{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T08:54:57Z","timestamp":1790931297424,"version":"4.1.0"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:00:00Z","timestamp":1790899200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:00:00Z","timestamp":1790899200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Lasers Med Sci"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Burns result in hypertrophic scarring, causing functional impairment, cosmetic and psychological concerns. Fractional CO\u2082 laser and botulinum, have shown promise in treatment. To evaluate the effectiveness of fractional laser treatment alone and combined with botulinum toxin A, delivered either through injections or topical application as fractional laser-assisted drug delivery in hypertrophic burn scar. A randomized comparative trial involving 16 patients with post-burn hypertrophic scars. The scar of each patient was divided into 3 sections: (1) fractional CO\u2082 laser combined with intralesional botulinum toxin type A, (2) fractional CO\u2082 laser monotherapy, and (3) fractional CO\u2082 laser with laser-assisted drug delivery of BTXA. Patients received three treatment sessions at monthly intervals, followed by a three-month follow up. Clinical outcomes were evaluated using the Vancouver Scar Scale. Intralesional BTXA demonstrated superior efficacy, achieving the greatest reductions in VSS (\u2212\u200958.25%). Intralesional BTXA in combination with fractional CO\u2082 laser represents a highly effective treatment for post-burn hypertrophic scars, offering superior improvements in scar pliability, contour, and patient comfort compared with laser monotherapy or LADD. These findings support intralesional BTXA as the preferred therapeutic approach, while highlighting the potential of combination protocols for optimizing scar outcomes.<\/jats:p>","DOI":"10.1007\/s10103-026-05026-9","type":"journal-article","created":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T08:25:45Z","timestamp":1790929545000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Treatment of hypertrophic scars using fractional CO2 laser alone in comparison with adding botulinium toxin either intalesional injection or assisted drug delivery"],"prefix":"10.1007","volume":"41","author":[{"given":"Aya","family":"Fahim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elham","family":"Saied","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marwa S.","family":"El-Mesidy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,2]]},"reference":[{"issue":"1","key":"5026_CR1","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1007\/s10103-023-03814-1","volume":"38","author":"E -Wasson","year":"2023","unstructured":"-Wasson E, Thandi C, Hitchens E, Thomas K et al (2023) An audit of the use of fractional CO2 laser for hypertrophic burn scars: a real-life perspective. Lasers Med Sci 38(1):144. https:\/\/doi.org\/10.1007\/s10103-023-03814-1","journal-title":"Lasers Med Sci"},{"key":"5026_CR2","doi-asserted-by":"publisher","first-page":"tkad009","DOI":"10.1093\/burnst\/tkad009","volume":"11","author":"M Sheng","year":"2023","unstructured":"Sheng M, Chen Y, Li H, Zhang Y et al (2023) The application of corticosteroids for pathological scar prevention and treatment: current review and update. Burns trauma 11:tkad009. https:\/\/doi.org\/10.1093\/burnst\/tkad009","journal-title":"Burns trauma"},{"issue":"1","key":"5026_CR3","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1093\/jbcr\/iraf167","volume":"47","author":"M -Shilova","year":"2026","unstructured":"-Shilova M, Plummer K, Ware R, Kimble R et al (2026) Laser-Assisted Drug Delivery for Hypertrophic Scar Treatment: A Scoping Review. J burn care research: official publication Am Burn Association 47(1):130\u2013146. https:\/\/doi.org\/10.1093\/jbcr\/iraf167","journal-title":"J burn care research: official publication Am Burn Association"},{"issue":"10","key":"5026_CR4","doi-asserted-by":"publisher","first-page":"e71161","DOI":"10.7759\/cureus.71161","volume":"16","author":"EE Raslan","year":"2024","unstructured":"Raslan EE, Bakhamees BH, Howsawi TA, Alshmrani LS et al (2024) The Efficacy of Botulinum Toxin Type A (BTA) in the Treatment of Hypertrophic Scars and Keloids: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Cureus 16(10):e71161. https:\/\/doi.org\/10.7759\/cureus.71161","journal-title":"Cureus"},{"issue":"1","key":"5026_CR5","doi-asserted-by":"publisher","first-page":"27233","DOI":"10.1038\/s41598-024-78094-y","volume":"14","author":"J -Wang","year":"2024","unstructured":"-Wang J, Huang L, Li J, Xu R et al (2024) Efficacy and safety of sequential treatment with botulinum toxin type A, fractional CO2 laser, and topical growth factor for hypertrophic scar management: a retrospective analysis. Sci Rep 14(1):27233. https:\/\/doi.org\/10.1038\/s41598-024-78094-y","journal-title":"Sci Rep"},{"issue":"10","key":"5026_CR6","doi-asserted-by":"publisher","first-page":"959","DOI":"10.1002\/lsm.23249","volume":"52","author":"SO -Tawfic","year":"2020","unstructured":"-Tawfic SO, El-Tawdy AM, Shalaby S, El-Khalawany MA et al (2020) Evaluation of fractional CO_2versus long-pulsed Nd:YAG lasers in hypertrophic scars and keloids: A randomized clinical trial. Lasers Surg Med 52(10):959\u2013965","journal-title":"Lasers Surg Med"},{"issue":"6","key":"5026_CR7","doi-asserted-by":"publisher","first-page":"e13980","DOI":"10.1111\/dth.13980","volume":"33","author":"HH -Sabry","year":"2020","unstructured":"-Sabry HH, Abdel-Motaleb AA, Shalaby SM (2020) Assessment of laser-assisted delivery versus intralesional injection of botulinum toxin A in treatment of hypertrophic scars and keloids. Dermatol Ther 33(6):e13980","journal-title":"Dermatol Ther"},{"issue":"1","key":"5026_CR8","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1111\/jocd.12828","volume":"18","author":"LM -Kasyanju Carrero","year":"2019","unstructured":"-Kasyanju Carrero LM, Ma WW, Liu HF, Yin XF et al (2019) Botulinum toxin type A for the treatment and prevention of hypertrophic scars and keloids: Updated review. J Cosmet Dermatol 18(1):10\u201315","journal-title":"J Cosmet Dermatol"},{"issue":"3","key":"5026_CR9","doi-asserted-by":"publisher","first-page":"862","DOI":"10.1007\/s00266-024-04351-0","volume":"49","author":"H -Shi","year":"2024","unstructured":"-Shi H, Zhang P, Zhang J, Sun J et al (2024) Dose-dependent effects of botulinum toxin type A on prevention of postoperative scars in various regions in the body: A prospective, double-blind randomized controlled trial. Aesthetic Plast Surg 49(3):862\u2013874","journal-title":"Aesthetic Plast Surg"},{"issue":"5","key":"5026_CR10","doi-asserted-by":"publisher","first-page":"NP273","DOI":"10.1093\/asj\/sjz165","volume":"40","author":"X -Guo","year":"2020","unstructured":"-Guo X, Song G, Zhang D, Jin X (2020) Efficacy of botulinum toxin type A in improving scar quality and wound healing: A systematic review and meta-analysis of randomized controlled trials. Aesthetic Surg J 40(5):NP273\u2013NP285","journal-title":"Aesthetic Surg J"},{"issue":"4","key":"5026_CR11","doi-asserted-by":"publisher","first-page":"1256","DOI":"10.1111\/jocd.15634","volume":"22","author":"AA -Tawfik","year":"2023","unstructured":"-Tawfik AA, Ali RA (2023) Evaluation of botulinum toxin type A for treating post burn hypertrophic scars and keloid in children: An intra-patient randomized controlled study. J Cosmet Dermatol 22(4):1256\u20131260","journal-title":"J Cosmet Dermatol"},{"issue":"3","key":"5026_CR12","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1002\/lsm.22120","volume":"45","author":"JS -Waibel","year":"2013","unstructured":"-Waibel JS, Wulkan AJ, Shumaker PR (2013) Treatment of hypertrophic scars using laser and laser assisted corticosteroid delivery. 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