Meghan Seago1,2, Peter R Shumaker1, Leah K Spring3, Murad Alam4, Firas Al-Niaimi5, R Rox Anderson6, Ofir Artzi7, Ardeshir Bayat8, Daniel Cassuto9, Henry Hl Chan10, Christine Dierickx11, Matthias Donelan12, Gerd G Gauglitz13, Boncheol Leo Goo14, Greg J Goodman15, Geoffrey Gurtner16, Merete Haedersdal17, Andrew C Krakowski18, Woraphong Manuskiatti19, William B Norbury20, Rei Ogawa21, David M Ozog22, Uwe Paasch23, E Victor Ross24, Matteo Tretti Clementoni25, Jill Waibel26. 1. Department of Dermatology, Naval Medical Center, San Diego, California, 92134. 2. Fellow, Micrographic Surgery and Surgical Oncology, Scripps Clinic, La Jolla, California, 92037. 3. Fellow, Micrographic Surgery and Surgical Oncology, SkinCare Physicians, Chestnut Hill, Massachusetts, 02467. 4. Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, 60611. 5. Private Practice, London, United Kingdom. 6. Department of Dermatology, Harvard Medical School, and Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, 02114. 7. Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. 8. Division of Dermatology, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa. 9. Private Practice, Milan, Italy. 10. Private Practice and Department of Medicine (Dermatology), University of Hong Kong, People's Republic of China. 11. Skinperium Clinic, Luxembourg, Luxembourg. 12. Department of Surgery, Massachusetts General Hospital, Shriners Hospitals for Children-Boston, Harvard Medical School, Boston, Massachusetts, 02114. 13. Department of Dermatology and Allergy, Ludwig Maximillian University, Munich, Germany. 14. Naeum Dermatology and Aesthetic Clinic/Skin Rehabilitation Center, Seoul, Korea. 15. Department of General Practice, Monash University, Clayton, Victoria, Australia. 16. Department of Surgery, Stanford University School of Medicine, Stanford, California, 94305. 17. Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark. 18. Division of Dermatology, St. Luke's University Health Network, Bethlehem, Pennsylvania, 18015. 19. Department of Dermatology, Siriraj Hospital, Bangkok, Thailand. 20. Department of Surgery, University of Texas Medical Branch, Shriners Hospital for Children-Galveston, Galveston, Texas, 77550. 21. Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan. 22. Department of Dermatology, Henry Ford Hospital, Detroit, Michigan, 48202. 23. Department of Dermatology, Venereology, and Allergy, University of Leipzig, Leipzig, Germany. 24. Scripps Clinic, San Diego, California, 92130. 25. Laserplast, Milan, Italy. 26. Miami Dermatology and Laser Institute, Miami, Florida, 33173.
Abstract
BACKGROUND AND OBJECTIVES: There is currently intense multidisciplinary interest and a maturing body of literature regarding laser treatments for traumatic scars, but international treatment guidelines and reimbursement schemes have not yet caught up with current knowledge and practice in many centers. The authors intend to highlight the tremendous potential of laser techniques, offer recommendations for safe and efficacious treatment, and promote wider patient access guided by future high-quality research. STUDY DESIGN/ MATERIALS AND METHODS: An international panel of 26 dermatologists and plastic and reconstructive surgeons from 13 different countries and a variety of practice backgrounds was self-assembled to develop updated consensus recommendations for the laser treatment of traumatic scars. A three-step modified Delphi method took place between March 2018 and March 2019 consisting of two rounds of emailed questionnaires and supplementary face-to-face meetings. The panel members approved the final manuscript via email correspondence, and the threshold for consensus was at least 80% concurrence among the panel members. RESULTS: The manuscript includes extensive detailed discussion regarding a variety of laser platforms commonly used for traumatic scar management such as vascular lasers and ablative and non-ablative fractional lasers, special considerations such as coding and laser treatments in skin of color, and 25 summary consensus recommendations. CONCLUSIONS: Lasers are a first-line therapy in the management of traumatic scars and contractures, and patients without access to these treatments may not be receiving the best available care after injury. Updated international treatment guidelines and reimbursement schemes, additional high-quality research, and patient access should reflect this status. Lasers Surg. Med.
BACKGROUND AND OBJECTIVES: There is currently intense multidisciplinary interest and a maturing body of literature regarding laser treatments for traumatic scars, but international treatment guidelines and reimbursement schemes have not yet caught up with current knowledge and practice in many centers. The authors intend to highlight the tremendous potential of laser techniques, offer recommendations for safe and efficacious treatment, and promote wider patient access guided by future high-quality research. STUDY DESIGN/ MATERIALS AND METHODS: An international panel of 26 dermatologists and plastic and reconstructive surgeons from 13 different countries and a variety of practice backgrounds was self-assembled to develop updated consensus recommendations for the laser treatment of traumatic scars. A three-step modified Delphi method took place between March 2018 and March 2019 consisting of two rounds of emailed questionnaires and supplementary face-to-face meetings. The panel members approved the final manuscript via email correspondence, and the threshold for consensus was at least 80% concurrence among the panel members. RESULTS: The manuscript includes extensive detailed discussion regarding a variety of laser platforms commonly used for traumatic scar management such as vascular lasers and ablative and non-ablative fractional lasers, special considerations such as coding and laser treatments in skin of color, and 25 summary consensus recommendations. CONCLUSIONS: Lasers are a first-line therapy in the management of traumatic scars and contractures, and patients without access to these treatments may not be receiving the best available care after injury. Updated international treatment guidelines and reimbursement schemes, additional high-quality research, and patient access should reflect this status. Lasers Surg. Med.
Authors: Brittany Buhalog; Farah Moustafa; Lisa Arkin; Kachiu Lee; Katherine Siwy; Matthias Donelan; C Scott Hultman; Peter R Shumaker Journal: Arch Dermatol Res Date: 2020-09-14 Impact factor: 3.017