Cannula-based versus common needle-based subcision in combination with fractional CO2 laser in the treatment of post-traumatic atrophic facial scars: A clinical trial

Abstract

Background Despite the presence of many treatment options for management of atrophic post-traumatic scar, it is still a challenging problem. Different modalities have been used and have shown some degree of success in the improvement of scars. Objective To evaluate and compare the effectiveness of the subcision technique by two different modalities (cannula based versus common needle) with fractional CO2 laser for the management of post-traumatic atrophic facial scars. Patients and methods This study was performed on 50 patients with post-traumatic facial scar were treated three times at a 4-week interval with a follow-up visit. Each scar were divided into two equal halves; cannula subcision technique was done for an upper and right half, while the lower left half-treated with common needle based one, followed by application of fractional CO2 laser to whole scar. The effectiveness of these two techniques of subcision was evaluated using Vancouver Scar Scale (VSS), along with patient and doctor’s satisfaction measures; in addition to the late adverse effects 3 months postsubcision. Results The study group included 50 patients, their ages ranged from 20 to 60 years old with mean (28.4±8.1). The mean total VSS score improved significantly from 5.65±1.61 to 3.64±1.33 and 4.78±1.34 to 3.16±1.42 with cannula-based subcision and common needle-based one, respectively (P < 0.001). However, the mean cannula was significantly superior to common needles (P = 0.001), as regard Vancouver score parameters (pigmentation, pliability, and height), such as the pigmentation, pliability, and height of the mean difference values of Vancouver score (2.1±1.18) and (1.57±1.07) P < 0.05 and a significant difference in Vancouver score parameters, such as the pigmentation, pliability, and height in both methods with fewer adverse effects and more satisfaction by both patient and physician in subcision technique using blunt cannula versus common needle one. Conclusion Cannula-based subcision is more preferred than common needle one in the treatment of post-traumatic atrophic facial scars because it is safer, more practical and with lesser side effects.