Enhanced Outcomes in Post-sternotomy Scar Management Using Combined ResurFX Laser Resurfacing and Silicone Gel Sheeting: A Randomized Controlled Trial

Abstract Postoperative hypertrophic and keloid scars, particularly over the presternal region, present significant cosmetic and functional challenges. Silicone gel sheeting (SGS) is a well-established first-line treatment, and nonablative fractional lasers like ResurFX have shown promising results. This study evaluates the combined efficacy of SGS and ResurFX laser versus SGS alone in hypertrophic scar prevention. In this prospective randomized controlled trial, 76 post-sternotomy patients were divided into two groups. Group 1 (n = 38) received SGS after ResurFX laser resurfacing; group 2 (n = 38) received SGS alone. Modified Vancouver Scar Scale (VSS) scores were assessed at 30, 60, 90, and 180 days. Statistical analysis was conducted using SPSS v26.0 with the Mann–Whitney U-test. At 90 and 180 days, group 1 demonstrated significantly lower VSS total scores (2.24 and 1.53) compared with group 2 (4.18 and 2.45). Significant improvements were observed in vascularity, pigmentation, and scar elevation in group 1. No significant differences were seen in scar width, pliability, or pruritus. The addition of ResurFX laser to SGS therapy significantly improves presternal scar outcomes in terms of vascularity, pigmentation, and elevation, with early and sustained benefits. This combined approach is safe, effective, and superior to monotherapy with SGS alone.