INFLUENCE OF DIFFERENT TECHNIQUES (“SURGICAL Vs. LASER”) ON PATHOPHYSIOLOGY OF SCAR FORMATION AND LYMPHATIC DRAINAGE IN HUMANS

Abstract

Background: Scars are pathological changes in skin tissues due to trauma, infection, and other factors, and are
generally believed to be caused by enhanced collagen synthesis capacity of fibroblasts in injured skin, resulting in an
abnormal increase and excessive deposition of collagen in the extracellular matrix.
Aim To perform an evaluation of skin scars formed by laser and surgical incisions and their influence on
pathophysiology and lymphatic outflow in humans.
Methods: 20 patients of skin-lesion were included in this study. Using methylene blue, the migration of dye through
lymphatic channels of the lower extremity was measured. The dose of methylene blue was kept to less than 2 mg/kg.
Afterwards, transverse incisions were made distally using a surgical blade or laser. Wounds were left to heal by
secondary intention. The tissue samples were obtained after 4 weeks for the migration of dye, and their evaluation
was done microscopically.
Results The wounds after laser treatment had not healed and were left with a visible area of granulation tissue and
hair loss. Wounds after surgical incisions healed completely. Significantly poorer dye migration was detected in
extremities after laser therapy than after surgical incision (p = 0.007).
Conclusions The outcome of this study shows that the size of the scar can depend on the incision technique used.
Bigger scars after laser treatment limit the lymphatic flow of the skin, affect the pathophysiology which may have
an adverse effect on lymphatics and mapping sentinel lymph nodes. However, this hypothesis requires further
research.