INTRODUCTION: Hypertrophic burn scars produce significant morbidity, including itching, pain, stiffness, and contracture. Best practices for management continue to evolve. Lasers have recently been added to treatment algorithms, but indications and efficacy have not been fully defined. We studied the impact of laser therapies on hypertrophic burn scars. METHODS: We conducted a prospective, before-after study in burn patients with hypertrophic scars. Procedures were performed more than 6 months after burn injury and were repeated monthly. The pulsed-dye laser was used for pruritus and erythema, whereas the fractional CO2 laser was used for stiffness and abnormal texture. All procedures were performed in the OR, with anesthesia. Outcomes are as follows: (1) Vancouver Scar Scale (objective changes in pigmentation, erythema, pliability, height; range, 0-15) and (2) UNC Scar Scale (subjective changes in pain, itching, tingling, stiffness; range, 0-12). Before-after scores were compared by Student t test, with significance assigned to P values of <0.05. RESULTS: During 2011, we treated 147 patients (mean age, 26.9 years; mean TBSA, 16.1%) over 415 sessions (2.8 sessions/patient), including pulsed dye laser (n = 327) and CO2 (n = 139), mean surface area of 83 cm. Etiology included flame (75), scald (37), and other (35). Treatments occurred 16 months (median) and 48 months (mean) after burn injury. Vancouver Scar Scale decreased from 10.4 (SD, 2.4) to 5.2 (1.9) (P < 0.0001). UNC Scar Scale decreased from 5.4 (2.5) to 2.1 (1.7) (P < 0.0001). Mean length of follow-up was 4.7 months. CONCLUSIONS: Laser therapies significantly improve both the signs and symptoms of hypertrophic burn scars, as measured by objective and subjective instruments.
INTRODUCTION:Hypertrophic burn scars produce significant morbidity, including itching, pain, stiffness, and contracture. Best practices for management continue to evolve. Lasers have recently been added to treatment algorithms, but indications and efficacy have not been fully defined. We studied the impact of laser therapies on hypertrophic burn scars. METHODS: We conducted a prospective, before-after study in burn patients with hypertrophic scars. Procedures were performed more than 6 months after burn injury and were repeated monthly. The pulsed-dye laser was used for pruritus and erythema, whereas the fractional CO2 laser was used for stiffness and abnormal texture. All procedures were performed in the OR, with anesthesia. Outcomes are as follows: (1) Vancouver Scar Scale (objective changes in pigmentation, erythema, pliability, height; range, 0-15) and (2) UNC Scar Scale (subjective changes in pain, itching, tingling, stiffness; range, 0-12). Before-after scores were compared by Student t test, with significance assigned to P values of <0.05. RESULTS: During 2011, we treated 147 patients (mean age, 26.9 years; mean TBSA, 16.1%) over 415 sessions (2.8 sessions/patient), including pulsed dye laser (n = 327) and CO2 (n = 139), mean surface area of 83 cm. Etiology included flame (75), scald (37), and other (35). Treatments occurred 16 months (median) and 48 months (mean) after burn injury. Vancouver Scar Scale decreased from 10.4 (SD, 2.4) to 5.2 (1.9) (P < 0.0001). UNC Scar Scale decreased from 5.4 (2.5) to 2.1 (1.7) (P < 0.0001). Mean length of follow-up was 4.7 months. CONCLUSIONS: Laser therapies significantly improve both the signs and symptoms of hypertrophic burn scars, as measured by objective and subjective instruments.
Authors: Jonathan C Hibbard; Jonathan S Friedstat; Sonia M Thomas; Renee E Edkins; C Scott Hultman; Michael R Kosorok Journal: Clin Trials Date: 2018-03-25 Impact factor: 2.486
Authors: Mark Brewin; Sharon Docherty; Vanessa Heaslip; Katie Breheny; Jonathon Pleat; Shelley Rhodes; Paul P M van Zuijlen; Mamta Shah Journal: NIHR Open Res Date: 2022-01-18
Authors: Sander B Kant; Carlo Colla; Eric van den Kerckhove; Andrzej Piatkowski de Grzymala Journal: Prosthet Orthot Int Date: 2019-03-12 Impact factor: 1.895
Authors: Michelle E Carrière; Kelly A A Kwa; Louise E M de Haas; Anouk Pijpe; Zephanie Tyack; Johannes C F Ket; Paul P M van Zuijlen; Henrica C W de Vet; Lidwine B Mokkink Journal: Plast Reconstr Surg Glob Open Date: 2019-09-30
Authors: Tomasz Żądkowski; Paweł Nachulewicz; Maciej Mazgaj; Magdalena Woźniak; Czesław Cielecki; Andrzej Paweł Wieczorek; Iwona Beń-Skowronek Journal: Medicine (Baltimore) Date: 2016-10 Impact factor: 1.889