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Randomized Controlled Trial
. 2023 Sep 23;14(1):269.
doi: 10.1186/s13287-023-03480-8.

Efficacy of fractional CO2 laser in combination with stromal vascular fraction (SVF) compared with fractional CO2 laser alone in the treatment of burn scars: a randomized controlled clinical trial

Masoumeh Roohaninasab  1   2 , Fariba Khodadad  1   2 , Afsaneh Sadeghzadeh-Bazargan  1   2 , Najmolsadat Atefi  1   2 , Sona Zare  2   3   4   5 , Alireza Jafarzadeh  1 , Seyyedeh Tahereh Rahimi  1 , Maryam Nouri  2 , Mohammad Ali Nilforoushzadeh  6   7 , Elham Behrangi  8   9 , Azadeh Goodarzi  1   2
Affiliations
Randomized Controlled Trial

Efficacy of fractional CO2 laser in combination with stromal vascular fraction (SVF) compared with fractional CO2 laser alone in the treatment of burn scars: a randomized controlled clinical trial

Masoumeh Roohaninasab et al. Stem Cell Res Ther. .

Abstract

Background: The appearance of skin scars is known as one of the main side effects of skin burns. Stromal vascular fraction (SVF), as a rich source of cell populations with tissue regeneration properties, plays an important role in the healing of skin lesions. Fractional CO2 lasers have occupied a special place in treating skin lesions, particularly skin scars, since their introduction. Our study aimed to compare the combination of SVF and fractional CO2 laser with fractional CO2 laser alone in the treatment of burn scars.

Method: This double-blind clinical trial study was conducted on ten patients with burn scars that were treated three times with a fractional CO2 laser at site of burn lesions, and one of the two areas studied was randomly injected with SVF. Two months after completion of the procedure, patients' scars were assessed using the Vancouver scar scale (VSS), biometric criteria, and physician and patient satisfaction ratings.

Results: The results confirmed a significant improvement in VSS, cutometry, R7 criteria, complete density sonography, and skin density sonography in the fractional CO2 laser-treated group. The VSS criteria, epidermal thickness sonography, complete density sonography, and skin density sonography in the group treated with the combination of fractional CO2 laser and SVF also showed significant improvement. The VSS criteria and melanin index of Mexameter in the group treated with SVF in combination with fractional CO2 laser were significantly better than the group treated with fractional CO2 laser alone. Also, physician and patient satisfaction in the group treated with SVF injection in combination with fractional CO2 laser was significantly higher than the other group.

Conclusion: The results confirm the efficacy of SVF injection in combination with fractional CO2 laser in the treatment of burn scars and can be considered as a treatment option for better management of these lesions.

Trial registration: The study protocol was retrospectively registered at Iranian Registry of Clinical Trials with code: IRCT20210515051307N1, Registration date: 2021-11-14, URL: https://www.irct.ir/trial/56337 .

Keywords: Ablative laser; Burn scar; CO2 fractional laser; CO2 laser; Efficacy; Fractional; Laser; SVF; Safety; Satisfaction; Scar; Stromal vascular fraction; Trial.

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Conflict of interest statement

All the authors declare that there is no conflict of interest for this project.

Figures

Fig. 1
Fig. 1
Skin burn scar before and after treatment with fractional CO2 laser
Fig. 2
Fig. 2
Viability of SVF cells (prepared for injection)
Fig. 3
Fig. 3
SVF cells CD44, CD73 (A) CD90, CD105 (B) surface markers and had very small expression against hematopoietic cell markers CD34/CD45 (C)
Fig. 4
Fig. 4
Sonographic findings before intervention with fractional CO2 laser
Fig. 5
Fig. 5
Sonographic findings after intervention with fractional CO2 laser
Fig. 6
Fig. 6
Skin burn scar before and after treatment with SVF and fractional CO2 laser
Fig. 7
Fig. 7
Sonographic findings before intervention with fractional CO2 laser and SVF
Fig. 8
Fig. 8
Sonographic findings after intervention with fractional CO2 laser and SVF
Fig. 9
Fig. 9
Comparison of the average amount of biometric variables of burn scar severity in the group treated with fractional CO2 laser
Fig. 10
Fig. 10
Comparison of the average amount of biometric variables of burn scar severity in the group treated with fractional CO2 laser combined with SVF injection
Fig. 11
Fig. 11
Comparison of the average amount of biometric variables of burn scar severity in the group treated with fractional CO2 laser combined with SVF injection and the group treated with fractional CO2 laser alone
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