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While various treatment options exist, their efficacy remains uncertain. Manual fractional technology with CO<jats:sub>2<\/jats:sub> laser technology, a novel approach, has shown promise; however, its effectiveness as a standalone ablative treatment is limited. This retrospective study aims to evaluate the clinical outcomes of combining Manual fractional technology with CO<jats:sub>2<\/jats:sub> laser technology with triamcinolone acetonide and 5-fluorouracil transdermal delivery for the treatment of hypertrophic scars. <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>This study retrospectively evaluated the clinical efficacy of MFT with CO<jats:sub>2<\/jats:sub> laser combined with transdermal triamcinolone acetonide and 5-fluorouracil in treating hypertrophic scars. <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A cohort of 42 patients with 48 hypertrophic scars underwent the combination therapy thrice. Scar evaluations were conducted using the patient and observer scar assessment scale (POSAS) before treatment and one month after each session. Adverse and complication reactions were monitored, and patients were followed for 6 months post-treatment. Hypertrophic scar recurrence and patient satisfaction were assessed. <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The total POSAS score significantly decreased from pre-treatment [48.00 (43.00, 53.75) VS 21.29\u00b17.167; <jats:italic>p<\/jats:italic>&lt;0.001]. In the subgroup analysis, treatment outcomes varied significantly by skin type, with scar quantity and genetic factors influencing remission time. The recurrence rate during the 6-month follow-up was 6.24%, with a satisfaction rate of 83.34%. No severe adverse reactions were reported. <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>The findings indicate that laser-assisted drug delivery using MFT with CO<jats:sub>2<\/jats:sub> laser demonstrates significant clinical efficacy, a low recurrence rate, and an absence of serious adverse reactions in treating hypertrophic scars. This method shows promise as a novel treatment modality for hypertrophic scars. <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Level of Evidence IV<\/jats:title>\n            <jats:p>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors \u00a0<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/www.springer.com\/00266\" ext-link-type=\"uri\">www.springer.com\/00266<\/jats:ext-link>.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00266-025-04837-5","type":"journal-article","created":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T09:43:26Z","timestamp":1743759806000},"page":"3756-3766","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Manual Fractional Technology with CO2 Laser Combined with Transdermal Drug Delivery for Hypertrophic Scar: A Retrospective Study"],"prefix":"10.1007","volume":"49","author":[{"given":"Houhuang","family":"Qiu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bingliang","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fuqiang","family":"Pan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siyuan","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liming","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,2]]},"reference":[{"issue":"1","key":"4837_CR1","doi-asserted-by":"publisher","first-page":"582","DOI":"10.1097\/01.ASW.0000527576.27489.0f","volume":"31","author":"FM Ghazawi","year":"2018","unstructured":"Ghazawi FM, Zargham R, Gilardino MS, et al. 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