One female patient working as the counter personnel at the department store had a sever car accident a few years old. Her face was hit from the accident, suffering major trauma and bone fracture. Although the wound has healed now, it has left an approximately 15cm-long atrophic scar with irregular radial shape across the lower eye, cheek, nose, and lips. As a result, the patient has to apply think layer of concealer on her face before she could face the customers at work. Another 19-year-old patient Zhen also suffered from a dark-brown hypertrophic scar in the shape of an earthworm on her knee after a car accident. Even though Zhen is an optimistic person and is enthusiastic in sports, she always has to hide her scar and worry about the peculiar look from her classmates during the PE class in school. Now they have accepted the laser compound treatment which improves the scar and reboots their confidence from the past.
China Medical University Hospital- Cosmetic Surgery Center Of Plastic Surgery Director Chang Chang-Zheng states that the scar from trauma is mainly divided into atrophic scar and hypertrophic scar. The former was mainly caused by external force that push the injured cortex to become thin and the damage on the collagen or subcutaneous tissue while the later was caused by the excessive tension during the healing process of trauma, resulting in continuous inflammation. Clinically, there have been cases with both situations. Other than that, the pigment after trauma accumulating or distributing unevenly as well as excessive vascular proliferation will also generate contrast with the color of peripheral skin. As a result, patients not only have to face with the trouble in appearance but also psychological impact. Chang Chang-Zheng suggests that “compound” laser offers a progressive treatment solution according to the category and cause of scar. For general hypertrophic scar, the patients will first need to receive several sessions of laser resurfacing to remove the unhealthy tissues left from continuous inflammation in the formation process of scars. In the second stage, the patients will receive several sessions of fractional laser treatment; in other words, the laser area is changed to a heating area of several micrometer apertures without destroying the entire tissues, in order to facilitate the restructuring, alignment and regeneration of superficial collagen in dermis. Finally in the last stage, the patients will undergo dual-pulsed dye laser or ND-Yag laser for the treatment troubles such as tincture and pigmentation.
Director Chang also reminds patients that such laser compound treatment not only requires complete laser instrument in medical institutions but also relies on the physician’s experience in finding the true cause. Most importantly, patients must have the patience and perseverance since each treatment interval takes about four weeks while the total treatment period lasts between eight months and one year. In spite of the longer period for laser compound treatment, the treatment comprehensively improves scars with poor development, when compared with the single laser treatment for the general skin abrasion or pigment removal in the past. Moreover, the prevention and care during would healing period are still very important. Apart from staying away from cigarette and nicotine, paying attention to sunburn protection and intensifying moisturizing in order to maintain water retention in skin and avoid pigmentation, patients should seek for medical help at the department of plastic surgery or cosmetics center early and take suggestions and treatment from professional physicians in case poor scar development.
China Medical University Hospital- Cosmetic Surgery Center Of Plastic Surgery Director Chang Chang-Zheng