Objective To investigate the application effect of Omaha system-based individualized nursing (featuring an innovative dynamic upgrading mechanism) in patients with moderate to severe melasma treated with Q-switched 1 064 nm fractional laser combined with tranexamic acid.

Methods A total of 121 patients with moderate to severe melasma were selected as the study subjects, and randomly divided into study group (n=61) and control group (n=60). Both groups received treatment with Q-switched 1 064 nm fractional laser combined with tranexamic acid. The control group received conventional nursing, while the study group received Omaha system-based personalized nursing intervention in addition to the conventional nursing of the control group. The clinical efficacy, Melasma Area and Severity Index (MASI) scores, incidence of adverse reactions, recurrence rate and patient satisfaction were compared between the two groups.

Results The total effective rate in the study group was 90.16%(55/61), which was higher than 83.33%(50/60) in the control group, the difference was not statistically significant (P>0.05). At 6 and 12 weeks post-treatment, the MASI scores in both groups were significantly lower than those before treatment, and the scores in the study group were significantly lower than those in the control group (P < 0.05). The total incidence of adverse reactions and the recurrence rate in the study group were significantly lower than those in the control group (P < 0.05). The overall satisfaction rate in the study group was 95.08%(58/61), which was significantly higher than 78.33%(47/60) in the control group (P < 0.05).

Conclusion Omaha system-based individualized nursing can optimize the long-term effects of Q-switched laser combined with tranexamic acid treatment, significantly reduce the risk of adverse reactions and recurrence, and improve patient satisfaction.