Treatment of Mesh Skin Grafted Scars Using a Plasma Skin Regeneration System

Objectives. Several modalities have been advocated to treat traumatic scars, including surgical techniques and laser resurfacing. Recently, a plasma skin regeneration (PSR) system has been investigated. There are no reports on plasma treatment of mesh skin grafted scars. The objective of our study is to evaluate the effectiveness and complications of plasma treatment of mesh skin grafted scars in Asian patients. Materials and Methods. Four Asian patients with mesh skin grafted scars were enrolled in the study. The plasma treatments were performed at monthly intervals with PSR, using energy settings of 3 to 4？J. Improvement was determined by patient questionnaires and physician evaluation of digital photographs taken prior to treatment and at 3 months post treatment. The patients were also evaluated for any side effects from the treatment. Results. All patients showed more than 50% improvement. The average pain score on a 10-point scale was 6.9 +/？ 1.2？SD and all patients tolerated the treatments. Temporary, localized hypopigmentation was observed in two patients. Hyperpigmentation and worsening of scarring were not observed. Conclusions. Plasma treatment is clinically effective and is associated with minimal complications when used to treat mesh skin grafted scars in Asian patients. 1. Introduction Laser treatment of scars was first reported in 1980s using continuous wave carbon dioxide (CO2), argon and neodymium: yttrium–aluminum garnet(YAG) lasers. Results were operator dependent and scar recurrence or worsening of scarring was observed [1]. In the 1990s, high energy pulsed CO2 and erbium:YAG (Er:YAG) lasers had become available and did improve scars and caused fewer significant side effects [2]. However, the epidermis is significantly damaged with use of these lasers and this can result in potential adverse effects, including prolonged erythema and pigmentary disturbances, especially in Asians [3]. The plasma skin regeneration system (PSR; Portrait, Rhytec, Inc., Waltham, MA) is a novel device that utilizes radiofrequency to convert nitrogen gas into a high energy state of matter called plasma. PSR has been shown to remove benign skin lesions with similar efficacy and a lower complication rate when compared to the CO2 laser [4]. We first reported the effectiveness of plasma treatment in improving traumatic scarring in 2009 [5].We hypothesized that the PSR system would be effective in improving mesh skin grafted scars, with minimal downtime and few adverse effects. 2. Materials and Methods Four Asian patients with traumatic scars and Fitzpatrick skin