Healing of chronic wounds with adjunctive ablative fractional laser resurfacing in two pediatric patients

Krakowski, Andrew C.; Diaz, Lucia Z.; Admani, Shehla; Uebelhoer, Nathan S.; Shumaker, Peter R.

doi:10.1002/lsm.22398

Cited by 21 publications

(12 citation statements)

References 21 publications

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“…Similarly, Vaderhobli et al [15] and Cercadillo‐Ibarguren et al [16] reported a width <200 μm in an incision of porcine tongue with the microsecond pulsed‐mode CO 2 laser at 0.2–3.5 W. Therefore, the use of ultrapulsed CO 2 laser can permit true “micron‐level” tissue debridement, achieving wound treatment with an unprecedented precision. Meanwhile, CO 2 laser may play a role in hemostasis, and control of local infection during the treatment of skin wounds [6–9] to promote faster wound healing. Therefore, it could serve as a more effective debridement than traditional surgery.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of the Efficacy of Ultrapulsed CO₂ Laser in Chronic Wounds

et al. 2020

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Background and Objectives Chronic wound repair is a major problem in wound treatment. Recently, several studies have suggested that carbon dioxide (CO2) laser can be used to improve the healing of chronic wounds. The aim of the present study was to preliminarily investigate the efficacy of laser debridement in treating chronic wound through a comparison of traditional instrument/surgical debridement with the ultrapulsed CO2 laser debridement in terms of wound healing, wound infection control, and wound blood perfusion. Study Design/Materials and Methods Patients with chronic wound admitted to the Wound Repair Clinic at The Affiliated Hospital of Southwest Medical University (Luzhou, China) between February 2019 and May 2019 were enrolled. They were randomly divided into two groups. The patients in one group were treated with traditional sharp instrument/surgical debridement (RT group; number of wounds: 28), while the patients in the other group were treated with ultrapulsed CO2 laser debridement (LT group; number of wounds: 26). An intergroup comparison was performed based on parameters, such as wound healing, wound infection control, and changes in wound blood perfusion. Results The wound healing rate and the total time to achieve healing were significantly better in the LT group versus the RT group at 7, 14, 21, and 28 days after treatment. The wound exudation scores were significantly higher in the LT group versus the RT group at 7, 14, and 28 days after treatment. The positive rate of pre‐debridement bacterial culture was significantly lower in the LT group versus the RD group at 14 and 28 days after treatment. The percentage of wound perfusion/normal periwound skin perfusion was significantly higher in the LT group versus the RT group at 1, 7, and 14 days after treatment. Conclusion For the treatment of chronic refractory wounds, the ultrapulsed CO2 laser exhibits higher accuracy, more effectively controls wound infection, promotes an increase in wound blood perfusion, and achieves faster wound healing compared with traditional sharp instrument/surgical debridement. Lasers Surg. Med. © 2020 Wiley Periodicals LLC

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Section: Discussionmentioning

confidence: 99%

“…An increasing number of studies have found that the carbon dioxide (CO 2 ) laser can be used not only for scar treatment [3,4], but also for wound debridement and treatment [5–11]. However, at present, the application of CO 2 laser in the treatment of chronic wounds has been few documented, mostly in case reports.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Efficacy of Ultrapulsed CO₂ Laser in Chronic Wounds

et al. 2020

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“…100 Prolonged and dysregulated inflammation is a major contributing factor to impaired ulcer healing. 101 The period of skin degradation before ulcer formation makes chronic wounds somewhat predictable, and also presents a potential window of opportunity for the application of prophylactic measures to prevent ulceration. This is not a new concept-various modalities such as barrier creams, compression therapy, and preventative offloading are routinely applied clinically for ulcer prevention by reducing the harmful impacts of external stressors on the skin.…”

Section: Potential Utility In Chronic Wound Preventionmentioning

confidence: 99%

When Wounds Are Good for You: The Regenerative Capacity of Fractional Resurfacing and Potential Utility in Chronic Wound Prevention

Leaker

Fuchs

Tam

2019

Advances in Wound Care

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Fractional resurfacing involves producing arrays of microinjuries on the skin, by thermal or mechanical means, to trigger tissue regeneration. Originally developed for cosmetic enhancement, fractional resurfacing induces a broad array of improvements in the structural and functional qualities of the treated skin and is especially effective at returning defective skin to a more normal state. In addition to fascinating questions about the nature of this remarkable regenerative capacity, there may be potential utility in ulcer prevention by halting or even reversing the progressive decline in overall skin quality that usually precedes chronic wound development. Recent Advances: Photoaging and scarring are the two skin defects most commonly treated by fractional resurfacing, and the treatment produces profound and long-lasting improvements in skin quality, both clinically and at the cellular/ histologic level. Chronic wounds usually occur in skin that is compromised by various pathologic factors, and many of the defects found in this ulcer-prone skin are similar to those that have seen improvements after fractional resurfacing. Critical Issues: The mechanisms responsible for the regenerative capacity of fractional resurfacing are mostly unknown, as is how ulcer-prone skin, which is usually afflicted by stressors external to the skin tissue itself, would respond to fractional resurfacing. Future Directions: Better understanding of the cellular and molecular mechanisms underlying the unique healing response to fractional resurfacing could reveal fundamental information about adult tissue regeneration, lead to improvements in current applications, as well as new therapies in other pathologic conditions.

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“…In an interesting case series two pediatric patients with chronic wounds within scars showed rapid healing with a singlepass treatment by fractionated carbon dioxide (CO 2 ) laser [46]. In another case series done by Phillips et al, CO 2 laser was used in the treatment of posttraumatic slow healing wounds in three elderly patients.…”

Section: Co 2 Laser and Wound Healingmentioning

confidence: 99%

Physical Modalities in the Management of Wound(s)

Feily¹,

Moeineddin²,

Mehraban³

2016

Wound Healing - New Insights Into Ancient Challenges

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Wound is caused by disruption of the integrity of body skin as a result of environmental or medical factors. Managing chronic and refractory wounds is a significant dilemma physicians are facing. Large varieties of treatment modalities have been used to enhance wound healing among which were different medicines, surgical procedures, physical therapy, hyperbaric oxygen therapy, and physical modalities such as laser and shockwave. In this chapter, the authors discuss physical modalities that are most used in the management of wound healing with a focus on lasers, shockwaves, photodynamic therapy, UVB therapy, and lights and describe some important experimental and clinical trials that have been done in this regard with an attempt to explain their mechanisms.

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Healing of chronic wounds with adjunctive ablative fractional laser resurfacing in two pediatric patients

Abstract: The combination of tolerability and efficacy observed in these cases introduces AFR as a potential promising adjunct to existing treatments for chronic, non-healing wounds in the pediatric population.

Cited by 21 publications

References 21 publications

Evaluation of the Efficacy of Ultrapulsed CO₂ Laser in Chronic Wounds

Evaluation of the Efficacy of Ultrapulsed CO₂ Laser in Chronic Wounds

When Wounds Are Good for You: The Regenerative Capacity of Fractional Resurfacing and Potential Utility in Chronic Wound Prevention

Physical Modalities in the Management of Wound(s)

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Healing of chronic wounds with adjunctive ablative fractional laser resurfacing in two pediatric patients

Abstract: The combination of tolerability and efficacy observed in these cases introduces AFR as a potential promising adjunct to existing treatments for chronic, non-healing wounds in the pediatric population.

Cited by 21 publications

References 21 publications

Evaluation of the Efficacy of Ultrapulsed CO2 Laser in Chronic Wounds

Evaluation of the Efficacy of Ultrapulsed CO2 Laser in Chronic Wounds

When Wounds Are Good for You: The Regenerative Capacity of Fractional Resurfacing and Potential Utility in Chronic Wound Prevention

Physical Modalities in the Management of Wound(s)

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Product

Resources

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Evaluation of the Efficacy of Ultrapulsed CO₂ Laser in Chronic Wounds

Evaluation of the Efficacy of Ultrapulsed CO₂ Laser in Chronic Wounds