Whatever the technique of the surgical repair, the scar remains and it is the most common cause for parents and patients dissatisfaction.

A new study published in the Annals of Plastic Surgery evaluated the efficacy of the fractional CO2 (FCO2) laser on the later appearance of cleft lip scars in general and to compare between the early and late use of this tool to know its ideal application time in particular.

In this study, 120 patients complaining of cleft lip scar were divided into three groups. Group 1 started FCO2 application 3 weeks postoperatively, group 2 started it 3 months postoperatively while group 3 applied local creams only as a control group. Fractional CO2 laser had been applied for 5-7 sessions. Vancouver scar scale was used for scar evaluation determining vascularity, pigmentation, pliability and height.

It was observed that patients had a great degree of improvement in their lip scar after FCO2 laser sessions. Vancouver Scar Scale score had insignificant differences between studied groups at the baseline before applying either FCO2 or local cream, whereas after their applications, it was significantly lower in group 1 in comparison with group 2 and group 3. Regarding the scar width assessment, it was significantly lower in group 1, when compared to groups 2 and 3. The visual analog scale by the participating medical personnel indicated that the FCO2-induced improvement in the lip scar appearance in group 1 more than groups 2 and 3 with a mean score of 44.17 ± 3.45, 36.53 ± 4.43 and 30.40 ± 5.22, respectively. The same assessment by the participating nonmedical personnel was significantly higher in group 1, than in group 2 and group 3.

Therefore, it was inferred that using FCO2 is significantly better than using local creams in the postoperative management of cleft lip scars. More in depth and early application of this tool is also significantly better than its delayed use.

Source: Annals of Plastic Surgery. 2020 Aug 11. doi: 10.1097/SAP.0000000000002511.