LAUSR

BACKGROUND Laser and intense pulsed light (IPL) therapies have shown promising effect on pathological scars, but the comparative effectiveness of laser and IPL therapies has not yet been studied. OBJECTIVES The aim of this study was to compare and rank the efficacy of laser and IPL therapies to determine the most effective treatment method for pathological scars. METHODS Relevant studies published up to February 2022 were identified by searching PubMed, Web of science, the Cochrane Library, CNKI, and Wanfang databases. We defined Vancouver Scar Scale (VSS) score as the primary outcome. Both frequentist and Bayesian approaches were used to perform a network meta-analysis (NMA). RESULTS We included 25 trials with a total of 1688 participants. The SUCRA rankings for VSS score based on the Bayesian approach suggested IPL + CO₂ (96.43%) > PDL + 1064 nm Nd:YAG (86.21%) > PDL + CO₂ (82.15%) > CO₂ (58.97%) > 1064 nm Nd:YAG (57.03%) > PDL (52%) > 532nm Nd:YAG (33.28%) > Er:YAG + IPL (28.38%) > Er:YAG (26.56%) > IPL (15.03%) > Control (13.97%). The ranking results based on the frequentist approach were basically consistent with those based on frequentist approach. CONCLUSIONS The results of the NMA showed that the combination of IPL and CO₂ laser has the highest probability of being the most effective intervention. However, our conclusions must be interpreted with caution due to the relatively few evaluation indicators included in our study. Future well-designed randomized controlled trials with large sample sizes are required to confirm our conclusions.