ABSTRACT
Aim: To assess and compare the outcomes of the cutaneous neck dissection incisions taken by Colorado microdissection needle, surgical blade and cutting electrocautery in patients with oral squamous cell carcinoma. Materials and Methods: A prospective, randomized control, comparative study was carried out on 21 patients. These patients were divided into 3 groups containing 7 patients in each group. The intra operative and post operative outcomes were evaluated. Statistical analysis was done by using descriptive and inferential statistics using Chisquare test, Fisher's Exact Test, one way ANOVA and multiple comparison Tukey Test and software used in the analysis were SPSS 27.0 version and GraphPad Prism 7.0 version and P < 0.05 is considered as level of significance. Results: The time taken for placing cutaneous skin incision and blood loss was more in the surgical blade group as compared to the Colorado microdissection needle and electrocautery. Statistically no significant difference between the three group while comparing the cutaneous neck incision healing and post operative scar formation. Conclusion: This study proves the superiority of the Colorado microdissection needle in terms of time taken and blood loss with similar aesthetic outcome in terms of cutaneous wound healing and post operative scar formation when compared to surgical blade and cutting electrocautery.
ABSTRACT
BACKGROUND: Annually, around 100 million patients worldwide acquire scars, some of which can cause significant problems. Various treatment interventions, such as topical scar creams, steroids, laser therapy, and surgery, have been developed to manage these scars. This study was conducted to evaluate the effectiveness of fractional CO2 laser treatment by assessing outcomes using the Patient Observer Scar Assessment Scale (POSAS) and clinical photographs. MATERIALS AND METHODS: A total of 47 patients were included in the study, divided into three groups: a post-acne scar group with 14 patients, a post-burn scar group with 17 patients, and a post-traumatic scar group with 16 patients. Detailed histories were taken, and clinical examinations were performed and recorded on a prepared proforma. Aesthetic outcomes were evaluated based on clinical photographs, and total patient and observer scores were recorded using POSAS at baseline, and after one and three months. POSAS comprises two components: the observer scale (POSAS-O) and the patient scale (POSAS-P). Fractional CO2 laser treatments were performed in each group, with sessions repeated every four weeks for three consecutive sessions. Data were analyzed using the paired t-test for before-and-after comparisons in each study group. Welch's ANOVA test was used for comparisons among the three groups at a significance level of p=0.05, using MS Excel (Microsoft Corporation, Redmond, Washington) and IBM SPSS Statistics for Windows, Version 20 (Released 2011; IBM Corp., Armonk, New York). RESULTS: The mean age for men was 26.38 ± 8.19 years and for women 22.21 ± 6.38 years. The study comprised 34 female patients (72.34%) and 13 male patients (27.66%). The mean POSAS observer and patient scales were recorded and compared for all three types of scars from baseline to three months. The mean percentage change in POSAS-O and POSAS-P (total score) in relation to different scar sites was recorded. The most significant difference in mean percentage change, statistically significant (p-value < 0.05), was observed for facial scars, followed by scars on the neck, and was minimal for scars on the hand, in both observer and patient groups. Even a single session of fractional CO2 laser therapy had profound effects on the overall quality of scars. CONCLUSION: Fractional carbon dioxide laser therapy improves the quality of scars and produces significant improvements in skin texture, with better effects on post-traumatic scars than on post-burn and post-acne scars. Future studies are needed to better understand the mechanism of action and to optimize the doses and timing of therapy.