Optimal Timing of Fractional CO2 Laser on Cleft Lip Scars: A Single-Blind Randomized Controlled Cohort Study

Abstract

BACKGROUND Scar is one of the most common complications for patients with cleft lip. Fractional CO2 laser is an effective method to improve the appearance of scars. However, there are no published articles about the optimal time for applying. OBJECTIVE To determine the optimal time to apply a fractional CO2 laser for the treatment of postsecondary repair scars in patients with cleft lip. METHODS Forty-two patients with linear scarring after cleft lip repair were recruited from November 2021 to October 2022. A single-blind, randomized, controlled cohort study was conducted to examine the impact of fractional CO2 laser treatment compared with conventional conservative treatment. Thirty patients started laser treatment at 1 month (n = 10), 3 months (n = 10), and 6 months (n = 10) postoperatively, and 12 patients were in the control group. Each patient was treated with high-energy low-density fractional CO2 laser treatment 3 times at an interval of 1 month. The Vancouver Scar Scale (VSS) was used for scar evaluation to determine vascularity, pigmentation, pliability, and height. RESULTS The VSS scores decreased significantly after laser treatment (p < .05), with the most significant improvement in scars in the group that started treatment 1 month after the surgery. CONCLUSION Early postoperative fractional CO2 laser treatment of cleft lip scars is more effective than later treatment.