Fractional Co2, Long Pulse Nd:YAG and Pulsed Dye Laser in the Management of Keloids

Ashwini, Annabathula (2017) Fractional Co2, Long Pulse Nd:YAG and Pulsed Dye Laser in the Management of Keloids. Masters thesis, PSG Institute of Medical Sciences and Research, Coimbatore.


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INTRODUCTION : Keloids are abnormal wound responses characterised by excessive deposition of collagen and glycoprotein. They are both aesthetically and symptomatically distressing for most of the patients. LASERs have become a well-known treatment modality for the management of keloids in recent years. There are reports of keloid management with pulsed dye LASER, fractional CO2 LASER and Nd:YAG LASER individually and also in combination of CO2 with PDL and CO2 with Nd:YAG. Here, we discuss a combination of all the 3 LASERs as therapy for keloids. AIM : To assess the efficacy of fractional CO2, long pulse Nd:YAG and pulsed dye LASER in the management of keloids. METHODS : Procedure: Patients were anaesthetised using topical combination of lidocaine and prilocaine. After half an hour, fractional CO2 was delivered. Five minutes after the delivery of fractional CO2, Cynergy multiplex (long pulse Nd:YAG and pulsed dye LASER) was delivered. This procedure was done at intervals of 4 weeks. Clinical improvement was monitored based on a VAS (visual analogue scale) graded by 3 blinded observers after assessing clinical photographs. The parameters analysed in the VAS were the colour, size and general impression. A score of 0 for ‘no improvement, 1 for ‘mild improvement’ (<25%), 2 for ‘moderate improvement’ (26%-50%), 3 for ‘good improvement’ (51%-75%) and 4 for ‘excellent improvement’ (76%-100%) was given. The mean of the scores given by the 3 observers for each patient was recorded and the results were interpreted accordingly. RESULTS : Out of the 11 patients, 1 patient had excellent improvement, 1 patient had good improvement, 4 patients had moderate improvement, 2 patients had mild improvement and 3 had no improvement. CONCLUSION : LASERs used either singly or in combination may be effective to a varying degree in the treatment of keloids. We plan to conduct studies combining all other modes of treatments along with LASERs to determine if better results can be achieved.

Item Type: Thesis (Masters)
Uncontrolled Keywords: LASERS ; Keloids ; Pulsed Dye Laser ; Fractional CO2 Laser ; Nd:YAG Laser.
Subjects: MEDICAL > Dermatology Venereology and Leprosy
Depositing User: Subramani R
Date Deposited: 25 Dec 2017 18:40
Last Modified: 25 Dec 2017 18:40

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