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Background <p>The efficacy of segmental carbon dioxide laser (FCO<sub>2</sub>L) combined with pulsed dye laser (PDL) treatment versus single laser treatment for hypertrophic scars has not been fully evaluated. This study conducted a network meta-analysis to compare the efficacy of the combined treatment with that of the single laser treatment.</p> Methods <p>PubMed, Embase, Cochrane Library, and Web of Science databases were systematically searched up to 28 April 2025. Two independent reviewers conducted study selection, data extraction, and risk-of-bias assessment. The quality of the included studies was evaluated using the Risk of Bias (RoB) 2.0 tool. A Bayesian network meta-analysis model was employed to calculate the standardized mean difference (SMD) and corresponding 95% confidence intervals (CIs) for VSS scores. Treatment rankings were determined using the surface under the cumulative ranking curve (SUCRA).</p> Results <p>A total of 14 randomized controlled trials were included, involving 326 patients. The network meta-analysis showed that the therapeutic effect of FCO<sub>2</sub>L combined with PDL was significantly better than that of the single therapy. Specifically: Compared with single PDL: SMD =  − 1.29 (95% CI:  − 1.94,  − 0.65). The SUCRA probability ranking showed that the combined ranking of FCO<sub>2</sub>L combined with PDL was the highest (probability &gt; 80%), followed by single FCO<sub>2</sub>L (70%-75%).</p> Conclusion <p>The combined use of FCO<sub>2</sub>L and PDL has significant advantages in improving hypertrophic scars. Although using FCO<sub>2</sub>L alone is effective, its therapeutic effect is not as good as the combined strategy.</p> Level of Evidence I <p>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors<a href="http://www.springer.com/00266">www.springer.com/00266</a>.</p>

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Comparative Efficacy of Combined Carbon Dioxide Fractional Laser and Pulse Dye Laser versus Monotherapy for Hypertrophic Scars: A Network Meta-Analysis of Randomized Controlled Trials

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月15日

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  • Derong He,
  • Jingjing Zhang,
  • Baiye Chen,
  • Chaofan Lin,
  • Weiwen Zhu,
  • Qingcheng Liu,
  • Xunyu Xu

摘要

Background

The efficacy of segmental carbon dioxide laser (FCO2L) combined with pulsed dye laser (PDL) treatment versus single laser treatment for hypertrophic scars has not been fully evaluated. This study conducted a network meta-analysis to compare the efficacy of the combined treatment with that of the single laser treatment.

Methods

PubMed, Embase, Cochrane Library, and Web of Science databases were systematically searched up to 28 April 2025. Two independent reviewers conducted study selection, data extraction, and risk-of-bias assessment. The quality of the included studies was evaluated using the Risk of Bias (RoB) 2.0 tool. A Bayesian network meta-analysis model was employed to calculate the standardized mean difference (SMD) and corresponding 95% confidence intervals (CIs) for VSS scores. Treatment rankings were determined using the surface under the cumulative ranking curve (SUCRA).

Results

A total of 14 randomized controlled trials were included, involving 326 patients. The network meta-analysis showed that the therapeutic effect of FCO2L combined with PDL was significantly better than that of the single therapy. Specifically: Compared with single PDL: SMD =  − 1.29 (95% CI:  − 1.94,  − 0.65). The SUCRA probability ranking showed that the combined ranking of FCO2L combined with PDL was the highest (probability > 80%), followed by single FCO2L (70%-75%).

Conclusion

The combined use of FCO2L and PDL has significant advantages in improving hypertrophic scars. Although using FCO2L alone is effective, its therapeutic effect is not as good as the combined strategy.

Level of Evidence I

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authorswww.springer.com/00266.