Laser-Assisted Skin Healing (LASH) in hypertrophic scar revision

Laser-Assisted Skin Healing (LASH) is based on the therapeutic effects of controlled thermal post-conditioning. The authors have previously demonstrated on humans that an 810-nm diode-laser system could assist wound closure leading to an improvement of wound healing with a resulting indiscernible scar. A 47-year-old woman (skin type II), who developed systematically hypertrophic scars after surgery, was enrolled for a hypertrophic scar revision. Excess scar tissue was removed. Immediately after the conventional closure of the incision, laser irradiation (120 J/cm(2)) using a 0.8 cm(2) spot size (rectangular spot, length = 20 mm, width = 4 mm) was applied. Topical silicone gel sheeting (Cerederm (R)) was applied for 2 months afterwards to prevent a thick scar from reforming. No complications occurred during the course of this study. No recurrence of hypertrophic scarring was noticed 6 months after scar revision. This study reports, for the first time, the possibility of improving the appearance of hypertrophic scarring in scar revision by altering through thermal stress the wound-healing process. Since the appropriate initial management of wounds is of importance, the LASH technique could be offered as a new approach to prevent hypertrophic scarring.