSS among patients with good response were 0.50 (p < 0.001) and 0.46 (p = 0.002), respectively. Given these findings, we established a treatment initiation threshold of 10 weeks, distinguishing patients into early and late treatment groups. The early treatment group showed borderline significantly lower posttreatment MSS and VSS scores than the late treatment group (MSS: 7.5 ± 2.1 vs. 9.3 ± 2.5, p = 0.011; VSS: 2.8 ± 2.0 vs. 4.5 ± 2.3, p = 0.011). Furthermore, both MSS and VSS of posttreatment showed significantly greater improvement in the early treatment group (4.4 ± 1.6 vs. 3.2 ± 1.9; p = 0.03 and 3.8 ± 1.8 vs. 2.8 ± 1.4; p = 0.04). Conclusions Early intervention using a PDL within 10 weeks post‐injury achieved better outcomes in treating traumatic and postoperative scars based on both clinical and patient opinions.