Early dye laser treatment of hypertrophic sternotomy scars with prominent vascular component.

PURPOSE: A considerable percentage of patients develop hypertrophic scarring due to the healing process after heart surgery. The purpose of this study was to determine whether PDL applied on the day of suture removal, is even more successful in minimizing symptoms that impair the patient's quality of life and the cosmetic appearance of scars from median sternotomy cardiac surgery procedure. Materials/methods: A total of 12 patients with hypertrophic sternotomy scars resulting from cardiac surgeries underwent 4-5 treatment sessions with Dye laser as soon as the wound's sutures were taken out. After 40 days, the patient was re-assessed using an in-vivo multispectral skin imaging optical evaluation of the skin structures. Images were captured before and after each treatment, as well as 6 and 12 months after the last treatment. Twelve months after the last session each patient's level of improvement was assessed using the Vancouver Scar Scale (VSS). Twelve months following the conclusion of treatments, the patients were given photographs and filled out a satisfaction questionnaire.

RESULTS

Analysis of the VSS subscales after 1 year from the last laser treatment showed significant improvement in all parameters examined. Nine patients (75%) were very satisfied, 3 patients (25%) were satisfied, and no patients expressed dissatisfaction or insufficient satisfaction. Relevant side effects were absent. Before and after all treatments, multispectral and hemoglobin analyses showed overall patient's improvement.

CONCLUSIONS

PDL therapy has been proven to physically improve hypertrophic sternotomy scars with few side effects, reducing or even completely avoiding the need for reconstructive surgery.