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    Improvement of Surgical Scars by Early Intervention With Carbon Dioxide Fractional Laser. Zhang Yunsong,Liu Yanhua,Cai Bing,Luo Chengen,Li Dongni,Wang Suijiang,Sun Zhongsheng,Luo Sheng-Kang Lasers in surgery and medicine BACKGROUND AND OBJECTIVES:Laser therapy during the early stage of wound healing can reduce surgical scar formation. Previous clinical trials showed that ablative fractional laser (AFL) therapy might have achieved the best outcomes; however, there was no consensus on the laser therapy protocol. The current study investigated the efficacy of early intervention with carbon dioxide FL (CO FL) in reducing the surgical scars in patients of all age groups to understand the effects of specific intervention timing, light dose, number of treatments, treatment interval on the therapeutic outcome, and side effects. STUDY DESIGN/MATERIALS AND METHODS:Within 1 week after suture removal, 18 patients received low-energy CO FL therapy on their incisional wounds from facial or neck surgery. The treatments were performed once every 3 months for 1-3 sessions. After the surgical treatment, we applied a topical gel that contained recombinant human epidermal growth factor (EGF) on the incisional wounds to facilitate wound healing. The outcomes were evaluated by the Vancouver Scar Scale (VSS) and a satisfaction survey (the quartile grading scale) before and 3 months after completing the therapy was conducted. During the same period, 15 patients who had not received any treatment for about one year after face and neck surgery were randomly selected as the untreated control group. RESULTS:In the treatment group, 18 patients had no obvious scar marks after the laser therapy. The satisfaction survey showed excellent outcomes in 16 (88.9%) patients and good outcomes in two (11.1%). After treatment, the average VSS scale and satisfaction score of the treatment group were 1.11 and 3.89, respectively; while the average VSS scale of the control group was 3.07 and the satisfaction score was 1.93. There were significant differences in VSS scale and satisfaction score between the treatment group and the control group (P < 0.01). No adverse effects were observed. CONCLUSIONS:Early intervention with CO FL on surgical wounds achieved satisfactory outcomes in improving the surgical scars. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc. 10.1002/lsm.23129