الفهرس 
Normal Wound HealingOnly 14 pages are availabe for public view
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Abstract
Introduction: Hypertrophic scars (HTSs) and keloids are common dermatological complaints caused by disruption of the normal wound-healing process. There is currently no clarification for the underlying pathogenesis of HTSs and keloids. These lesions may show an abnormal wound-healing response to external physical trauma and represent an underlying complication of the extracellular matrix remodeling process. Newly published studies consider the value of laser therapy, including the flash-lamp pulsed dye, fractional carbon dioxide laser, copper bromide laser. Since combination therapy may result in synergistic effects and regarding the lack of studies on this issue, the current study is performed to determine the comparative effects of ablative fractional Carbon Dioxide laser combined with Injection of 5-fluorouracil versus intralesional injection of 5- fluorouracil and ablative fractional CO2 laser each as monotherapy in the treatment of hypertrophic scars and keloids.
Patients and Methods: This study is a randomized controlled comparative and prospective study. Thirty patients with hypertrophic scars and keloids were collected and divided into 3 groups each group included 10 patients. group A: which is the main purpose of the study was treated by Intralesional 5-Fluorouracil combined with Ablative Fractional Carbon Dioxide Laser. group B: treated by Ablative Fractional Carbon Dioxide Laser as a monotherapy. group C: treated by Intralesional 5-Fluorouracil as a monotherapy. Assessment of results was done using Vancouver scar scale, Observer Scar Assessment scale and Patient Scar Assessment Scale.
Results: A total of 30 patients were included in our final analysis, patients were divided into three groups. There was a significant difference in age between the 3 groups as group B has the oldest median age 35 years old while group C and A were 29.5 and 17 years old respectively, with p value 0.006. There was no statistically significant difference between three groups in other baseline characters as cause of scar, skin type, scar site, scar duration and length with p values > 0.05. Comparison between VSS before and after treatment showed a signfiicant difference in the three groups with p value 0.0001. After completion of treatment there was a signficant difference reported between the three groups with p value 0.0001. Improvement after completion of treatment was observed to be the highest in group A with mean improvement 69.9% followed by group B 32% and group C 11.8%. There was a statistically significant difference with p value 0.0001.
Conclusion: 5FU injection along with Fractional CO2 laser showed the highest improvement percentage among all groups. Fractional CO2 laser showed acceptable results in management of hypertrophic scars; however, it was inferior to combination with 5FU arm. Intralesional 5FU injection as a monotherapy was accompanied with the highest incidence of complications and decline in the evaluating scores (VSS and POSAS).