Early Fractional Ablative Laser for Skin Cancer Excision Scars: A Randomized Split-Scar Study.

ABSTRACT

BACKGROUND: Fractional ablative laser resurfacing has been shown to improve the final cosmetic appearance of surgical scars, but optimal timing is unknown. OBJECTIVE: To compare surgical scars treated with fractional carbon dioxide (CO 2 ) laser performed on Day 0 and Day 14. METHODS: Prospective, randomized, split-scar, physician-blinded study of 30 surgical scars on the limbs. Scars halves received fractional CO 2 laser on either Day 0 or Day 14. Scar assessment at 6 months evaluated patient preference, physician modified Manchester Scar Scale (MMSS) score, and quantitative scar analysis on histology (fractal dimension [F D ] and lacunarity [L] analysis). RESULTS: There was no significant difference in patient assessment (54% preferred Day 0 side, 46% preferred Day 14 side, p = .58) or physician assessment (mean MMSS 8.4 for Day 0 vs 8.7 for Day 14, p = .28). Fractal dimensions were similar for both interventions (mean 1.778 for Day 0 vs 1.781 for Day 14, p = .80). Lacunarity was similar for both interventions (mean 0.368 for Day 0 vs 0.345 for Day 14, p = .44). LIMITATIONS: Single-center study with wounds limited to limbs of skin Phototype I-II subjects; 4 of whom were lost to follow-up. CONCLUSION: Intraoperative CO 2 laser is noninferior to Day 14 laser resurfacing for surgical scar treatment.