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<p>Hypertrophic sternotomy scars in children after congenital heart disease (CHD) surgery pose a significant burden. Evidence for combining pulsed dye laser (PDL) with ablative fractional lasers (AFLs) in this population is scarce. This study aimed to compare the efficacy and safety of combined ultrapulse fractional CO₂ laser and PDL versus PDL alone for treating these scars.&#xa0;This retrospective study reviewed 36 children treated with either combined laser (<i>n</i> = 18) or PDL alone (<i>n</i> = 18) as part of routine clinical care, without randomization.Both groups received four treatment sessions. Scar improvement was assessed using the Vancouver Scar Scale (VSS) at baseline, 3 months, and 6 months post-treatment.&#xa0;Baseline characteristics were comparable. VSS scores improved significantly in both groups over time. At 3 months, there was no significant difference in median VSS scores between groups (control: 2.0, observation: 2.0, <i>p</i> = 0.072). At 6 months, the observation group showed a non-significant trend toward higher (worse) median scores (control: 4.0, observation: 3.5, <i>p</i> = 0.883). Adverse events (blisters, pigmentation) were similar between groups. However, scar re-growth occurred in 3 patients in the observation group versus none in the control group.&#xa0;Combined ultrapulse fractional CO₂ laser and PDL therapy did not demonstrate superior efficacy over PDL monotherapy for pediatric post-sternotomy hypertrophic scars and was associated with a potential risk of rebound scar proliferation. PDL alone appears to be a safer and effective first-line treatment in this specific population.</p>

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A comparative study of ultrapulse CO₂ fractional laser combined with pulsed dye laser versus pulsed dye laser alone for hypertrophic chest scars following pediatric congenital heart surgery

  • 期刊论文

  • 发表日期：

    2026年6月20日

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  • Zhaoming Liu,
  • Xiangjing Li,
  • Lei Xue,
  • Qi Liu,
  • Fangfang Li,
  • Yang Gao

摘要

Hypertrophic sternotomy scars in children after congenital heart disease (CHD) surgery pose a significant burden. Evidence for combining pulsed dye laser (PDL) with ablative fractional lasers (AFLs) in this population is scarce. This study aimed to compare the efficacy and safety of combined ultrapulse fractional CO₂ laser and PDL versus PDL alone for treating these scars. This retrospective study reviewed 36 children treated with either combined laser (n = 18) or PDL alone (n = 18) as part of routine clinical care, without randomization.Both groups received four treatment sessions. Scar improvement was assessed using the Vancouver Scar Scale (VSS) at baseline, 3 months, and 6 months post-treatment. Baseline characteristics were comparable. VSS scores improved significantly in both groups over time. At 3 months, there was no significant difference in median VSS scores between groups (control: 2.0, observation: 2.0, p = 0.072). At 6 months, the observation group showed a non-significant trend toward higher (worse) median scores (control: 4.0, observation: 3.5, p = 0.883). Adverse events (blisters, pigmentation) were similar between groups. However, scar re-growth occurred in 3 patients in the observation group versus none in the control group. Combined ultrapulse fractional CO₂ laser and PDL therapy did not demonstrate superior efficacy over PDL monotherapy for pediatric post-sternotomy hypertrophic scars and was associated with a potential risk of rebound scar proliferation. PDL alone appears to be a safer and effective first-line treatment in this specific population.