EFEKTIFITAS TERAPI SUBCISION TERHADAP KOMBINASI SUBCISION DENGAN LASER ERBIUM:GLASS1540nm PADA SKAR AKNE HIPOTROFIK TIPE ROLLING DAN BOXCAR

Abstract

Hipotrophy acne scar (HAS) is a disorder which is relatively difficult to tackle. Subcision and Erbium : Glass 1540 nm laser are one of the therapeutical alternatives that can be applied and are relatively new therapy methods. The aim of this study is to find out the effectiveness of subcision therapy compared with combination therapy of Erbium Glass 1540 nm in the therapy of rolling and boxcar type of HAS. This study was conducted on 48 HAS patients who suffer from boxcar or rolling type of HAS, determined at the start of study. Randomization was then done, dividing the patients into 2 groups, i.e. the single therapy group (subcision) which consisted of 24 people, 12 with the boxcar type an12 with the rolling type. The second group was the combination therapy group (subcision and Erbium : Glass 1540 nm laser), which consisted of 24 people, 12 with the boxcar type an12 with the rolling type. Evaluation was conducted in the 1, 7, and 15th weeks, employing the optical profilometry evaluation (Visioscan VC 98) and photography. At the end of the study was found a significant improvement (p<0,001) both in the single therapy group and in the combination therapy group. In the combination therapy group was seen a significantly better result in the quantity of HAS (p=0,05) and the size (p<0,001) when compared to the single therapy group. There was no significant difference concerning the improvement of quantity nor size of HAS between the boxcar and the rolling type in both groups. In the post-therapy photo assesment was noted a moderate degree improvement, however, there was no significant difference found between the single therapy and the combination therapy both in boxcar-type HAS (p=0,3) or in rolling type HAS (p=0,6). Pain and hematoma during subcision were found in all of patients. Most of the patients in the combination group didn't experience any complications during the laser therapy concerning patients satisfactions of the result of the therapy, more patients who underwent combination therapy (31,91%) claimed that they were very satisfied, compared to those who underwent single therapy (6,38%). Skar akne hipotrofi (SAH) merupakan kelainan yang relatif sulit diterapi. Subcision dan laser Erbium : Glass merupakan alternatif terapi yang relatif barn. Tujuan penelitian ini untuk mengetahui efelctivitas terapi subcision dibandingkan dengan terapi kombinasi subcision dan laser Erbium : Glass 1540 nm pada penyembuhan SAH tipe rolling dan boxcar. Penelitian ini dikuti oleh 48 orang penderita SAH yang pada awal penelitian ditentukan SAH tipe boxcar atau rolling. Selanjutnya dilakukan randomisasi menjadi 2 kelompok yaitu kelompok terapi tunggal (subcision) sebanyak 24 orang yang terdiri dari 12 orang tipe boxcar dan 12 orang tipe rolling, dan kelompok terapi kombinasi (subcision dan laser Erbium : Glass 1540 nm) sebanyak 24 orang yang terdiri dari 12 orang tipe boxcar dan 12 orang tipe rolling. Evaluasi dilakukan pada minggu ke 1,7 dan 15 menggunakan pengukuran optikal profilometri (Visiosca, VC 98) dan fotografi. Pada akhir penelitian terjadi perbaikan yang bermakna (p<0,001) baik menggunakan terapi tunggal maupun kombinasi. Dengan terapi kombinasi didapatkan basil yang lebih baik secara bermakna pada jumlah SAH (p=0,05) maupun ukuran SAH (p<0,001) dibandingkan terapi tunggal. Tidak ada perbedaan bermakna pada perbaikan jumlah dan ukuran SAH antara tipe boxcar dan rolling menggunakan terapi tunggal, begitu pula menggunakan terapi kombinasi Pada penilaian foto pasca terapi terjadi perbaikan derajat sedang, namun tidak dijumpai perbedaan bermalcna antara terapi tunggal dan terapi kombinasi baik pada SAH tipe boxcar (p=0,3) maupun rolling (p=0,6). Nyeri dan hematom dijumpai pada seluruh penderita saat terapi subcision. Pada kelompok terapi kombinasi sebagian besar penderita tidak dijumpai komplikasi mat terapi laser. Tingkat kepuasan terhadap hasil terapi, penderita yang sangat puas dengan terapi kombinasi (31,91%) jumlahnya lebih banyalc dibanding terapi tunggal (6,38%).