2. Laser versus other treatments outcome details.
| Comparison | Trials (participants) | Outcome | Definition of outcome in trial/measurement details | Data reported |
| 585‐nm PDL versus TAC | 2 RCTs (Omranifard 2007: 80 participants; 80 scars and Manuskiatti 2002: 10 participants; 20 segments) | Scar severity | Omranifard 2007: Patient Satisfaction assessed by VBS, including pigmentation, vascularity, pliability and height (photographs were taken). Self‐assessment: number of participants who considered their scars better or much better after up to 12 months Manuskiatti 2002: categories of 25% increments of improvement in scar severity after 32 weeks (graded by the participant) | Omranifard 2007: VBS (Mean + SD) Post‐treatment PDL: 4.2 + 1.6 TAC: 6.7 + 1.6 Self‐assessment PDL: 70% TAC: 30% Manuskiatti 2002: Number of participants with a 50% improvement or higher PDL: 8/10 TAC: 10/10 |
| 585‐nm PDL versus TAC | 2 RCTs (Omranifard 2007: 80 participants; 80 scars and Manuskiatti 2002: 10 participants; 20 segments) | Incidence and severity of treatment‐related adverse effects | Omranifard 2007: complications, such as textural or discolouration (hypo‐ or hyperpigmentation) during up to 12 months Manuskiatti 2002: Immediate treat reactions included mild to moderate pain during treatment, burning sensation, spots of purpura, erosion secondary to blistering. Treatment‐related adverse sequelae including hypopigmentation, telangiectasia, and skin atrophy during 32 weeks. | Omranifard 2007: no complication was observed Manuskiatti 2002: Sequelae: PDL: 0/10 TAC: 5/10 (Hypopigmentation 2, Telangiectasia 2, skin atrophy 1) Mild to moderate pain related to treatment: PDL: 9/10 Control: 10/10 (further details not provided) |
| 585‐nm PDL versus TAC | 2 RCTs (Omranifard 2007: 80 participants; 80 scars and Manuskiatti 2002: 10 participants; 20 segments) | Scar size, colour, height, length, width, pliability, skin surface texture, pruritus and pain | Omranifard 2007: vascularity, using a transparent tool for blanching the scar. Scar height scores: calliper by measuring the maximum vertical elevation of the scar above the normal skin after up to 12 months Manuskiatti 2002: scar height evaluated using a dial calliper, erythema using a hand‐held colorimeter after 32 weeks. | Omranifard 2007: Vascularity (Mean) Pre‐treatment PDL: 2.3 TAC: 2.3 Post‐treatment PDL: 1.1 TAC: 1.95 Height (Mean) Pre‐treatment PDL: 2.16 TAC: 2.18 Post‐treatment PDL: 1.32 TAC: 1.93 Manuskiatti 2002: No significant difference between groups in height (results presented only in graphs) |
| 585‐nm PDL versus 5‐FU | 1 RCT (Manuskiatti 2002: 10 participants; 20 segments) | Scar severity | Manuskiatti 2002: categories of 25% increments of improvement in scar severity after 32 weeks (graded by the participant). | Manuskiatti 2002: Number of participants with a 50% improvement or higher PDL: 8/10 5‐FU: 10/10 |
| 585‐nm PDL versus 5‐FU | 1 RCT (Manuskiatti 2002: 10 participants; 20 segments) | Incidence and severity of treatment‐related adverse effects | Manuskiatti 2002: immediate treatment reactions included mild to moderate pain during treatment and spots of purpura during 32 weeks. | Manuskiatti 2002:
Mild to moderate pain during the injection:
PDL: 9/10
5‐FU: 10/10
Purpura: PDL: 10/10 5‐FU: 2/10 No permanent sequelae were reported in the areas submitted to laser therapy or 5‐FU. |
| 585‐nm PDL versus 5‐FU | 1 RCT (Manuskiatti 2002: 10 participants; 20 segments) | Scar size, colour, height, length, width and pliability, skin surface texture, pruritus and pain | Manuskiatti2002: scar height evaluated using a dial calliper, erythema using a hand‐held colorimeter after 32 weeks. | No significant difference between groups in height (results presented only in graphs) |
| 585‐nm PDL versus TAC plus 5‐FU | 1 RCT (Manuskiatti 2002: 10 participants; 20 segments) | Scar severity | Manuskiatti 2002: categories of 25% increments of improvement in scar severity after 32 weeks (graded by the participant). | Manuskiatti 2002: Number of participants with a 50% improvement or higher PDL: 8/10 TAC plus 5‐FU: 9/10 |
| 585‐nm PDL versus TAC plus 5‐FU | 1 RCT (Manuskiatti 2002: 10 participants; 20 segments) | Incidence and severity of treatment‐related adverse effects | Manuskiatti 2002: immediate treatment reactions included mild to moderate pain during treatment and spots of purpura during 32 weeks. | Manuskiatti 2002:
Mild to moderate pain during the injection:
PDL: 9/10
5‐FU: 10/10
Purpura: PDL: 10/10 5‐FU: 3/10 No permanent sequelae were reported in the areas submitted to laser therapy or 5‐FU. |
| 585‐nm PDL versus TAC plus 5‐FU | 1 RCT (Manuskiatti 2002: 10 participants; 20 segments) | Scar size, colour, height, length, width and pliability, skin surface texture, pruritus and pain | Manuskiatti2002: scar height evaluated using a dial calliper, erythema using a hand‐held colorimeter after 32 weeks. | Mild to moderate pain not related to treatment PDL: 9/10 TAC plus 5‐FU: 10/10 No significant difference between groups in height (results presented only in graphs). |
| 585‐nm PDL versus Silicone Gel Sheeting | 1 RCT (Wittenberg 1999; 20 participants; 40 segments) | Incidence and severity of treatment‐related adverse effects | Wittenberg 1999: No definition is provided | Wittenberg 1999: one participant dropped out due to pain during laser treatment. One participant did not use SGS because of skin irritation. |
| Erbium laser versus TAC | 1 RCT (Omranifard 2007: 80 participants; 80 scars) | Scar severity | Omranifard 2007: Patient Satisfaction assessed by VBS, including pigmentation, vascularity, pliability and height. (photographs were taken) Self‐assessment: improvement of the scars severity after up to 12 months. | Omranifard 2007: VBS (Mean + SD) Post‐treatment Erbium: 4.6 + 1.9 TAC: 6.7 + 1.6 Self‐assessment (number of participants who considered their scars better or much better) Erbium: 65% TAC: 30% |
| Erbium laser versus TAC | 1 RCT (Omranifard 2007: 80 participants; 80 scars) | Incidence and severity of treatment‐related adverse effects | Omranifard 2007: complications, such as textural or discoloration (hypo‐ or hyperpigmentation) during up to 12 months. | Omranifard 2007: no complication was observed |
| Erbium laser versus TAC | 1 RCT (Omranifard 2007: 80 participants; 80 scars) | Scar size, colour, height, length, width and pliability, skin surface texture, pruritus and pain | Omranifard 2007: vascularity, using a transparent tool for blanching the scar. Scar height scores: calliper by measuring the maximum vertical elevation of the scar above the normal skin after up to 12 months. | Omranifard 2007: Vascularity (Mean) pre‐treatment Erbium: 2.4 TAC: 2.3 Post‐treatment Erbium: 1.15 TAC: 1.95 Height (Mean) Pre‐treatment Erbium: 2.18 TAC: 2.18 Post‐treatment Erbium: 1.39 TAC: 1.93 |
| Fractional CO2 Laser versus TAC | 1 RCT (Srivastava 2019; 40 participants; 40 scars) | Scar severity | Srivastava 2019: VSS | Srivastava 2019 Results of full scale were not reported |
| Fractional CO2 Laser versus TAC | 1 RCT (Srivastava 2019; 40 participants; 40 scars) | Incidence and severity of treatment‐related adverse effects | Srivastava 2019: pain at injection site, telangiectasia, skin atrophy and charring were evaluated and reported (when they occurred) during 24 weeks. | Srivastava 2019: Number of participants reporting treatment‐related adverse effects Pain at injection site FCO2: 2/20 TAC: 8/20 Telangiectasia FCO2: 0/20 TAC: 2/20 Skin atrophy FCO2: 0/20 TAC: 1/20 Charring FCO2: 3/20 TAC: 0/20 |
| Fractional CO2 Laser versus TAC | 1 RCT (Srivastava 2019; 40 participants; 40 scars) | Scar size, colour, height, length, width and pliability, skin surface texture, pruritus and pain | Srivastava 2019: height measured with callipers; vascularity by visual inspection; pliability by palpation; pigmentation after blanching (using a piece of clear plastic sheet till scar flattening occurred) and comparing it with the surrounding skin, pruritus, and pain not related to treatment after 24 weeks. | Srivastava 2019: Height (Mean + SD) Pre‐treatment FCO2: 1.95 + 0.76 TAC: 1.75 + 0.64 Post‐treatment FCO2: 0.25 + 0.44 TAC: 0 + 0 Vascularity Pre‐treatment FCO2: 2.05 + 0.69 TAC: 1.65 + 0.49 Post‐treatment FCO2: 0.45 + 0.51 TAC: 0 + 0 Pliability Pre‐treatment FCO2: 1.85 + 0.67 TAC: 1.9 + 0.64 Post‐treatment FCO2: 0.9 + 0.31 TAC: 0 + 0 Pigmentation Pre‐treatment FCO2: 1.60 + 0.50 TAC: 1.7 + 0.47 Post‐treatment FCO2: 0.8 + 0.41 TAC: 0.8 + 0.41 |
| Fractional CO2 Laser versus Verapamil | 1 RCT (Srivastava 2019; 40 participants 40 scars) | Scar severity | Srivastava 2019: VSS | Srivastava 2019: Results of full scale were not reported |
| Fractional CO2 Laser versus Verapamil | 1 RCT (Srivastava 2019; 40 participants 40 scars) | Incidence and severity of treatment‐related adverse effects | Srivastava 2019: pain at injection site, telangiectasia, skin atrophy and charring were evaluated and reported (when they occurred) during 24 weeks. | Srivastava 2019: Number of participants reporting treatment‐related adverse effects Pain at injection site FCO2: 2/20 Verapamil: 0/20 Telangiectasia FCO2: 0/20 Verapamil: 0/20 Skin atrophy FCO2: 0/20 Verapamil: 0/20 Charring FCO2: 3/20 Verapamil: 0/20 |
| Fractional CO2 Laser versus Verapamil | 1 RCT (Srivastava 2019; 40 participants 40 scars) | Scar size, colour, height, length, width and pliability, skin surface texture, pruritus and pain | Srivastava 2019: height measured with callipers; vascularity by visual inspection; pliability by palpation; pigmentation after blanching (using a piece of clear plastic sheet till scar flattening occurred) and comparing it with the surrounding skin, pruritus, and pain not related to treatment after 24 weeks. | Srivastava 2019: Height (Mean + SD) Pre‐treatment FCO2: 1.95 + 0.76 Verapamil: 2.05 + 0.6 Post‐treatment FCO2: 0.25 + 0.44 Verapamil: 0.05 + 0.22 Vascularity Pre‐treatment FCO2: 2.05 + 0.69 Verapamil: 1.95 + 0.69 Post‐treatment FCO2: 0.45 + 0.51 Verapamil: 0.1 + 0.31 Pliability Pre‐treatment FCO2: 1.85 + 0.67 Verapamil: 2.1 + 0.64 Post‐treatment FCO2: 0.9 + 0.31 Verapamil: 0 + 0 Pigmentation Pre‐treatment FCO2: 1.60 + 0.50 Verapamil: 1.65 + 0.49 Post‐treatment FCO2: 0.8 + 0.41 Verapamil: 0.55 + 0.51 |
5‐FU: Fluorouracil; PDL: Pulsed‐Dye Laser; TAC: Triamcinolone acetonide;VSS: Vancouver Scar scale.