The influence of morphofunctional parameters on the effectiveness of high-intensity laser therapy for patients with hypertrophic skin scars

Abstract

Different combinations of high-intensity laser therapy (HILT) methods cause multidirectional therapeutic effects, the causes of dissociation of which may be due to the parameters of the morphofunctional status of scar tissue — the determinants of the effectiveness. Objective: to identify the determinants of the effectiveness of high-intensity laser therapy in patients with developing and mature hypertrophic skin scars. Methods: 100 patients with developing (n=49) and mature (n=51) hypertrophic scars were studied. In patients with developing scars, acombination of selective angiophotothermolysis (λ=0,578 µm) and subsequent fractional ablative photothermolysis (λ=10,6 µm) was used, and in patients with mature scars, acombination of selective angiophotothermolysis (λ=0,578 µm) followed by planar ablative photodisruption (λ=10,6 µm) was applied. Dermatoscopic methods for assessing the morphofunctional properties of the skin, instrumental methods for assessing the elasticity, microcirculation and metabolism of scar tissue, and assessment of the quality of life of patients were used. Results. Combinations of selective angiophotothermolysis, fractional ablative photothermolysis and planar ablative photodisruption cause pronounced therapeutic effects in patients with developing and mature hypertrophic skin scars, which are manifested by regression of clinical signs of scar tissue, remodeling of scar tissue, improvement of elasticity, microcirculation and metabolism of scars, which leads to an improvement in the quality of life of patients. Conclusion. The determinants of the effectiveness of HILT in patients with developing hypertrophic scars are the indicators of the patient’s clinical status, the morphofunctional properties of the scar tissue, the parameters of microcirculation and metabolism.