***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: BACKGROUND AND OBJECTIVES Caesarean section ( c-section ) scars can be pose functional and cosmetic challenges and ablative fractional laser ( AFXL ) treatment may offer benefit to patients . We evaluated textural and color changes over time in AFXL-treated versus untreated control scars . MATERIAL S AND METHODS A r and omized , controlled , intra-individual split-scar trial with three sessions of AFXL-treatments for mature c-section scars . Setting s of AFXL were adjusted to each individual scar . End-points were blinded on-site clinical evaluations at 1 , 3 , and 6 months follow-up ( Patient and Observer Scar Assessment Scale [ POSAS ] and Vancouver Scar Scale [ VSS ] ) , blinded photo-evaluations , reflectance measurements , tissue histology , and patients satisfaction . RESULTS Eleven of 12 patients completed the study . At 1 month follow-up , AFXL-treated scars were significantly improved in pliability ( POSAS P = 0.01 VSS P = 0.02 ) and smoother in surface relief ( POSAS P = 0.03 ) compared to control scars . At 1 - 3 months , overall scar appearance was dominated by transient erythema and hyperpigmentation , confirmed by reflectance measurements ( erythema% and pigmentation% peaked at 1 and 3 month follow-up , respectively ) . At 6 months follow-up , AFXL-treated scars improved on POSAS-total score though not significantly ( P = 0.06 ) . Correspondingly , blinded photo-evaluation found AFXL-treated scars significantly improved compared to controls ( VAS P = 0.02 ) . Histology indicated new dermal collagen and elastic fibers on AFXL-treated scars . At 6 months follow-up , a majority of patients ( 64 % ) favored subsequent AFXL-treatment of their untreated control scar tissue . CONCLUSIONS Scar remodeling is initiated 1 month after AFXL treatment , but overall scar improvement is concealed until laser-induced color changes resolve . At 6 months follow-up , the benefit of AFXL treatment on c-section scars emerges . Lasers Surg . Med . 49:189 - 197 , 2017 . © 2016 Wiley Periodicals , The aim of this study was to compare the effects of the pulsed-dye laser ( PDL ) at a wavelength of 585 nm with those at 595 nm in the treatment of post-surgical scars , starting on the day of suture removal . The study was a prospect i ve , non-r and omized , double-blind , controlled , clinical trial , set in an outpatient clinic . Fifteen out patients with 21 post-operative scars at least 3 cm long were recruited , and 14 patients with 19 scars completed the study . Scars were divided into three equal portions . Each outer portion was r and omly allocated to PDL at 585 nm or at 595 nm ( 3.5 J/cm2 , 450 μs , 10 mm spot size ) , and the center was an untreated control ; treatment was composed of three laser sessions at 4-week intervals . A blinded examiner evaluated the three scar sections using the Vancouver scar scale for pigmentation , vascularity , pliability , and height . Cosmetic appearance was evaluated with a visual analog scale . Punch biopsies of three r and omly selected scars were evaluated . Pigmentation : more scars after laser treatments were of normal color than in the control , but the difference was not statistically significant . Vascularity : after treatment , more scars had normal vascularity in all three groups than at baseline ( P < 0.05 ) ; the largest increase was with a wavelength of 585 nm ( 10.5–94.7 % ) , then 595 nm ( 15.8–78.9 % ) , then control ( 5.2–36.6 % ) . Pliability : there was more normal pliability in all three groups than at baseline ( P < 0.05 ) , with greater improvements in the laser-treated groups . Height : significantly more flat scars after 585 nm PDL ( 63.2 % ) than at baseline ( 21.1 % ) ( P < 0.05 ) . We observed a slight but non-significant decrease in the scar heights with 595 nm PDL in comparison with the control . Histology : after laser irradiation , the treated sections were more similar to a non-scarring process than the control . Cosmetic outcome : visual analog scales increased in all groups ( P < 0.05 ) , but the greatest increases were observed in the 585 nm and 595 nm laser-treated groups ( 50 % and 60 % , respectively ) compared with controls ( 30 % ) . There were significantly higher scores with the lasers than for the control ( P < 0.001 ) at each visit after baseline . Both the 585 nm and 595 nm PDL treatments were effective in improving the appearance and normalizing the vascularity and pliability of post-operative scars . Both wavelengths improved the scars ’ visual appearance more than controls . We found that 585 nm appears to be the preferred wavelength , as it substantially normalized the height in addition to the vascularity and pliability in a significant number of scars More than 70 million surgical procedures are performed annually in the USA with the majority involving a skin lesion and almost all individuals in their lifetime will have one or more surgical procedures result ing in scars . Patients and physicians alike are thereby motivated to improve the cosmetic outcome of scars . Prior studies have shown that the pulsed dye laser ( PDL ) is effective in improving the quality and appearance of the scar when using the 585-nm PDL immediately after the removal of sutures . Most published studies used a pulse duration of 450 µs , which along with the other study parameters , has led to an overall improvement of the scars . However , a pulse duration of 1.5 ms is also available when using the pulsed dye laser and it should theoretically cause fewer side-effects . To our knowledge , there are no other studies comparing the effectiveness of different pulse duration s in the treatment of surgical scars starting on the day of suture removal . The purpose of this study is to compare the effect of different pulse duration s ( 450 µs vs. 1.5 ms ) in the treatments of postsurgical linear scars immediately after suture removal when using the 585-nm pulsed dye laser ( PDL ) .  Twenty non-hospitalized male and female patients ( older than 18 years of age ) with skin types I – IV and with postoperative linear scars measuring at least 2.1 cm were enrolled in this prospect i ve study . Scars were r and omly divided into three equal sections . The different fields were r and omly chosen to receive treatment ( two out of three fields ) or remain as control ( one field ) . The two fields chosen to be treated received treatment with the 585-nm PDL using a 7-mm spot size at 4.0 J. One of the treated sections was r and omly selected to receive a pulse duration of 450 µs , and the other section to receive a 1.5-ms pulse . The remaining scar section was design ated as control ( no treatment ) . The three sections were mapped and recorded . The patient received treatment immediately after the sutures were removed from the wound and then monthly for 3 months . Evaluations were performed before each treatment and 1 month after the last treatment . The short-pulse and long-pulse 585-nm PDL-treated sections demonstrated a statistically significant overall average improvement of the VSS of 92 and 89 % , respectively , compared to 67 % for the control site ( Fig. 1 ) . Further , for individual parameters of the Vancouver scar scale ( VSS ) , there were significant ( p < 0.05 ) differences between control and treatment groups for all parameters , but there were no differences between the short- and long-pulse treatment groups for any parameter . Both short-pulse and long-pulse PDL are safe and effective in improving the quality and cosmetic appearance of surgical scars in skin type ’s I – IV starting on the day of suture removal with no significant difference between the two pulse duration BACKGROUND AND OBJECTIVES Laser treatment in the early phases of wound healing may reduce scar formation . However , little is known on when in the early wound healing phases laser exposure most optimally should be provided and at which fluence levels . This study investigates the clinical effect of non-ablative-fractional-laser ( NAFL ) performed at three early time points at a range of fluence levels versus untreated control scars . MATERIAL S AND METHODS A r and omized , controlled , intra-individual trial with erbium-glass 1,540 nm NAFL versus no laser treatment on sixteen subjects receiving 10 st and ardized full-thickness punch-biopsy wounds . A single NAFL-exposure was applied to test-wounds 1 day before , immediately after , or 2 weeks after wounding . Three fluence levels provided deep and superficial energy depositions ( range 30 - 70 mJ/microbeam ) . Primary outcome comprised the total-score of the observer part of Patient-Observer-Scar- Assessment -Scale ( POSAS ) , performed by blinded on-site assessment at 3 months follow-up . Secondary outcomes were clinical evaluation on visual-analogue-scale ( VAS ) , reflectance measurements , and histology .  RESULTS NAFL-treatment applied 1 day before , immediately after or 2 weeks after wounding had the potential to offer subtle but detectable improvement in clinical scar appearance compared to untreated controls . Thus , NAFL-exposure 1 day before wounding ( POSAS-total : median of 15 vs. control-median of 16 , P = 0.03 , VAS : median 4.1 vs. control-median 5.5 , P = 0.03 , medium-fluence ) , as well as immediately- , and 2 weeks after wounding ( POSAS-total : P ≤ 0.05 , low-fluence ) induced improvement compared to untreated controls . No significant differences in dyschromia were detected between NAFL-treated and control scars . Histology showed subtle changes towards more mature interwoven bundles of collagen in NAFL-treated scars as compared to controls . CONCLUSIONS This study indicates that a single NAFL-treatment at low to medium fluence performed 1 day prior , or in the early phases of wound healing , may have the potential to optimize scar formation in full thickness wounds . Lasers Surg . Med . 50:28 - 36 , 2018 . © 2017 Wiley Periodicals , Background The use of lasers has been proposed for scar revision . A recent pilot clinical study demonstrated that lasers could also be used immediately after surgery to reduce the appearance of scars . The LASH ( Laser-Assisted Skin Healing ) technique induces a temperature elevation in the skin which modifies the wound-healing process . We report a prospect i ve comparative clinical trial aim ed at evaluating an 810-nm diode-laser system to accelerate and improve the healing process in surgical scars immediately after skin closure . Methods Twenty-nine women and 1 man ( mean age = 41.4 years ; Fitzpatrick skin types I-IV ) were included to evaluate the safety and performance of the laser system . The laser dose ( or fluence in J/cm² ) was selected as a function of phototype and skin thickness . Each surgical incision ( e.g. , abdominoplasty ) was divided into two parts . An 8-cm segment was treated with the laser immediately after skin closure . A separate 8-cm segment was left untreated as a control . Clinical evaluations ( overall appearance ratings , comparative scar scale ) of all scars were conducted at 10 days , 3 months , and 12 months by both surgeon and patients . Profilometry analysis from silicone replicas of the skin was done at 12 months . Wilcoxon signed-rank test analyses were performed . Results Twenty-two patients were treated using a high dose ( 80–130 J/cm² ) and 8 patients with a low dose ( < 80 J/cm² ) . At 12 months in the high-dose group , both surgeon and patients reported an improvement rate of the laser-treated segment over the control area of 72.73 and 59.10 % , respectively . For these patients , profilometry results showed a decrease in scar height of 38.1 % ( p = 0.027 ) at 12 months for the laser-treated segment versus control . Three patients treated with higher doses ( > 115 J/cm² ) experienced superficial burns on the laser-treated segment , which resolved in about 5–7 days . For the eight patients treated at low dosage ( < 80 J/cm² ) , there was no significant difference in the treated segment versus the control segment . No side effects were observed . Conclusion This prospect i ve comparative trial demonstrates that an 810-nm diode laser treatment , performed immediately after surgery , can improve the appearance of a surgical scar . The dose plays a great role in scar improvement and must be well controlled . There is interest in LASH for hypertrophic scar revision . LASH can be used to prevent and reduce scars in plastic surgery BACKGROUND Many studies have examined laser treatment of scars , but cosmetic results have been variable . Although no studies have examined the effect of purpura on scar improvement using the pulsed dye laser ( PDL ) , many clinicians believe inducing purpura results in better and quicker improvement . OBJECTIVE To determine whether PDL treatment of fresh surgical scars with purpura‐inducing setting s improves clinical appearance more than non‐purpura‐inducing setting s or no treatment . METHODS Twenty‐six subjects with surgical scars enrolled 
    Output:
    
In general , laser-treated wounds and scars showed benefit from laser intervention , though not always reaching significance .
In conclusion , laser intervention when introduced in inflammation , proliferation or remodelling phase has the potential to reduce cutaneous scar formation .