LAUSR

Abstract Background Laser therapy is widely used in scar repair, and the use of 5-fluorouracil (5-FU) as an adjuvant treatment has also attracted attention. This study aimed to compare the therapeutic efficacy of 5-FU combined with ultra-pulsed fractional carbon dioxide laser (UFCL) treatment and UFCL treatment alone for hypertrophic scars after burns, and to analyse influencing factors to provide evidence for clinical practice. Methods A total of 150 patients with hypertrophic scars from burns were randomly divided into an observation group (OG) and a control group (CG). Assessments were based on the Vancouver scar scale (VSS), patient scar assessment scale (PSAS), and records of adverse reactions (AR). Results There were no statistically significant differences between the two groups in terms of burn causes, disease duration, hypertrophic scar formation time, and wound healing time (P > 0.05). After treatment, the OG showed greater improvements in VSS and PSAS scores compared to the CG. In terms of clinical efficacy, 11 cases in the OG achieved complete recovery, and 42 cases showed visible improvement, with a total effective rate of 93.33%, higher than that of the CG. The incidence of AR in the OG (6.67%) was lower as against the CG. Multivariate regression analysis indicated that advanced age, longer disease duration, and higher pre-treatment VSS scores were negatively correlated with treatment effectiveness (P < 0.05). Conclusion The combination of 5-FU and UFCL treatment is significantly more effective than laser treatment alone. Risk factors affecting clinical efficacy include advanced age, longer disease duration, and higher pre-treatment VSS scores.