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Aljefri YE, Ghaddaf AA, Alahmadi RA, Alkhamisi TA, Alkhunani TA, Samarkandy SJ, Alamri AM. Ablative fractional carbon dioxide laser combined with autologous platelet-rich plasma in the treatment of atrophic acne scars: A systematic review and meta-analysis. Dermatol Ther 2022; 35:e15888. [PMID: 36183145 DOI: 10.1111/dth.15888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/07/2022] [Accepted: 09/29/2022] [Indexed: 11/29/2022]
Abstract
Atrophic acne scars are the most common cutaneous seqaule of acne vulgaris, representing 80%-90% of all acne scars. Ablative fractional carbon dioxide (FCO2 ) laser is the gold standard treatment for atrophic scars. Additionally, platelet-rich plasma (PRP) is suggested to accelerate the healing process and collagen synthesis. The aim of the present systematic review and meta-analysis was to determine the efficacy and safety of PRP combined with Ablative FCO2 laser in the treatment of moderate to severe atrophic acne scars. Randomized controlled trials (RCTs) that have compared PRP in combination with ablative FCO2 laser to ablative FCO2 laser alone with respect to the efficacy and safety measures were included. We have systematically explored Embase, Medline, and CENTRAL databases via Ovid. The outcomes that our systematic review sought to evaluate were clinical improvement, patient satisfaction, and Goodman and Baron's qualitative acne scar score. The dichotomous outcomes were presented as odds ratio (OR) while the continuous outcomes were presented as standardized mean difference (SMD). Eleven RCTs that represents 313 participants were included. The combined use of laser and PRP showed a statistically significant clinical improvement and patient satisfaction compared to the use of laser alone (OR = 2.56, 95% CI 1.37-4.78 and OR = 3.38, 95% CI 1.80-6.34, respectively). Also, a significant improvement in Goodman and Baron's score was achieved by combining PRP with laser (SMD = -0.40, 95% CI -0.65 to -0.14). The combined treatment of laser and PRP was highly synergistic, effective, and safe in treating moderate to severe atrophic acne scars.
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Affiliation(s)
- Yara E Aljefri
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Abdullah A Ghaddaf
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Rana A Alahmadi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Taif A Alkhamisi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Tala A Alkhunani
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Sahal J Samarkandy
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- Department of Dermatology, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Awadh M Alamri
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- Department of Dermatology, King Abdulaziz Medical City, Jeddah, Saudi Arabia
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Abstract
Wound healing is a dynamic and highly regulated process that can be separated into three overlapping and interdependent phases: inflammation, proliferation, and remodelling. This review focuses on the inflammation stage, as it is the key stage of wound healing and plays a vital role in the local immune response and determines the progression of wound healing. Inflammatory cells, the main effector cells of the inflammatory response, have been widely studied, but little attention has been paid to the immunomodulatory effects of wound healing in non-inflammatory cells and the extracellular matrix. In this review, we attempt to deepen our understanding of the wound-healing microenvironment in the inflammatory stage by focusing on the interactions between cells and the extracellular matrix, as well as their role in regulating the immune response during the inflammatory stage. We hope our findings will provide new ideas for promoting tissue regeneration through immune regulation.
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Affiliation(s)
- Zhen Wang
- Department of Plastic Surgery and Burns, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- The Collaborative Innovation Center of Tissue Damage Repair and Regeneration Medicine of Zunyi Medical University, Zunyi, China
| | - Fang Qi
- Department of Plastic Surgery and Burns, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- The Collaborative Innovation Center of Tissue Damage Repair and Regeneration Medicine of Zunyi Medical University, Zunyi, China
| | - Han Luo
- Department of Plastic Surgery and Burns, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- The Collaborative Innovation Center of Tissue Damage Repair and Regeneration Medicine of Zunyi Medical University, Zunyi, China
| | - Guangchao Xu
- Department of Plastic Surgery and Burns, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- The Collaborative Innovation Center of Tissue Damage Repair and Regeneration Medicine of Zunyi Medical University, Zunyi, China
| | - Dali Wang
- Department of Plastic Surgery and Burns, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- The Collaborative Innovation Center of Tissue Damage Repair and Regeneration Medicine of Zunyi Medical University, Zunyi, China
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