Early Protocol-Based Fractional CO2 Laser Intervention for Post-Surgical Cleft-Lip Scars: A Prospective Clinical Study in Iraq.

BACKGROUND

Traditional Surgical management of cleft lip has been shown to achieve successful functional outcomes and reasonable aesthetic results. However, the postsurgical scar still presents an aesthetic concern. Recently, the development of fractional photothermolysis has revolutionized laser scar surgery, including cleft lip repair. However, this therapeutic technique has not been used in the early postoperative surgical correction of cleft lip. A new protocol has been suggested.

METHODS

Fifty-two children with unilateral cleft-lip deformity, 27 were males (51.9%), and 25 were females (48.1%), with an age range of 83 to 308 days, were included in this study. From June 17, 2021, to June 4, 2024, at the author's private clinic, all patients received a CO2 fractional laser session after primary cleft lip surgery to improve the surgical outcomes of their cleft lip scars. The number of fractional laser sessions ranged from 3 to 10 sessions. The time period between sessions was 4 to 6 weeks. Basically, the assessment interval was 1 month. The evaluation of scar improvement was performed by showing each patient 2 photographs (first and last) using the Vancouver Scar Scale (VSS) and a new scale for the level of the vermilion notch.

RESULTS

The study showed a highly significant improvement in the pliability, vascularity, and notching scores for the treated patients. However, the level of improvement for both pigmentation and height criteria scores was found to be statistically insignificant.

CONCLUSION

The new protocol shows promising results in minimizing cleft lip surgical scars in the early postoperative phase. Early fractional CO2 laser proved to be a valuable treatment modality for the rehabilitation of cleft lip. It was found to be highly effective from both healing and aesthetic criteria.