{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T00:43:26Z","timestamp":1793666606758,"version":"4.5.1"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:00:00Z","timestamp":1741737600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:00:00Z","timestamp":1741737600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100002386","name":"Cairo University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002386","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Lasers Med Sci"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Hypertrophic scar could be associated with several complications that interfere with patient daily activities, physical and psychological health and impact patient quality of life. Several therapeutics and maneuvers are used for treatment of hypertrophic scar with variable success and side effects. We aim to evaluate safety and efficacy of fractional carbon dioxide laser on treatment of hypertrophic scar both clinically and histopathologically. Hypertrophic scars in each patient of total thirty patients were subjected to random division with sealed envelope into two parts, part A treated with fractional carbon dioxide laser every month for 5 sessions, and part B lift without treatment for control. Hypertrophic scars in each patient were single or multiple, Single scar was more than 15\u00a0cm length. Clinical evaluation was done by two blinded dermatologists, using Vancouver Scar Scale (VSS) and Patient and Observer Scar Assessment Scale (POSAS) for each part before, 3 months and 6 months after treatment. Histopathological evaluation was done for each part before and 3 months after treatment by measuring epidermal thickness, collagen area percent, and elastin area percent. The upper significant clinical and histopathological improvement was shown in carbon dioxide laser treated parts than control parts without significant side effects for fractional carbon dioxide laser treatment. Treatment of hypertrophic scar with fractional carbon dioxide laser is beneficial and generally considered safe, with minimal risk of harm when performed with appropriate laser parameters for male and female patients with skin type III and IV, at different ages and different body regions.<\/jats:p>","DOI":"10.1007\/s10103-025-04371-5","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T21:57:01Z","timestamp":1741730221000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Fractional carbon dioxide laser treatment of hypertrophic scar clinical and histopathological evaluation"],"prefix":"10.1007","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6726-8317","authenticated-orcid":false,"given":"Zaynab Sayed","family":"Keshk","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manal Mohammad","family":"Salah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nevien Ahmed","family":"Samy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,12]]},"reference":[{"issue":"9","key":"4371_CR1","doi-asserted-by":"publisher","first-page":"2729","DOI":"10.1111\/jocd.14310","volume":"20","author":"ML Elsaie","year":"2021","unstructured":"Elsaie ML (2021) Update on management of keloid and hypertrophic scars: a systemic review. J Cosmet Dermatol 20(9):2729\u20132738","journal-title":"J Cosmet Dermatol"},{"issue":"4","key":"4371_CR2","doi-asserted-by":"publisher","first-page":"974","DOI":"10.1111\/bjd.18219","volume":"182","author":"GC Limandjaja","year":"2019","unstructured":"Limandjaja GC, Belien JM, Scheper RJ, Niessen FB, Gibbs S (2019) Hypertrophic and keloid scars fail to progress from the CD 34\u2013 \/\u03b1-smooth muscle actin (\u03b1\u2010 SMA)\u2009+\u2009immature scar phenotype and show gradient differences in \u03b1\u2010 SMA and p16 expression. Br J Dermatol 182(4):974\u2013986","journal-title":"Br J Dermatol"},{"key":"4371_CR3","doi-asserted-by":"publisher","unstructured":"Kant S, van den Kerckhove E, Colla C, van der Hulst R, Piatkowski de Grzymala A (2019) Duration of Scar Maturation: Retrospective Analyses of 361 Hypertrophic Scars Over 5 Years. Advances in Skin & Wound Care [Internet]. 32(1):26\u201334. Available from: https:\/\/doi.org\/10.1097\/01.asw.0000547415.38888.c4","DOI":"10.1097\/01.asw.0000547415.38888.c4"},{"key":"4371_CR4","doi-asserted-by":"crossref","unstructured":"Kruglikov IL, Scherer PE (2019) Caveolin-1 as a target in prevention and treatment of hypertrophic scarring. Npj Regenerative Med. 4(1)","DOI":"10.1038\/s41536-019-0071-x"},{"key":"4371_CR5","doi-asserted-by":"publisher","unstructured":"Lee KC, Bamford A, Gardiner F, Agovino A, ter Horst B, Bishop J et al (2020) Burns objective scar scale (BOSS): Validation of an objective measurement devices based burn scar scale panel. Burns [Internet]. 46(1):110\u201320. Available from: https:\/\/doi.org\/10.1016\/j.burns.2019.05.008","DOI":"10.1016\/j.burns.2019.05.008"},{"key":"4371_CR6","doi-asserted-by":"publisher","unstructured":"Yuan B, Upton Z, Leavesley D, Fan C, Wang X-Q (2023) Vascular and Collagen Target: A Rational Approach to Hypertrophic Scar Management. Advances in Wound Care [Internet]. 12(1):38\u201355. Available from: https:\/\/doi.org\/10.1089\/wound.2020.1348","DOI":"10.1089\/wound.2020.1348"},{"key":"4371_CR7","doi-asserted-by":"publisher","unstructured":"Simbolon Sitohang IB, Sirait SAP, Safira FD (2021) Fractional carbon dioxide laser for treating hypertrophic scars: A systematic review of randomised trials. Australasian Journal of Dermatology [Internet]. 63(1):27\u201335. Available from: https:\/\/doi.org\/10.1111\/ajd.13730","DOI":"10.1111\/ajd.13730"},{"issue":"2","key":"4371_CR8","first-page":"372","volume":"13","author":"GM Mekeres","year":"2023","unstructured":"Mekeres GM, Buha\u0219 CL, Csep AN, Beiu\u0219anu C, Gineta Andreescu, Marian P et al (2023) The importance of psychometric and physical scales for the evaluation of the consequences of Scars\u2014A. Literature Rev 13(2):372\u2013383","journal-title":"Literature Rev"},{"key":"4371_CR9","doi-asserted-by":"publisher","unstructured":"Park JW, Koh YG, Shin SH, Choi Y-J, Kim W-S, Yoo HH et al (2022) Review of Scar Assessment Scales. Medical Lasers [Internet]. 11(1):1\u20137. Available from: https:\/\/doi.org\/10.25289\/ml.2022.11.1.1","DOI":"10.25289\/ml.2022.11.1.1"},{"key":"4371_CR10","doi-asserted-by":"publisher","unstructured":"Poetschke J, Gauglitz GG (2020) Treatment of Immature Scars: Evidence-Based Techniques and Treatments. Textbook on Scar Management [Internet]. 193\u2013201. Available from: https:\/\/doi.org\/10.1007\/978-3-030-44766-3_22","DOI":"10.1007\/978-3-030-44766-3_22"},{"key":"4371_CR11","doi-asserted-by":"publisher","unstructured":"P\u00f6tschke J, Gauglitz G (2022) Laser Treatment of Scars. Energy for the Skin [Internet]. 275\u201387. Available from: https:\/\/doi.org\/10.1007\/978-3-030-90680-1_25","DOI":"10.1007\/978-3-030-90680-1_25"},{"key":"4371_CR12","doi-asserted-by":"publisher","unstructured":"Mony MP, Harmon KA, Hess R, Dorafshar AH, Shafikhani SH (2023) An Updated Review of Hypertrophic Scarring. Cells [Internet]. 12(5):678. Available from: https:\/\/doi.org\/10.3390\/cells12050678\/https:\/\/doi.org\/10.1097\/sap.0000000000002086","DOI":"10.3390\/cells12050678"},{"issue":"7","key":"4371_CR13","doi-asserted-by":"publisher","first-page":"914","DOI":"10.1002\/lsm.23366","volume":"53","author":"H Deng","year":"2020","unstructured":"Deng H, Tan T, Luo G, Tan J (2020) Cecilia. Vascularity and thickness changes in immature hypertrophic scars treated with a pulsed dye laser. Lasers Surg Med 53(7):914\u2013921","journal-title":"Lasers Surg Med"},{"key":"4371_CR14","doi-asserted-by":"publisher","unstructured":"Kloth C, Kratzer W, Schmidberger J, Beer M, Clevert DA, Graeter T (2020) Ultrasound 2020\u2013 Diagnostics & Therapy: On the Way to Multimodal Ultrasound: Contrast-Enhanced Ultrasound (CEUS), Microvascular Doppler Techniques, Fusion Imaging, Sonoelastography, Interventional Sonography [Internet]. Vol. 193, R\u00f6Fo - Fortschritte auf dem Gebiet der R\u00f6ntgenstrahlen und der bildgebenden Verfahren. Georg Thieme Verlag KG; pp. 23\u201332. Available from: https:\/\/doi.org\/10.1055\/a-1217-7400","DOI":"10.1055\/a-1217-7400"},{"key":"4371_CR15","doi-asserted-by":"publisher","unstructured":"Leitgeb RA, Baumann B (2018) Multimodal Optical Medical Imaging Concepts Based on Optical Coherence Tomography [Internet]. Vol. 6, Frontiers in Physics. Frontiers Media SA; Available from: https:\/\/doi.org\/10.3389\/fphy.2018.00114","DOI":"10.3389\/fphy.2018.00114"},{"key":"4371_CR16","doi-asserted-by":"publisher","unstructured":"Maehara A, Sanz-S\u00e1nchez J, Garcia-Garcia HM (2024) IVUS has more robust data than OCT for PCI guidance: PROS and CONS [Internet]. Vol. 20, EuroIntervention. Europa Digital & Publishing; pp. e1132\u20135. Available from: https:\/\/doi.org\/10.4244\/EIJ-E-24-00028","DOI":"10.4244\/EIJ-E-24-00028"},{"key":"4371_CR17","doi-asserted-by":"publisher","unstructured":"Steelman ZA, Ho DS, Chu KK, Wax A (2019) Light-scattering methods for tissue diagnosis [Internet]. Vol. 6, Optica. Optica Publishing Group; p. 479. Available from: https:\/\/doi.org\/10.1364\/optica.6.000479","DOI":"10.1364\/optica.6.000479"},{"key":"4371_CR18","doi-asserted-by":"publisher","unstructured":"Soto JM, Rodrigo JA, Alieva T (2021) Partially Coherent Optical Diffraction Tomography Toward Practical Cell Study [Internet]. Vol. 9, Frontiers in Physics. Frontiers Media SA; Available from: https:\/\/doi.org\/10.3389\/fphy.2021.666256","DOI":"10.3389\/fphy.2021.666256"},{"issue":"1","key":"4371_CR19","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1002\/der2.64","volume":"2","author":"C Gianatasio","year":"2021","unstructured":"Gianatasio C, Abrouk M, Waibel JS (2021) Treatment approaches for treating hypertrophic scars and keloids. Dermatological Reviews 2(1):11\u201322","journal-title":"Dermatological Reviews"},{"key":"4371_CR20","doi-asserted-by":"crossref","unstructured":"El-Orabi RA, El-Hadidy MR, El-Sabbagh AH Assessment and management of immature facial scars by non-surgical methods. Chinese Journal of Plastic and Reconstructive Surgery [Internet]. 2022 Jun 1 [cited 2022 Oct 17];4(2):67\u201373. Available from: https:\/\/www.sciencedirect.com\/science\/article\/pii\/S2096691122000310","DOI":"10.1016\/j.cjprs.2022.06.004"},{"key":"4371_CR21","doi-asserted-by":"crossref","unstructured":"Frech FS, Hernandez L, Urbonas R, Zaken GA, Dreyfuss I, Nouri K (2023) Hypertrophic scars and keloids: advances in treatment and review of established therapies. Am J Clin Dermatol","DOI":"10.1007\/s40257-022-00744-6"},{"key":"4371_CR22","doi-asserted-by":"publisher","unstructured":"Pan Z, Tang Y, Hua H, Hou Z, Zhou B (2023) Multiple Mode Procedures of Ultra-Pulse Fractional CO2 Laser: A Novel Treatment Modality of Facial Atrophic Acne Scars. Journal of Clinical Medicine [Internet]. 12(13):4388. Available from: https:\/\/doi.org\/10.3390\/jcm12134388","DOI":"10.3390\/jcm12134388"},{"key":"4371_CR23","doi-asserted-by":"publisher","unstructured":"Won T, Ma Q, Chen Z, Gao Z, Wu X, Zhang R (2021) The efficacy and safety of low-energy carbon dioxide fractional laser use in the treatment of early\u2010stage pediatric hypertrophic scars: A prospective, randomized, split\u2010scar study. Lasers in Surgery and Medicine [Internet]. 54(2):230\u20136. Available from: https:\/\/doi.org\/10.1002\/lsm.23459","DOI":"10.1002\/lsm.23459"},{"key":"4371_CR24","doi-asserted-by":"publisher","unstructured":"Yasseen Y, Mohamed E, Aboul Fotouh S, Sayed Mahmoud A (2022) A Comparative Study between Autologous Nanofat Graft and Fractional CO2 Laser in the Management of Post Burn Scars. The Egyptian Journal of Plastic and Reconstructive Surgery [Internet]. 46(3):211\u201321. Available from: https:\/\/doi.org\/10.21608\/ejprs.2022.254697","DOI":"10.21608\/ejprs.2022.254697"},{"key":"4371_CR25","doi-asserted-by":"publisher","unstructured":"Tan J, Zhou J, Huang L, Fu Q, Ao M, Yuan L et al (2020) Hypertrophic Scar Improvement by Early Intervention With Ablative Fractional Carbon Dioxide Laser Treatment. Lasers in Surgery and Medicine [Internet]. 53(4):450\u20137. Available from: https:\/\/doi.org\/10.1002\/lsm.23301","DOI":"10.1002\/lsm.23301"},{"key":"4371_CR26","doi-asserted-by":"publisher","unstructured":"12 Tawfic TSO, El-Tawdy A, Shalaby S, Foad A, Shaker O, Sayed SS et al (2020) Evaluation of Fractional CO2 Versus Long Pulsed Nd:YAG Lasers in Treatment of Hypertrophic Scars and Keloids: A Randomized Clinical Trial. Lasers in Surgery and Medicine [Internet]. 52(10):959\u201365. Available from: https:\/\/doi.org\/10.1002\/lsm.23249","DOI":"10.1002\/lsm.23249"}],"container-title":["Lasers in Medical Science"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10103-025-04371-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10103-025-04371-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10103-025-04371-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T07:21:55Z","timestamp":1771399315000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10103-025-04371-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,12]]},"references-count":26,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["4371"],"URL":"https:\/\/doi.org\/10.1007\/s10103-025-04371-5","relation":{},"ISSN":["1435-604X"],"issn-type":[{"value":"1435-604X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,12]]},"assertion":[{"value":"26 April 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 February 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 March 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"A written informed consent for procedure, photos and publication was taken from each patient more than 18 years and from legal guardians for age less than 18 years.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"There are no conflicts.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"137"}}