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Effect of PRF & Fractional CO2 Laser in Postburn Hypertrophic Scars

Early Phase 1
Not yet recruiting
Conditions
Hypertrophic Scars
Burn Scar Patients
Interventions
Device: Fractional CO2 laser assisted PDT
Biological: Plasma rich in growth factors (PRGF-Endoret)
Registration Number
NCT06664268
Lead Sponsor
Assiut University
Brief Summary

Recent advancements in scar management include the use of Plasma Rich Fibrin (PRF) injections and fractional CO2 laser treatments. Both modalities are considered innovative approaches that offer promising outcomes in scar revision .

Plasma Rich Fibrin (PRF) is a newer modality in regenerative medicine derived from the patient's own blood. Unlike platelet-rich plasma (PRP), PRF does not use anticoagulants during processing, leading to a natural fibrin matrix that supports prolonged release of growth factors and cytokines . This matrix has been shown to enhance wound healing and improve scar texture and appearance. Studies have demonstrated PRF's efficacy in treating various skin conditions, including acne scars and general skin rejuvenation, suggesting potential benefits for postburn scar management .

Fractional CO2 laser therapy is a well-established technique for scar treatment, including postburn scars. This technology utilizes laser energy to create microthermal zones in the skin, which stimulates collagen production and skin remodeling while minimizing damage to surrounding tissues . Clinical trials have validated the effectiveness of fractional CO2 lasers in reducing scar thickness and improving skin texture, making it a popular choice for scar revision .

Detailed Description

Postburn scars often result in significant functional and aesthetic challenges for plastic surgeons. These scars can cause physical limitations, psychological distress, and a decrease in quality of life. Traditional treatments, including topical therapies, silicone gel sheets, and surgical interventions, frequently fall short in providing optimal results, particularly for extensive or complex scars .

Recent advancements in scar management include the use of Plasma Rich Fibrin (PRF) injections and fractional CO2 laser treatments. Both modalities are considered innovative approaches that offer promising outcomes in scar revision .

Plasma Rich Fibrin (PRF) is a newer modality in regenerative medicine derived from the patient's own blood. Unlike platelet-rich plasma (PRP), PRF does not use anticoagulants during processing, leading to a natural fibrin matrix that supports prolonged release of growth factors and cytokines . This matrix has been shown to enhance wound healing and improve scar texture and appearance. Studies have demonstrated PRF's efficacy in treating various skin conditions, including acne scars and general skin rejuvenation, suggesting potential benefits for postburn scar management .

Fractional CO2 laser therapy is a well-established technique for scar treatment, including postburn scars. This technology utilizes laser energy to create microthermal zones in the skin, which stimulates collagen production and skin remodeling while minimizing damage to surrounding tissues . Clinical trials have validated the effectiveness of fractional CO2 lasers in reducing scar thickness and improving skin texture, making it a popular choice for scar revision .

Despite the individual benefits of PRF and fractional CO2 laser treatments, there is a lack of direct comparative studies assessing their relative efficacy in postburn scar management. Comparative research is essential to determine which treatment provides superior outcomes and to guide clinical decision-making .

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
30
Inclusion Criteria
  • Patients aged from 18 to 60 years
  • Mature post burn scars (more than 6 months).
  • Scar area does not exceed 5% of body surface area (TBSA).
Exclusion Criteria
  • Immature scars (less than 6 months).
  • Large scar area (more than 5%of body surface area (TBSA).
  • Previous scar treatment with other modalities.
  • Keloid scars.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Group AFractional CO2 laser assisted PDTfractional CO2 laser alone
Group BPlasma rich in growth factors (PRGF-Endoret)PRF Injection and fractional CO2 laser
Group BFractional CO2 laser assisted PDTPRF Injection and fractional CO2 laser
Primary Outcome Measures
NameTimeMethod
Clinical Assessment6 months

1. Clinical Assessment:

By Vancouver Scar Scale (VSS) which consists of four items:

1. Pigmentation (0-2) Normal 0 Hypopigmentation 1 Hyperpigmentation 2

2. Vascularity (0-3) Normal 0 Pink 1 Red 2 Purple 3

3. Pliability (0-5) Normal 0 Supple 1 Yielding 2 Firm 3 Banding 4 Contracture 5

4. Height (0-3) Normal (flat) 0 0-2 mm 1 2-5 mm 2 \>5 mm 3 It has a score ranging from 0-13 , The VSS set a precedent for systematic scar assessment by collecting subjective assessments and using a semiquantitative approach. 0 (best) - 13 (worst)

Ultrasound Assessment6 months

Ultrasound Assessment: to detect changes in hypertrophic scar thickness before, during, and after treatment By Measurement of

* scar thickness in millimeters

Secondary Outcome Measures
NameTimeMethod
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