Issue 25-3, 2026

Original article

https://doi.org/10.38025/2078-1962-2026-25-3-48-56

Efficacy of Rehabilitation of Patients with Traumatic Impregnation of Facial Skin: A Randomized Controlled Trial

View article (Download PDF file)



Download XML file

ORCIDNatalia A. Shanina1,*, ORCIDAlexander V. Patrushev1,2, ORCIDDenis V. Kovlen1,3

1 Military Medical Academy, Saint Petersburg, Russia 2 Almazov National Medical Research Centre, Saint Petersburg, Russia 3 Albrecht Federal Scientific and Educational Center for Medical and Social Expertise and Rehabilitation, Saint Petersburg, Russia


ABSTRACT

INTRODUCTION.Traumatic impregnation (tattoo) of the face is an artificial blue-black spot formed as a result of foreign particles entering the dermis. Rehabilitation of patients with this psychotraumatic condition consists of eliminating the cosmetic defect, namely, removing foreign particles from the skin, which is a difficult task and, until recently, was only possible in the early stages (before the epithelialization of wounds).

AIM.To evaluate the dynamics of indicators of limitation of vital activity in patients with traumatic impregnation during the implementation of the developed rehabilitation program, including the sequential use of two types of laser radiation.

MATERIALS AND METHODS.The study was conducted at the Military Medical Academy (St. Petersburg, Russia) in the period from January 2024 to March 2025. The study included 70 patients with traumatic impregnation of facial skin, who were randomly divided into two groups. The first was the study group (35 people), where the developed rehabilitation program using laser technologies was used. The second was the control group (35 people), where the standard approach was used (rinsing of wounds and mechanical removal of foreign particles from the skin within 72 hours after the injury and application of methyluracil ointment to the lesions for a month). The duration of observation of patients was 3 months. Control examinations were carried out before the start of rehabilitation (visit 1) and after 3 months (visit 2). The indicators of disability were assessed in accordance with the International Classification of Functioning of the World Health Organization, 2001 (ICF-WHO): psychomotor functions (PF), emotional functions (EF), pain sensation (PS), protective functions of the skin (PFS), reparative functions of the skin (RFS), stress coping (SC), basic interpersonal interactions (BII), work and employment (WE).

RESULTS.In the study group, the effectiveness of rehabilitation was significantly higher than in the control group, which was reflected in a significant difference between the groups in the main recorded indicators at visit 2: PF1group = 0.64 arb. unit, PF2group = 1.52 arb. unit, p = 0.011; EF1group = 1.03 arb. unit, EF2group = 1.67 arb. unit, p < 0.001; PS1group = 1.73 arb. unit, PS2group = 2.0 arb. unit, p = 0.033; PFS1group = 0.73 arb. unit, PFS2group = 1.39 arb. unit, p < 0.001; RFS1group = 0.61 arb. unit, RFS2group = 2.30 arb. unit, p < 0.001; SC1group = 0.85 arb. unit, SC2group = 1.21 arb. unit, p = 0.028; WE1group = 0.61 arb. unit, WE2group = 1.03 arb. unit, p = 0.039. No differences were registered in terms of basic interpersonal interactions (BII1group = 1.0 arb. unit, BII2group = 1.15 arb. unit, p = 0.091).

DISCUSSION.The proposed correction technique makes it possible to fully restore the functional characteristics of the skin to a normal level, thereby eliminating the traumatic situation in the form of a persistent facial skin defect.

CONCLUSION.The developed method of rehabilitation of patients with traumatic impregnation, including the sequential use of two variants of high-intensity laser irradiation within one procedure, is highly effective and allows for significantly improved results in comparison with the standard protocol.


KEYWORDS: traumatic impregnation, traumatic tattoo, laser technologies, rehabilitation, limitation of life activity

FOR CITATION: Shanina N.A., Patrushev A.V., Kovlen D.V. Efficacy of Rehabilitation of Patients with Traumatic Impregnation of Facial Skin: A Randomized Controlled Trial. Bulletin of Rehabilitation Medicine. 2026; 25(3):48–56. https://doi.org/10.38025/2078-1962-2026-25-3-48-56 (In Russ.).

FOR CORRESPONDENCE:

Natalia A. Shanina, E-mail: shanina_n@mail.ru, vmeda-nio@mil.ru


References:

  1. Gorouhi F., Davari P., Kashani M.N., et al. Treatment of traumatic tattoo with the Q-switched Nd:YAG laser. J. Cosmet. Laser. Ther. 2007; 9(4): 253–255. https://doi.org/10.1080/14764170701708263
  2. Bonan P.., Bassi A., Bruscino N., et al. Combined pulsed dye laser and Q-switched Nd: YAG laser intraumatic facial tattoo removal: a case series. Dermatol. Ther. 2019; 32(5): e13069. https://doi.org/10.1111/dth.13069
  3. Hanke C.W., Conner A.C., Probst E.L., et al. Blast tattoos resulting from black powder firearms. J. Am. Acad. Dermatol. 1987; 17: 819–825. https://doi.org/10.1016/s0190-9622(87)70269-2
  4. Pallua N., Schneider W., Berger A. Treatment of traumatic facial tattoos caused by black gunpowder. Injury. 1993; 24: 227–230. https://doi.org/10.1016/0020-1383(93)90174-5
  5. Bernstein S., Barros B., Zaenglein A.L. A Gunpowder Tattoo in a 6-Year-Old Girl. Pediatr. Dermatol. 2016; 33(3): e210–e211. https://doi.org/10.1111/pde.12835
  6. Siemers F., Stang F.H., Namdar T., et al. Removal of accidental inclusions following blast injury by use of a hydrosurgery system (VersajetTM). Injury Extra. 2010; 41: 83–84.
  7. Dash G., Patil A., Kassir M., et al. Non-laser treatment for tattoo removal. J. Cosmet. Dermatol. 2023; 22(1): 74–78. https://doi.org/10.1111/jocd.14819
  8. Gupta J., Chouhan K., Kumar A., et al. Mini-Punch Skin Excision: A Newer Novel Approach for Tattoo Removal. J. Cutan. Aesthet. Surg. 2019; 12(1): 49–51. https://doi.org/10.4103/JCAS.JCAS_133_18
  9. Moreno-Arias G.A., Casals-Andreu M., Camps-Fresneda A. Use of Q-switched alexandrite laser (755 nm, 100 nsec) for removal of traumatic tattoo of different origins. Lasers Surg. Med. 1999; 25: 445–450. https://doi.org/10.1002/(sici)1096-9101(1999)25:5<445::aid-lsm12>3.0.co;2-q
  10. Bonan P., Bassi A., Bruscino N., et al. Combined pulsed dye laser and Q-switched Nd: YAG laser intraumatic facial tattoo removal: a case series. Dermatol. Ther. 2019; 32(5): e13069. https://doi.org/10.1111/dth.13069
  11. Yang Q., Xue P., Fan X., et al. Lasers treatment for traumatic facial tattoo. Lasers Med. Sci. 2022; 38(1): 28. https://doi.org/10.1007/s10103-022-03658-1
  12. Шанина Н.А., Патрушев А.В., Махоня Д.А. Лечение травматической татуировки лица. Эстетическая медицина. 2020: 29(1): 71–73. [Shanina N.A., Patrushev A.V., Mahonya D.A. Treatment of traumatic facial tattoo. Aesthetic medicine. 2020; 29(1):71–73. (In Russ.).]



Creative Commons License
The content is available under the Creative Commons Attribution 4.0 License.

©


This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.