Korean J Dermatol.  2020 Aug;58(7):445-452.

The Effectiveness of Fractional Carbon Dioxide Laser plus Intralesional Triamcinolone Acetonide Compared with Intralesional Triamcinolone Acetonide Monotherapy for the Treatment of Keloid and Hypertrophic Scar: A Systematic Review and Meta-analysis

• Kim WI
• Heo J
• Kim S
• Cho MK

Abstract

Background
Fractional carbon dioxide laser (FCL) has been used to treat keloid and hypertrophic scars as monotherapy or combination therapy, including intralesional triamcinolone acetonide (ITAC). However, whether the combination of FCL and ITAC is really effective compared with other treatments, such as ITAC monotherapy in treating keloid and hypertrophic scars, remains unclear.
Objective
To evaluate the effectiveness of FCL plus ITAC compared with ITAC monotherapy in treating keloid and hypertrophic scars.
Methods
A computerized search was performed in different databases, including Cochrane, Embase, and PubMed. One randomized controlled trial and two controlled clinical trials were included. Statistical analyses of the extracted outcome data from the studies were then calculated using the Rex Software (version 3.0.1).
Results
A total of 203 records were identified by searching databases, including Cochrane, Embase, and PubMed. The meta-analysis results, including three studies, demonstrated that although FCL combined with ITAC showed a slightly pronounced improvement in keloid and hypertrophic scars than ITAC monotherapy, there was no statistical difference (SMD: 0.26, 95% confidence interval [CI]: −0.10∼0.61, p=0.1541).
Conclusion
FCL combined with ITAC may not be a cost-effective treatment for the treatment of keloid and hypertrophic scars due to similar effectiveness compared with ITAC monotherapy. However, this study had limitations, including insufficiency of published articles and data. Therefore, further investigations are needed.

Keyword

Fractional carbon dioxide laser; Hypertrophic scar; Keloid; Triamcinolone acetonide