Microwaves versus combined microwaves and fractional carbon dioxide laser in the treatment of postpartum abdominal laxity among Filipino patients in a tertiary hospital: a randomized, prospective, assessor-blinded, simultaneous split-abdomen trial
Description
This study compared microwaves alone versus combined microwaves and fractional carbon dioxide (CO2) laser in treating postpartum abdominal laxity in 32 Filipino patients. Patients underwent three microwaves sessions on both sides of the abdomen, with one randomized side receiving an additional laser session. Both treatments showed significant improvement in global aesthetic improvement scale scores and patient satisfaction scores (p < 0.001), but combined therapy showed superior results. Mild adverse effects were limited to laser treatment. The combined approach is thus safe and effective, offering a promising solution for postpartum abdominal laxity.
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Clinical photographs of the abdomen were taken with a 100-megapixel camera (realme 11 Pro 5G, realme) with fixed aperture, ISO, and shutter speed settings, against a blue background in a well-lit room under uniform body positions, camera angle, height, distance and lighting, with anterior, 45-degree and 90-degree lateral views taken at a uniform distance from the wall as guided by fixed floor markings. Using these photos, improvement of skin laxity was rated on each hemiabdomen using the Global Aesthetic Improvement Scale (GAIS) by three blinded board-certified fellows of the Philippine Dermatological Society. GAIS scores were obtained one month after every treatment session on each hemiabdomen. A score of 1 and above was considered a significant improvement from baseline. Subjects’ satisfaction was also graded on each hemiabdomen using the Patient Satisfaction (PS) score one month after every treatment session. A score of 2 and above was considered significant satisfaction with the improvement from the baseline. Waist circumference (WC) and waist-to-hip ratio (WHR), measured according to WHO expert committee guidelines12 , and body mass index (BMI), computed from height and weight, were determined at the initial and completion consult. After obtaining informed consent, one patient volunteered to undergo 4-mm skin punch biopsies on both sides of the abdomen at baseline and completion follow-up. All biopsy specimens were fully submerged in 10% buffered formalin and processed into paraffin blocks before being cut into tissue sections. All sections were stained with Hematoxylin and Eosin, Masson Trichrome for examination of the epidermis and dermal collagen, and Verhoeff-Van Gieson for staining elastic fibers. Data on adverse effects, e.g., the sign or symptom, severity (rated from 1-10), onset, duration, and management done, were also obtained immediately and one month after treatment sessions. Global Aesthetic Improvement Scale 0 - Unchanged or Worsened - The appearance substantially remains the same or worsened compared with the original condition 1 - Improved - Improvement of the appearance, better compared with the initial condition, but a touch up is advised 2 - Much improved - Marked improvement of the appearance, but not completely optimal 3 - Very much improved - Excellent corrective result Patient Satisfaction Score 0 - Not Satisfied 1 - Slightly Satisfied 2 - Satisfied 3 - Very Satisfied 4 - Extremely Satisfied