Open Access

REVIEW

The Effects of Laser Therapy in Treating Hypertrophic Scars and Keloids after Median Sternotomy: A Scoping Review

Laura Schianchi^1,*, Fabrizio Vaira², Massimo Chessa^1,3, Serena Francesca Flocco⁴, Arianna Magon⁴, Gianluca Conte⁴, Karina Geraldina Zuniga Olaya⁵, Giacomo Bortolussi⁶, Erika Cioffi¹, Matteo Riccardo Di Nicola², Santo Raffaele Mercuri², Rosario Caruso^4,7
1 Adult Congenital Heart Disease Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, 20097, Italy
2 Dermatology and Cosmetology Unit, IRCCS Ospedale San Raffaele, Milan, 20132, Italy
3 Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, 20132, Italy
4 Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, 20097, Italy
5 Department of Congenital Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Milan, 20097, Italy
6 Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Milan, 20097, Italy
7 Department of Biomedical Sciences for Health, University of Milan, Milan, 20133, Italy
* Corresponding Author: Laura Schianchi. Email:

Congenital Heart Disease https://doi.org/10.32604/chd.2024.053999

Received 15 May 2024; Accepted 29 August 2024; Published online 11 September 2024

Abstract

Background: Hypertrophic scars and keloids, common complications following median sternotomy for cardiac surgery, significantly impact patient quality of life due to their aesthetic and symptomatic burden. Recent advancements in laser therapy have made it a prominent option for managing these complex scars, yet a comprehensive understanding of its efficacy is lacking. The aim of this scoping review is to explore the effects of laser therapy in managing hypertrophic scars and keloids after median sternotomy. Methods: This scoping review analyzed studies up to February 2024 from databases including PubMed, EMBASE, CINAHL, Scopus, Web of Science, and the Cochrane Library. We included any study that assessed laser therapy’s effects on hypertrophic scars and keloids following median sternotomy. Studies were selected based on predefined inclusion criteria without publication year, design, or origin restrictions. Results: Six studies met the inclusion criteria, involving a total of five RCTs and one review. These studies primarily tested 585 and 595-nm pulsed dye laser (PDL) treatments, focusing on scar appearance, patient symptoms, and treatment satisfaction. Most studies reported significant improvements in scar height reduction and patient symptom relief after treatment, with mixed results for scar erythema and elasticity. Adverse events were generally mild and transient. Conclusions: Laser therapy offers a beneficial approach for improving the appearance and symptoms of hypertrophic scars and keloids post-median sternotomy. However, further research is necessary to optimize treatment parameters and explore the long-term psychosocial impacts of this therapy. This review highlights the need for more comprehensive studies to establish standardized treatment protocols and evaluate their effectiveness.

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Keywords

Laser therapy; hypertrophic scars; keloids; median sternotomy; cardiac surgery; pulsed dye laser; scar management

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