Laser in the treatment of hypertrophic burn scars

Abstract

This prospective study looked at the outcome of laser (light amplification by stimulated emission of radiation) treatment for hypertrophic scarring. Dermatrade mark K laser (a set of combined lasers erbium:yttrium aluminium garnet/carbon dioxide, qualified as a class IV laser) was used. Between 21 June 2000 and 19 November 2002, at the Siemianowice Burn Center, Poland, 592 interventions, using laser, were performed on N= 327 patients (220 women and 107 men, aged between 3 and 80 years). The majority of cases [N= 223 (68.9%)] were patients with post-burn hypertrophic scars, and 104 cases (31.8%) had various types of hypertrophic scars. Evaluation took place using an adapted Vancouver Scar Scale and digital photographs as well as the patient's opinion. It was noted that after laser treatment, satisfactory results were achieved in 72% of cases. The scars had become less red (192/327 scored no redness at the end of the study versus 92/327 upon initial), less raised (272/327 scored a flat scar versus 72/327 upon initial) and demonstrated an improved viscoelasticity (192/327 scored a soft skin versus 62/327 upon initial). Laser treatment did not improve contractures in post-burn hypertrophic scars. Results were not confirmed using objective measurement tools, as these were not available to us.

Fractional nonablative 1540 nm laser resurfacing for thermal burn scars: A randomized controlled trial

“…The remodeling potential has been utilized to treat scar tissue like acne scars and surgical scars [11,22]. Limited evidence exists on laser treatment for burn scars, including a recent case report with nonablative fractional laser [9], uncontrolled trials with pulsed dye laser, erbium:YAG laser and CO 2 laser [23][24][25] and one RCT, which compares three repetitive treatments with the pulsed dye laser versus no treatment, unfortunately with no benefits on scar redness and textural improvement from the laser treatments [26].…”

Evaluation of Clinical Results, Histological Architecture, and Collagen Expression Following Treatment of Mature Burn Scars With a Fractional Carbon Dioxide Laser

“…13 After 1 to 5 sessions at 6-month to Abbreviations: H&E, hematoxylin-eosin; VVG, Verhoff von Giesen. a P Ͻ .05, which indicates that the change from pretreatment to posttreatment is statistically significant.…”

The Use of CO2 Fractional Photothermolysis for the Treatment of Burn Scars

“…A total of 387 CO 2 laser procedures were performed on 131 patients for the treatment of symptomatic burn scars and skin grafts between October 1, 2011 and May 1, 2014 (average, 2.95 procedures per patient; range [1][2][3][4][5][6][7][8][9][10][11]. Patients were all adults with an average age of 43.0: 67 men and 64 women.…”

“…Regardless of the specific mechanism, numerous papers have described positive clinical outcomes with the use of this laser for various scars, including acne, atrophic, incisional, hypertrophic, and burn scars. 8,9,20 Despite exciting preliminary data seen with ablative fractional CO 2 laser treatment of hypertrophic burn scars, there is a paucity of high-level evidence to validate its use. Scar appearance, scar tension, and pruritus are difficult to quantify objectively, and patient-reported outcomes studies are needed to verify the improvement seen by surgeons.…”

“…More recently, the use of certain lasers, with and without surgical release, has been shown to be beneficial in the treatment of HTSs, as well as their associated symptoms. [5][6][7][8][9][10][11][12][13] Laser treatment of HTS, in particular pulsed dye and fractional CO 2 , has been shown to improve abnormal pigmentation, pruritus, pain, tightness, and the abnormal appearance of a previously meshed skin graft. 6,8,10,[14][15][16][17] Mechanistically, the idea has been proposed that the laser, like the knife in a Z-plasty, breaks up the disorganized collagen fibrils that create the contracture.…”