Early intervention by Z-plasty combined with fractional CO2 laser therapy as a potential treatment for hypertrophic burn scars.

The aim of this study is to determine whether Z-plasty combined with fractional CO2 laser therapy can be a potential management option for hypertrophic burn scars in the proliferation stage. A total of 105 patients (46 male and 59 female patients) diagnosed with hypertrophic scars under tension but without any functional limitations were enrolled in this study. The Vancouver Scar Scale (VSS) score and scar height were analyzed and compared. The VSS scores for all scars were improved in all groups after treatment. The scar height was also significantly decreased in each group after treatment (P < 0.05). In the C group, the scar height decreased significantly to 2.62 ± 0.21 mm, which was the maximum extent at the ≦ 6 month time point compared to the decrease in the other groups. Compared to the > 12 month time point for the C group, there was a significant difference between the ≦ 6 month time point for the L group and the > 12 month time point for the Z group. The proportion of satisfied patients was highest at 89.47% at the ≦6 month time point in the C group and lowest at 65.52% at the > 12 month time point in the L group. Six representative cases are presented. Z-plasty can decrease the thickness of a hypertrophic burn scar, which not only reduces the scar tension but also makes it easy to treat the scar with a fractional CO2 laser. Subsequent treatment with a fractional CO2 laser can better improve the color and texture of the scar.