الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Hypertrophic scars (HTS) and keloids represent an abnormal variant of normal wound healing, characterized by fibroblast hyperproliferation and excess collagen formation.
HTS and keloids are a challenge for the treating physician because of the weak response to treatment, recurrences after treatment, and side effects associated with the treatment modalities.
The use of new, innovative therapeutic options, including combinations of treatments, offers the possibility of lesion regression and/or symptomatic improvement.
This study aimed to compare the effect of Fractional CO2 laser on post-burn hypertrophic scars and keloids alone or in combination with topical triamcinolone acetonide or with topical 5-fluorouracil.
This study was a prospective study conducted on 30 patients with post-burn hypertrophic scars and keloids (22 HTS and 8 keloids) who were recruited from the Dermatology Outpatient Clinic of the Alexandria Main University Hospital.
Same lesion was divided into three parts; part A was treated with fractional CO2 laser alone, part B was treated with fractional CO2 laser followed by topical application of triamcinolone acetonide suspension, and part C was treated with fractional CO2 laser followed by topical application of 5- fluorouracil (5%) solution.
In the current study, the age of patients ranged from 13 to 37 years with a mean ± SD of 21.80 ± 7.64 years and females were more predominant than males (70% vs 30%).
The commonest symptom was disfigurement which was presented in all 30 patients (100%). In addition, the commonest affected sites were trunk (43.3%) and upper limb (40%).
In the current study, we noted in the three parts (A, B, & C) significant improvement in terms of vascularity (P<0.001*), pliability (P<0.001*), decrease in the height of the lesion (P<0.001*), and decrease in the VSS (P<0.001*) before and after treatment. While as regards pigmentation, a significant improvement before and after treatment was reported only in the part treated by fractional CO2 and triamcinolone acetonide suspension
(P= 0.039*).
The decrease in vascularity, pliability, the height of the lesion, and change in VSS were significantly improved when using CO2 laser in combination with topical TACA or 5FU than CO2 alone. On the other hand, using combined CO2 laser and TACA resulted in significant decrease in pigmentation than using laser alone or with 5-FU which resulted in increased pigmentation.