Prevention or treatment of hypertrophic burn scarring: a review of when and how to treat with the pulsed dye laser.

The purpose of this review is to investigate the use of Pulsed Dye Laser (PDL) as a therapeutic tool for hypertrophic burns scarring. The difference between keloids and hypertrophic scars is first described. The review then outlines the progress and assessment of hypertrophic scars for burns patients and the problem of their clinical management. The assessment using both objective and subjective measurements for complete account of hypertrophic scars is explained. The efficacy of PDL for both prevention and treatment is summarised for all hypertrophic scarring and the various laser treatment protocols in previous research is studied. The differentiation between prevention and treatment is discussed in relation to scar duration and the need for prevention rather than treatment is then proposed for intervention using PDL. The paper concludes with recommendations for future research through a prospective randomised, controlled study using 595 nm PDL in the prevention of scars with less than 6 month duration.