The 1470 nm diode laser with an intralesional fiber device: a proposed solution for the treatment of inflamed and infected keloids

Abstract

Background: Keloids are the result of abnormal wound healing and often are subject to infections and recurrent inflammation. We present a study conducted with a 1470 nm diode laser using an intralesional optical fiber device for the treatment of inflamed keloid scars. We evaluate its efficacy as a novel alternative method to decrease keloid infection and inflammation.

Methods: The patients who underwent 1470 nm laser treatment from February 2016 to February 2018 at the plastic and reconstructive surgery department of the Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University with keloid accompanying serious local infection and fester were included. Patients took curative effect evaluation before and 1 year after the treatment. The test items included infection frequency in each year; pain, by visual analogue scale (VAS); itch, using VAS; quality of life (QOL), using QOL scale; and blood supply, using PeriCam PSI.

Results: A total of 19 patients (mean age 35.21 years, range 11-66) with history of inflamed keloids with episodes of infection or abscess were enrolled. Patients underwent to a 1470 nm laser therapy for average of 1.16 times. After treatment, infection frequency and blood supply in keloids were reduced (p < 0.001). Pain, itching, and QOL were improved (p < 0.001).

Conclusion: The present study shows that 1470 nm fiber laser treatment could improve inflamed keloids fairly well by decreasing inflammation, and a relative stabilization of collagen composition. Therefore, it is an effective minimally invasive scar therapy, but further studies are essential to confirm the present results.

Keywords: 1470 nm; Diode laser; Fiber laser; Hypertrophic scars; Keloid scars.

Fig. 1

Photographs of cases. A 37-year-old female suffered by inflamed keloid with recurrent episodes of infections 6 times per year (a), and 1-year after laser treatment, she did not present any further infection (b). A 45-year-old female had an inflamed keloid with 3 times events of infection per year (c), and  1-year after laser treatment, no further episodes of infection were registered (d)

Fig. 2

PeriCam PSI blood perfusion imager showing the reduction of blood supply in keloid after 1470 nm laser treatment. A 12-year-old boy had recurrent infections on his keloid 6 times per year (a, b before treatment). After 1-year laser treatment, no further infections were recorded, and the keloid blood supply reduced to 8.21% (c, d). The infected area is highlighted in black circle

Fig. 3

The diagram showed the decreasing of infection frequency and improvement of quality of life (QOL). ***p < 0.001

Fig. 4

The diagram showed the reduction of pain, itch, and blood supply. ***p < 0.001