Effects of Different Techniques ("Surgical Versus Laser") on Impairment of Lymphatic Drainage and Scar Formation in Humans
Abstract
Scars are abnormal changes in skin tissue caused by injuries, infections, and various factors. They commonly
result from fibroblasts in affected skin synthesizing collagen, leading to irregular growth and excessive collagen
accumulation within the extracellular matrix.
This study aims to investigate the effects of surgical and laser methods on scar formation mechanisms and
lymphatic drainage, as well as their outcomes. The objective is to assess skin scars created by laser and surgical
incisions and their impact on pathophysiology and lymphatic flow in humans.
A total of 20 patients with skin lesions were included in this study. The migration of methylene blue dye through
the lymphatic vessels of the lower limbs was evaluated, with the administered dose limited to under 2 mg/kg.
Transverse incisions were then performed distally using either a surgical blade or laser. The wounds were allowed to heal by secondary intention. The results indicated that laser-treated wounds did not heal completely, retaining a noticeable area of granulation tissue along with hair loss. In contrast, wounds created through surgical incisions healed entirely. Additionally, significantly lower dye migration levels were observed in the limbs after laser treatment compared to surgical incisions (p = 0.007). The findings suggest that scar size may be influenced by the type of incision used. However, further research is required to validate these results.
2. Van der Ploeg IM, Madu MF, van der Hage JA, et al. Blue dye can be safely omitted in most sentinel node procedures for melanoma. Melanoma Res. 2016;26:464-8. https://doi. org/10.1097/CMR.0000000000000271
3. Baleg SM, Bidin N, Suan LP, et al. The effect of CO2 laser treatment on skin tissue. J Cosmet Dermatol. 2015;14:246- 53. https://doi.org/10.1111/jocd.12142
4. Omi T, Numano K. The role of CO2 laser and fractional CO2 laser in dermatology. Laser Ther. 2014;23:49-60. https://doi.org/10.5978/islsm.14-RE-01
5. Walsh JT Jr, Flotte TJ, Anderson RR, Deutsch TF. Pulsed CO2 laser tissue ablation: effect of tissue type and pulse duration on thermal damage. Lasers Surg Med. 1988;8:108-18. https://doi.org/10.1002/lsm.1900080204
6. Haedersdal M. Cutaneous side effects from laser treatment of the skin: skin cancer, scars, wounds, pigmentary changes, and purpura: use of pulsed dye laser, copper vapor laser, and argon laser. Acta Derm Venereol Suppl (Stockh). 1999;207:1-32. https://doi.org/10.1080/0001555579207132
7. López-Prior V, Díaz-Expósito R, Casáns Tormo I. Influence of previous breast surgery in sentinel lymph node biopsy in patients with breast cancer. Rev Esp Med Nucl Imagen Mol. 2017;36:212-8. https://doi.org/10.1016/j.remnie.2017.05.003
8. Shen W, Xu W, Chen H. Immunological mechanisms of scarring and their psychological impact on patients. Am J Clin Exp Immunol. 2021;10(3):65-70.
9. Wang F, Li X, Wang X, Jiang X. Efficacy of topical silicone gel in scar management: A systematic review and meta-analysis of randomised controlled trials. Int Wound J. 2020;17(3):765-73. https://doi.org/10.1111/iwj.13337
10. Shi L, Yang S. Experiences of effective scar reduction and secondary hyperpigmentation after treatment of problematic skin. Southeast Asia Reg Med Aesthet Congr. 2005.
11. Chen Q, Zhao T, Xie X, Yu D, Wu L, Yu W, et al. MicroRNA-663 regulates the proliferation of fibroblasts in hypertrophic scars via transforming growth factor-beta1. Exp Ther Med. 2018;16:1311-7. https://doi.org/10.3892/etm.2018.6350
12. Qiu SS, Dotor J, Hontanilla B. Effect of P144(R) (anti- TGF-beta) in an “in vivo” human hypertrophic scar model in nude mice. PLoS One. 2015;10:e0144489. https://doi.org/10.1371/journal.pone.0144489
13. Chen Q, Zhao T, Xie X, Yu D, Wu L, Yu W, et al.MicroRNA-663 regulates the proliferation of fibroblasts in hypertrophic scars via transforming growth factor-beta1. Exp Ther Med. 2018;16:1311-7. https://doi.org/10.3892/etm.2018.6350
14. Bailey AJ, Bazin S, Sims TJ, Le Lous M, Nicoletis C, Delaunay A. Characterization of the collagen of human hypertrophic and normal scars. Biochim Biophys Acta. 1975;405:412-21. https://doi.org/10.1016/0005-2795(75)90106-3
Files | ||
Issue | Vol 8 No 1 (2025) | |
Section | Original Article(s) | |
Keywords | ||
Skin scar Pathophysiology Surgical incision Laser incision Skin cancer |
Rights and permissions | |
![]() |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |