Evidence map›Paper›PMID 39333369›Full record

SynthesisAesthetic plastic surgery2025

Combined Stromal Vascular Fraction and Fractional CO2 Laser Therapy for Hypertrophic Scar Treatment: A Systematic Review and Meta-Analysis.

Omar Alomari, Muhammed Edib Mokresh, Meryem Hamam, Asude Ukba Teker, Cagla Sumeyye Caliskan, Seljan Sadigova, Sinem Nur Ertan, Magda Wojtara, Gaye Filinte

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Aesthetic plastic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Efficacy and safety of fractional COFrontiers in medicine · 2025
    Pooled it
  2. An Overview of the Mechanisms of Fractional COLasers in medical science · 2026
    Review
  3. Long-term efficacy and safety of carbon dioxide (COAmerican journal of translational research · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Omar Alomari *Hamidiye International Faculty of Medicines, Hamidiye International School of Medicine, University of Health Sciences, 3400, 34668, Istanbul, Turkey. dromari2001@gmail.com.ORCID 0000-0003-3651-4129
Muhammed Edib Mokresh *Hamidiye International Faculty of Medicines, Hamidiye International School of Medicine, University of Health Sciences, 3400, 34668, Istanbul, Turkey.
Meryem HamamHamidiye International Faculty of Medicines, Hamidiye International School of Medicine, University of Health Sciences, 3400, 34668, Istanbul, Turkey.
Asude Ukba TekerHamidiye International Faculty of Medicines, Hamidiye International School of Medicine, University of Health Sciences, 3400, 34668, Istanbul, Turkey.
Cagla Sumeyye CaliskanHamidiye International Faculty of Medicines, Hamidiye International School of Medicine, University of Health Sciences, 3400, 34668, Istanbul, Turkey.
Seljan SadigovaHamidiye International Faculty of Medicines, Hamidiye International School of Medicine, University of Health Sciences, 3400, 34668, Istanbul, Turkey.
Sinem Nur ErtanHamidiye International Faculty of Medicines, Hamidiye International School of Medicine, University of Health Sciences, 3400, 34668, Istanbul, Turkey.
Magda WojtaraDepartment of Human Genetics, University of Michigan Medical School, Ann Arbor, USA.
Gaye FilinteDepartment of Plastic, Reconstructive and Aesthetic Surgery, Dr. Lutfi Kirdar Kartal Training and Research Hospital, Istanbul, Turkey.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHypertrophic scars (HTSs) result from aberrant wound healing processes, leading to raised, thickened tissue with functional discomfort and cosmetic concerns. Current treatments, including corticosteroid injections and laser therapy, have limitations. Stromal vascular fraction (SVF) therapy and CO2 laser treatment offer promising avenues, with SVF therapy showing regenerative potential and CO2 laser therapy promoting precise tissue removal and wound healing. This study aims to investigate the combined application of SVF therapy and CO2 laser treatment for HTS, aiming to enhance treatment efficacy, tissue remodeling, and aesthetic outcomes, ultimately improving patient satisfaction in HTS management.

methodPubMed, Scopus, Embase, and Web of Science databases have been searched for relevant studies. The "R" software (version 4.3.1) along with the "tidyverse" and "meta" statistical packages utilized to analyze data related to the efficiency of this combined method. A random-effects model was fitted to the data. For each study, continuous outcomes were pooled by calculating the standardized mean difference, along with their 95% confidence intervals. The assessment of heterogeneity utilized the I

resultsSix articles fulfilled our inclusion criteria and were included in our review. Results from the pooled analysis of Vancouver Scar Scale (VSS) scores across three included studies indicated a significant impact of the SVF+CO2 method on VSS scores post-treatment (SMD=-3.0144; 95% CI:-4.3706 to -1.6583, p<0.0001). However, analysis of transepidermal water loss levels before and after treatment showed no significant difference (SMD=-2.7603; 95% CI: -6.8729 to 1.3522; p=0.1883). Comparatively, in a pooled analysis of two studies, the combined SVF+CO2 method demonstrated superior efficacy in VSS scores compared to other methods (SMD= -1.3573; 95% CI: -2.2475 to -0.4672, p = 0.0028), with moderate heterogeneity across studies (I^2=23.0%, p = 0.2545).

conclusionThe combined application of SVF and CO2 laser treatment shows significant promise in improving hypertrophic scars' appearance and texture. The SVF+CO2 method demonstrates superior efficacy compared to other modalities, suggesting its potential as a valuable therapeutic approach for hypertrophic scar management. LEVEL OF EVIDENCE III: 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 www.springer.com/00266 .

Indexed as

Cicatrix, HypertrophicLasers, GasCombined Modality TherapyFemaleHumansMaleTreatment OutcomeWound HealingCO2 laser treatmentHypertrophic scarsScar remodelingSVF therapyTreatment efficacy

Identifiers

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.