The purpose of the present work is to study a combined use of hypertrophic skin scars treatment by cryodestruction and СО2-laser.
The method was used in 17 patients aged from 17 to 35 years old with hypertrophic skin scars from 1 to 5 years old. The patients with the scars were divided into groups according to the scar size. All the patients had linear form of scar. First, high-powered (15- 25 Watts) polishing with СО2-laser of the most extruded scar portions in continuous beaming mode up to formation of thermal necrosis zone was performed. During the operation the power can be changed for some times. The marking is the tissue color local alteration, i.e. thermal necrosis in the center and the tissue blanching on the edge with ablative deformity. Then within the period from one to three days cryodestruction was carried out. The choice criterion was the termination of so-called "capillary whirl" circum the area of thermal necrosis. For cryodestruction exercise liquid nitrogen was applied. The manipulation is performed extremely quickly, in one movement, carefully taking the scar without touching the boundary zone which has a so-called "verge". Then germfree drapes with liberal amount of acerbine are overlapped.
At the cytological examination of touch smear it has been established that the healing process is accelerated on account of wound process course phologistic phase reduction. Cytologically: inflammatory-regenerative and regenerative cytogram type. It was manifested in quantity reduction of safe neutrophils up to 40-70 %, increase of tissular primitive polyphibroblasts, phibroblasts, lymphocytes up to 20-35 %, increase of macrophages number up to 5-10 %.
Bacteriological data testified to the decrease of the flora amount and the decrease of COI number by a factor of 2-3 in the wounds healed with acerbine.
In 9 persons the change of hypertrophic scars to atrophic ones was without dysfunction. These scars are easily disguised with usual dry powder. In two persons the result was poor positive, i.e. the scar is visually accessible but not skin surface overhanging, without tension function. One cryodestruction scar area elcosis case was marked. Because of allergic anamnesis the treatment with acerbine was carried out. Secondary adhesion with stellation scar formation was performed.
The given method can be recommended for linear skin scars elimination, it seems to be advisable to recommend acerbine using while cryo- and laser-burns owing to excellent cosmetic results, one of explanations of which the pH (acidity) coinciding with the pH of skin is; the method is possible to apply at keloid cicatrices.
The article is admitted to the International Scientific Conference " Innovation technologies in medicine"; Spain (Costa Brava) of the July 8-15, 2007г.; came to the editorial office on 06.06.07