Clinical and Histological Assessment of Combined Fractional CO2 Laser and Growth Factors Versus Fractional CO2 Laser Alone in the Treatment of Facial Mature Burn Scars: A Pilot Split-Face Study

Background and Objectives To investigate the therapeutic efficacy and safety of growth factors combined with fractional carbon dioxide (CO2) laser in comparison with fractional CO2 alone in a sample of patients with facial mature burn scars. Study Design/Materials and Methods Fifteen Egyptian patients with bilateral facial burn scars were treated with six sessions of fractional CO2 laser at 6-week intervals. Following each laser session, a topical growth factors cocktail was applied to one side of the face in a split-face manner. Clinical evaluation by Vancouver Scar Scale (VSS), Patient and Observer Scar Assessment Scale (PSOS), and photography before and 2 months after the last laser session was done. Three millimeter punch biopsies were obtained from each side of the face pre- and 1-month posttreatment to measure the mean area percent of collagen. Results Posttreatment, both VSS and PSOS scores decreased on both sides of the face being more significant on the growth factors treated side, showing more scar pliability and shorter downtime (P = 0.001). A significant difference in the mean area percent of collagen was also noted on both sides. Conclusion Adding topical growth factors to fractional CO2 laser treatments is effective and safe with better results as regards scar pliability and shorter downtime than fractional CO2 laser alone. Lasers Surg. Med. (c) 2020 Wiley Periodicals, Inc.