Abstract: Objective To evaluate the effects of scar plastic surgery versus dot matrix CO₂ laser on the cosmetic outcomes of burn patients. Methods A total of 50 patients with deep burns requiring plastic surgery, who were admitted between February 2021 and February 2024, were selected and randomly divided into a control group and an observation group using a random number table, with 25 cases in each group. The observation group received scar plastic surgery treatment, while the control group received dot matrix CO₂ laser therapy. The Vancouver Scar Scale （VSS） scores of both groups at different time points, scar hyperplasia, and adverse reactions during the treatment were recorded and compared between the two groups. Results By the end of the last follow-up （6 months after treatment）, all the 50 patients included in this study were followed up, and there were no cases of drop-out or loss to follow-up. The VSS scores of the two groups showed a downward trend over time, and there were significant differences in VSS scores at different time points after treatment （P<0.05）. Different treatment schemes and time had interactive effects on VSS scores （P<0.05）. The number of mild hyperplasia in the observation group was more than that in the control group, while the numbers of moderate and severe hyperplasia in the observation group were less than those in the control group （P<0.05）. The satisfaction rate in the observation group was higher than that in the control group （P<0.05）. The incidence rates of wound infection, redness, and pain in both groups of patients were low, and the rates were not different between the two groups （P>0.05）. Conclusion Scar plastic surgery is more effective in improving the cosmetic outcomes of burn patients and reducing the degree of scar hyperplasia than dot matrix CO₂ laser treatment.

Key words: Scar plastic surgery, Dot matrix CO₂ laser, Cosmetic effect, Scar hyperplasia