Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
Showing 3 appraisals
Lasers in medical science
Efficacy and safety of recombinant human epidermal growth factor combined with fractional carbon dioxide laser for facial atrophic acne scars: a systematic review and meta-analysis of randomized trials
BACKGROUND: The combination of recombinant human epidermal growth factor (rhEGF) and fractional carbon dioxide (CO2) laser therapy is increasingly used in the treatment of facial atrophic acne scars. OBJECTIVE: This study aimed to systematically assess the efficacy and safety of rhEGF combined with fractional CO2 laser therapy for managing facial atrophic acne scars. METHODS: PubMed, Embase, the Cochrane Library, Web of Science, CNKI (China National Knowledge Infrastructure), Wanfang, SinoMed, and VIP were searched from inception to July 29, 2025. Parallel-group or split-face randomized controlled trials (RCTs) comparing fractional CO2 laser therapy + rhEGF with fractional CO2 laser therapy for treating atrophic acne scars were considered for inclusion. Risk of bias was assessed using the Cochrane Collaboration's risk-of-bias tool. The meta-analysis based on fixed or random effects models was carried out for Echelle d'Evaluation Clinique des Cicatrices d'acne (ECCA) scores, Vancouver Scar Scale (VSS) scores, transepidermal water loss (TEWL), etc. It was registered on PROSPERO (ID: CRD42024599311). RESULTS: Twelve RCTs involving 1,044 patients were included, and all trials were conducted in China. Follow-up durations across studies ranged from 1 week to 12 months. Compared with fractional CO₂ laser therapy alone, the combination therapy significantly reduced ECCA scores by a mean of 11.14 points (95% CI: -16.82 to -5.45, P = 0.0001) and VSS scores by a mean of 1.54 points (95% CI: -2.55 to -0.54, P = 0.003). The combination therapy demonstrated advantages in improving the durations of crust formation. The incidence of adverse events, particularly hyperpigmentation (RR = 0.41, 95% CI: 0.20 to 0.86; P = 0.02), was significantly lower in the combination therapy group. According to the GRADE assessment, the certainty of evidence ranged from very low to moderate for most outcomes. CONCLUSION: This study suggests that rhEGF combined with fractional CO₂ laser therapy may be beneficial for treating atrophic acne scars. However, because of the low to moderate certainty of evidence according to GRADE assessment, more robust, large-scale RCTs are needed to confirm these findings and define optimal treatment parameters.
23 May 2026
Read appraisal →Lasers in medical science
Comparative clinical effects of extraoral photobiomodulation using laser and LED on pain, swelling, and quality of life following impacted mandibular third molar surgery: a randomized split-mouth trial
This study aimed to compare the clinical effectiveness of extraoral photobiomodulation using laser and light-emitting diode (LED) in reducing postoperative pain, swelling, and improving oral health-related quality of life following impacted mandibular third molar surgery. This randomized, split-mouth clinical trial included 72 patients with bilaterally symmetrical impacted mandibular third molars. Participants were allocated into three groups: low-level laser therapy (LLLT), LED, and LLLT-LED. Each patient received PBM treatment on one side and served as their own control. LLLT (810 nm GaAlAs diode laser) and LED (618 nm OsseoPulse) were applied extraorally on postoperative days 0, 2, and 7. Pain was assessed using a visual analog scale (VAS) at 4h and daily up to day 7. Swelling was measured via standardized facial distances at baseline, day 2, and day 7. Quality of life was evaluated using the OHIP-14 questionnaire preoperatively and on day 7. LED therapy significantly reduced pain at the 4th hour and on postoperative days 3 to 6 (p < 0.05). Regarding postoperative swelling, a significant difference was observed only in the LLLT-LED group, where the LED-treated side showed greater overall swelling reduction from preoperative to postoperative day 7 (p < 0.05). Quality-of-life scores improved in both groups, with more domains showing significant change in the LLLT group (10 vs. 7). LED was more effective for early postoperative pain control and showed greater late-phase swelling reduction in the side-to-side comparison. Quality-of-life scores improved in both groups, with a larger number of significantly improved domains in the LLLT group.
21 May 2026
Read appraisal →The Journal of dermatological treatment
Beyond efficacy: pulse duration is crucial for adverse events in pulsed dye laser therapy for rosacea
BACKGROUND: Pulsed dye laser (PDL) is widely used for erythematotelangiectatic rosacea (ETR); however, the influence of pulse duration remains unclear. OBJECTIVE: To compare the efficacy and tolerability of 6 and 10 ms PDL pulse durations for ETR. METHODS: In this single-center, prospective, randomized controlled study, 80 patients with ETR received single PDL treatment using either a 6 or 10 ms pulse duration (9-11 J/cm2, 7 mm spot size). Erythema was assessed by blinded dermatologists using the Clinical Erythema Assessment (CEA) and telangiectasia scores, and Rosacea Area and Severity Index (RASI). ImageJ analysis measured the Relative Intensity of Redness (RIR) and Percentage of Erythema Area (PEA). Adverse events were recorded on days 3 and 7, and patient global assessment (PGA) and symptom improvement were evaluated at week 4. RESULTS: Both groups showed significant improvements in CEA, RASI, RIR, and PEA (p < 0.001), with no significant between group differences. However, edema (p < 0.05) and purpura (p < 0.001) were more frequent with the 6 ms setting. No significant differences were observed between the groups on the PGA, erythema improvement scale, or symptom improvement scale. CONCLUSION: Both pulse durations effectively reduced erythema, but 10 ms demonstrated more favorable tolerability.
13 May 2026
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