Long-term Efficacy of Q-switched 1064 nm Nd-YAG Laser for Treatment of Split-thickness Skin Graft: A Randomized Controlled Trial

Objective: The aim of this study was to investigate the efficacy of the Q-switched 1064 nm Nd:YAG laser for reducing hyperpigmentation and erythema and increasing pliability in skin grafts.Material and Methods: This was a prospective randomized controlled trial. Half of each skin graft was treated with a Q-switched 1064 nm Nd:YAG laser 4 times, and the other half was left untreated and collectively used as the controls. The treatment results were evaluated by clinical photographs, and assessment of the melanin index (MI), erythema index (EI), and elasticity parameters at baseline and at 2 weeks after each session and 1 month after the final treatment.Results: Ten skin graft sites from 10 patients were included. Most patients had lesions at a lower extremity. After 4 sessions of treatment, average melanin index at the treated sites was non-significantly decreased compared to both baseline (p-value=0.232) and the untreated sites (p-value=0.770). The elasticity of the treated sites increased significantly when compared to baseline (p-value=0.039), but non-significantly when compared to the untreated sites (p-value=0.846). The EI at the treated sites non-significantly decreased compared to both baseline (p-value=0.432) and the untreated sites (p-value=0.164). Conclusion: This study found the Q-switched 1064 nm Nd:YAG laser treatment to be a potentially promising modality for increasing the pliability of skin grafts, but reductions in hyperpigmentation and erythema were only clinically significant.