Clinical Trial: Comparison of Dual-mode ER:YAG Laser in Patients With Long Keloid/Hypertrophic Scars

Study Status: Withdrawn
Recruit Status: Withdrawn
Study Type: Interventional

Official Title: Within-subject Randomized Clinical Trial Comparing Dual-mode ER:YAG Laser in Patients With Long Keloid/Hypertrophic Scars

Brief Summary:

Skin injuries due to trauma are relatively common, and patients are very concerned about scars caused by trauma and primary repair. Recently, the use of ablative and non-ablative lasers based on the fractional approach has become a novel strategy for the treatment of scars.

The objective of this study is to compare the efficacy of dual-mode Er:YAG laser delivering pulses either with and without heat/coagulation in a cohort of patients with long keloid/hypertrophic scars.

The main hypothesis is that ablative fractional laser without heat/coagulation is equivalent to laser with heat/coagulation in terms of scars volume reduction, while the secondary hypothesis is that ablative fractional laser without heat/coagulation is superior in terms of post-operative erythema and hypopigmentation reduction.


Detailed Summary:

Background

Skin injuries, such as lacerations or abrasions, due to trauma are relatively common, and patients are very concerned about scars caused by trauma and primary repair. Multiple modalities for improving the clinical appearance of scars have been attempted with varying success, including corticosteroids, dermabrasion, surgical revision, chemical peeling, silicone gel application, pressure therapy, and radiation. Lasers such as the carbon dioxide (CO2), erbium: yttrium-aluminum-garnet (Er:YAG), and pulsed dye (PDL) lasers have all been used with differing success in the treatment of scars. The goal of all these treatments is to soften depressions and stimulate neocollagenesis in order to fill in the residual defects.

Ablative lasers used for skin resurfacing, such as the CO2 and Er:YAG laser, can reduce various scars, but significant adverse effects limit their use, and patient downtime can be extensive. Owing to these potential risks, nonablative lasers have been developed as a safe alternative to ablative laser resurfacing, and have been reported to be effective and safe for scars. However outcomes have remained unsatisfactory and require several treatments to achieve satisfactory efficacy.

Recently, the use of ablative and non-ablative lasers based on the fractional approach has become a novel strategy for the treatment of scars, and some authors have suggested that treatment with fractional lasers for various scars, such as postoperative, atrophic, and acne scars, has been demonstrated to safely improve the appearance of the scars. However, there is a lack of studies comparing coagulation modality of such lasers.

Objective

The objective of this study is to compare
Sponsor: University Hospital Inselspital, Berne

Current Primary Outcome: Any reduction from baseline of scars volume as assessed by image analysis [ Time Frame: 24 weeks ]

Original Primary Outcome: Any reduction from baseline of scars volume as assessed by image analysis [ Time Frame: 28 weeks ]

Current Secondary Outcome:

  • Any reduction from baseline of scars volume as assessed by image analysis [ Time Frame: 4, 8, 12, 16, 24 weeks ]
  • Any improvement of scars as assessed by physician according to an ordinal 6-points scale [ Time Frame: 4, 8, 12, 16, 24 weeks ]
  • Overall patient satisfaction to the proposed therapy as assessed by visual analogue scale [ Time Frame: 16, 24 weeks ]
  • Erythema index as assessed by image analysis [ Time Frame: 4, 8, 12, 16, 24 weeks ]
  • Hypopigmentation as assessed by image analysis [ Time Frame: 4, 8, 12, 16, 24 weeks ]


Original Secondary Outcome:

  • Any reduction from baseline of scars volume as assessed by image analysis [ Time Frame: 4, 8, 12, 16, 28 weeks ]
  • Any improvement of scars as assessed by physician according to an ordinal 6-points scale [ Time Frame: 4, 8, 12, 16, 28 weeks ]
  • Overall patient satisfaction to the proposed therapy as assessed by visual analogue scale [ Time Frame: 16, 28 weeks ]
  • Erythema index as assessed by image analysis [ Time Frame: 4, 8, 12, 16, 28 weeks ]
  • Hypopigmentation as assessed by image analysis [ Time Frame: 4, 8, 12, 16, 28 weeks ]


Information By: University Hospital Inselspital, Berne

Dates:
Date Received: September 2, 2015
Date Started: May 2016
Date Completion:
Last Updated: April 12, 2017
Last Verified: April 2017