Treatment of burn hypertrophic scar with fractional ablative laser‐assisted drug delivery can decrease levels of hyperpigmentation

Kurup, Sanjana; Travis, Taryn E; Shafy, Rahma Abd El; Shupp, Jeffrey W.; Carney, Bonnie C

doi:10.1002/lsm.23662

Cited by 7 publications

(1 citation statement)

References 26 publications

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“…A fractional ablative CO 2 laser (Lumenis, Israel) was used to treat these areas on six marked areas on each pig, three per side. The laser was used with the DeepFX handpiece at 1% density, 250 Hz, and 10 mm spot size, mimicking a clinically relevant setting utilized to treat burn hypertrophic scar in our patient population [6,16]. The energy setting was varied and was set to either 70, 100, or 120 mJ, with each energy level being used on two of the marked areas, one per side, to create n = 4 per group.…”

Section: Animal Modelmentioning

confidence: 99%

Altering CO₂ Laser Pulse Energy Settings Did Not Influence Differential Gene Transcription in Normal Skin in a Red Duroc Pig Model

Hussein,

Travis,

Moffatt

et al. 2024

Lasers Surg Med

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ObjectivesFractional ablative CO2 lasers are used clinically to treat cutaneous burn scars with reported varying degrees of effectiveness. It was hypothesized that different laser pulse energy settings may lead to differential gene transcription in a porcine model.MethodsUninjured skin from red Duroc pigs was treated with a fractional ablative CO2 laser set to 70, 100, or 120 mJ across the abdomen (n = 4 areas per treatment). Punch biopsies of both treated and untreated sites were taken before treatment (baseline), at 30 min, and at each hour for 6 h and stored in All‐Protect tissue reagent. The biopsies were then used to isolate RNA, which was subsequently used in qRT‐PCR for eight genes associated with wound healing and the extracellular matrix: CCL2, IL6, FGF2, TIMP1, TIMP3, COL1A2, MMP2, and DCN. RPL13a was used as a housekeeping gene to normalize the eight genes of interest. One‐way ANOVA tests were used to assess for differences among laser pulse energies and two‐way ANOVA tests were used to assess the differences between treated and untreated areas.ResultsWhile six of the eight genes were upregulated after treatment (p < 0.05), there were no significant differences in gene expression between the different laser pulse energies for any of the eight genes.ConclusionWhile laser treatment is correlated with a positive and significant upregulation for six of the eight genes 4 h after intervention, the pulse energy settings of the laser did not lead to a statistically significant difference in gene transcription among the treatment areas. Different laser pulse energies may not be required to induce similar cellular responses in a clinical setting.

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Section: Animal Modelmentioning

confidence: 99%

Altering CO₂ Laser Pulse Energy Settings Did Not Influence Differential Gene Transcription in Normal Skin in a Red Duroc Pig Model

Hussein,

Travis,

Moffatt

et al. 2024

Lasers Surg Med

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Addressing Burn Hypertrophic Scar Symptoms Earlier: Laser Scar Revision May Begin as Early as 3–6 Months After Injury

Slavinsky,

Wong,

Carney

et al. 2024

Lasers Surg Med

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ObjectivesFractional ablative CO2 laser (FLSR) is used to treat hypertrophic scars (HTSs) resulting from burn injuries, which are characterized by factors, such as erythema, contracture, thickness, and symptoms of pain and itch. Traditionally, waiting a year after injury for scar maturation before starting laser treatment has been recommended; however, the potential benefits of earlier intervention have gained popularity. Still, the optimal timing for beginning laser intervention in patients with HTSs remains uncertain. This study aims to evaluate the ideal timing for the initiation of FLSR for HTSs using several qualitative and quantitative assessment measures. It was hypothesized that early intervention would lead to similar improvement trends as later intervention, however, would be more ideal due to the shortened time without symptom relief for patients.MethodsPatients who received three or more laser treatment sessions and completed both pre‐ and posttreatment evaluations were included in this analysis (n = 69). FLSR treatment was administered at 4–8‐week intervals. Patients starting treatment before 6 months after injury were classified as the early‐stage intervention group and those beginning treatment at 6–12 months after injury were classified as the late‐stage intervention group. Demographic data, including the age of patients at the time of first treatment, age of scars at the time of first treatment, biological sex, ethnicity, Fitzpatrick skin type, and use of laser‐assisted drug delivery, were collected by retrospective chart review. Patients were evaluated on six subjective scales and objectively for scar stiffness with durometry. For all scales, higher scores indicate worse scars. A two‐way ANOVA, Student's t‐test, and Mann–Whitney U‐test were used to compare scores from the pre‐ to posttreatment evaluations.ResultsThere were no significant differences between the groups for any of the demographic or scar‐specific variables; thus, differences in outcome can be attributed to the timing of intervention. Both groups demonstrated an improvement in scars with treatment over time (p < 0.05). Both early‐ and middle‐stage initiation showed scar symptom improvement in five out of six scales. In the late‐stage intervention, the Patient and Observer Scar Assessment Scale‐Patient average score did not show improvement. In the early‐stage intervention, the Vancouver Scar Scale total did not show improvement. Quantitative evaluation of scar stiffness by durometry did not show symptom improvement in either group. The Scar Comparison Scale demonstrated the greatest improvement across groups.ConclusionLaser treatment led to scar improvement in at least one scale at each stage of initiation. Both intervention timelines resulted in equivalent outcomes, and early intervention should be considered when initiating FLSR treatment in burn scars to alleviate symptoms earlier.

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The Effect of Fat Grafting on Scars Hyperpigmentation: A Systematic Review and Meta-Analysis

Alessandri Bonetti,

Arellano,

Scarabosio

et al. 2024

Aesth Plast Surg

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Treatment of burn hypertrophic scar with fractional ablative laser‐assisted drug delivery can decrease levels of hyperpigmentation

Cited by 7 publications

References 26 publications

Altering CO₂ Laser Pulse Energy Settings Did Not Influence Differential Gene Transcription in Normal Skin in a Red Duroc Pig Model

Altering CO₂ Laser Pulse Energy Settings Did Not Influence Differential Gene Transcription in Normal Skin in a Red Duroc Pig Model

Addressing Burn Hypertrophic Scar Symptoms Earlier: Laser Scar Revision May Begin as Early as 3–6 Months After Injury

The Effect of Fat Grafting on Scars Hyperpigmentation: A Systematic Review and Meta-Analysis

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Treatment of burn hypertrophic scar with fractional ablative laser‐assisted drug delivery can decrease levels of hyperpigmentation

Cited by 7 publications

References 26 publications

Altering CO2 Laser Pulse Energy Settings Did Not Influence Differential Gene Transcription in Normal Skin in a Red Duroc Pig Model

Altering CO2 Laser Pulse Energy Settings Did Not Influence Differential Gene Transcription in Normal Skin in a Red Duroc Pig Model

Addressing Burn Hypertrophic Scar Symptoms Earlier: Laser Scar Revision May Begin as Early as 3–6 Months After Injury

The Effect of Fat Grafting on Scars Hyperpigmentation: A Systematic Review and Meta-Analysis

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Altering CO₂ Laser Pulse Energy Settings Did Not Influence Differential Gene Transcription in Normal Skin in a Red Duroc Pig Model

Altering CO₂ Laser Pulse Energy Settings Did Not Influence Differential Gene Transcription in Normal Skin in a Red Duroc Pig Model