Nanofat Injection and Fractional CO2 Laser for Post-Traumatic Atrophic Scars (NANOCO2-PTS)

June 30, 2026 updated by: Sameh Sarsik, Tanta University

Safety and Efficacy of Nanofat Injection and Fractional CO2 Laser: Monotherapy Versus Combined Therapy in Post-Traumatic Atrophic Scars

Post-traumatic atrophic scars are characterized by skin depressions caused by loss of collagen and can lead to cosmetic and psychological concerns. Several treatment options have been proposed, including fractional carbon dioxide (CO2) laser resurfacing and autologous nanofat grafting, both of which may improve scar appearance through skin remodeling and regeneration. This prospective comparative study evaluates the safety and efficacy of fractional CO2 laser alone, autologous nanofat injection alone, and combination therapy in patients with post-traumatic atrophic scars. Sixty participants were assigned to one of three treatment groups and were assessed using the Vancouver Scar Scale, physician global assessment, patient satisfaction, dermoscopic examination, and histopathological evaluation. The study aims to determine whether combining fractional CO2 laser and nanofat injection provides superior clinical and regenerative outcomes compared with either treatment alone while maintaining an acceptable safety profile.

Study Overview

Status

Enrolling by invitation

Conditions

Intervention / Treatment

Detailed Description

Post-traumatic atrophic scars are characterized by dermal collagen loss, epidermal thinning, and alterations in skin texture and pigmentation. These scars may result in significant cosmetic disfigurement and negatively affect patients' quality of life. Despite the availability of multiple treatment modalities, no single intervention has consistently demonstrated optimal efficacy.

Fractional carbon dioxide (CO2) laser induces controlled microthermal injury that stimulates collagen remodeling and skin regeneration. Autologous nanofat grafting, which is rich in adipose-derived regenerative cells and growth factors, has emerged as a promising regenerative treatment for improving skin quality and scar remodeling. Combining these two modalities may provide synergistic effects by enhancing tissue regeneration and improving both structural and aesthetic outcomes.

This prospective comparative study was conducted to evaluate and compare the safety and efficacy of fractional CO2 laser monotherapy, autologous nanofat injection monotherapy, and combination therapy in the treatment of post-traumatic atrophic scars. Clinical efficacy was assessed using physician evaluation, Vancouver Scar Scale scores, and patient satisfaction, while dermoscopic and histopathological examinations were performed to investigate treatment-induced structural changes and the mechanisms underlying scar improvement.

The study aimed to determine whether combined therapy offers superior clinical and regenerative outcomes compared with either treatment alone while maintaining an acceptable safety profile.

Study Type

Interventional

Enrollment (Estimated)

60

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Egypt
    • Gharbia Governorate
      • Tanta, Gharbia Governorate, Egypt, 31527
        • Tanta University Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Male or female participants aged 12 years or older.
  • Presence of post-traumatic atrophic scar(s) of at least 6 months' duration.
  • No scar treatment received during the previous 6 months.
  • Willingness and ability to provide written informed consent (or assent with -parental/guardian consent for minors, according to local regulations).
  • Willingness to comply with study procedures and follow-up assessments.

Exclusion Criteria:

  • Hemoglobin <10 g/dL.
  • Active infection or viral skin disease.
  • Coagulopathy or hemophilia.
  • Current anticoagulant therapy.
  • Diabetes mellitus.
  • History of keloid formation.
  • History of malignancy or prior radiation therapy.
  • Immunosuppression.
  • Long-term systemic corticosteroid therapy.
  • Photosensitivity disorders.
  • Pregnancy or breastfeeding.
  • Renal or hepatic disease.
  • Systemic diseases affecting wound healing.
  • Thin patients with insufficient adipose tissue for adipose tissue harvesting.
  • Previous scar treatment within the preceding 6 months.
  • Use of systemic retinoids within the preceding 6 months. -Use of topical retinoids within the preceding 2 weeks.-

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Fractional CO2 Laser
Participants will receive three sessions of fractional carbon dioxide laser treatment at one-month intervals.
Device: Fractional CO2 Laser
Fractional ablative carbon dioxide laser (10,600 nm) administered in three sessions at one-month intervals for treatment of post-traumatic atrophic scars.
Other Names:
  • Fractional Carbon Dioxide Laser
Active Comparator: Autologous Nanofat Injection
Participants will receive one session of autologous nanofat injection for treatment of post-traumatic atrophic scars.
Biological: Autologous Nanofat Injection
A single session of intradermal injection of autologous nanofat prepared from centrifuged and mechanically emulsified adipose tissue for treatment of post-traumatic atrophic scars.
Other Names:
  • Autologous Nanofat
Active Comparator: Fractional CO2 Laser + Autologous Nanofat Injection
Participants will receive three sessions of fractional carbon dioxide laser at one-month intervals followed by one session of autologous nanofat injection.
Device: Fractional CO2 Laser
Fractional ablative carbon dioxide laser (10,600 nm) administered in three sessions at one-month intervals for treatment of post-traumatic atrophic scars.
Other Names:
  • Fractional Carbon Dioxide Laser
Biological: Autologous Nanofat Injection
A single session of intradermal injection of autologous nanofat prepared from centrifuged and mechanically emulsified adipose tissue for treatment of post-traumatic atrophic scars.
Other Names:
  • Autologous Nanofat

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Vancouver Scar Scale Score
Time Frame: Baseline and 3 months after completion of treatment
The change in scar severity assessed using the Vancouver Scar Scale (VSS), including vascularity, pigmentation, and pliability, from baseline to the post-treatment assessment.
Baseline and 3 months after completion of treatment

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Physician Global Assessment of Clinical Improvement
Time Frame: 3 months after completion of treatment
Clinical improvement evaluated by three blinded dermatologists using a quartile grading scale (poor: 0-25%, fair: 25-50%, good: 50-75%, excellent: 75-100% improvement).
3 months after completion of treatment

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Tanta University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

June 28, 2026

Primary Completion (Estimated)

June 1, 2027

Study Completion (Estimated)

June 30, 2027

Study Registration Dates

First Submitted

June 25, 2026

First Submitted That Met QC Criteria

June 25, 2026

First Posted (Actual)

July 1, 2026

Study Record Updates

Last Update Posted (Actual)

July 2, 2026

Last Update Submitted That Met QC Criteria

June 30, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • TANTA-33465-11-19
  • TU-DERM-PTAS-2020-01 (Registry Identifier: Internal Protocol Number)
  • 33465/11/19 (Other Identifier: Ethics Approval Number)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be shared publicly because participant consent for public data sharing was not obtained and the dataset contains potentially identifiable information.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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