Effects of multiple modes of UltraPulse fractional CO2 laser treatment on extensive scarring: a retrospective study

Abstract

The main therapeutic options for extensive scarring (e.g., > 20% of the total body surface area, or TBSA) after burns and trauma have focused on conservative treatments, such as compression, moisturization, and topical agent application. However, these treatments may not achieve optimal effects due to the large size and complexity of the scars. UltraPulse fractional CO2 laser treatment is a novel approach that is currently a subject of intense interest; this treatment is most widely used to improve texture, pliability, and pigmentation in all types of scars. However, no studies on the independent use of UltraPulse fractional CO2 laser treatment for extensive scars have been reported. This retrospective study evaluated a total of 21 patients, whose scars covered 20 to 65% TBSA. Scar thickness was measured by ultrasonography before treatment. Personalized treatment modalities and parameters were set according to the scar type and thickness. Scar formation and treatment effects were evaluated by photography, the Patient and Observer Scar Assessment Scale (POSAS), and patients’ judgment of effectiveness. Where the scars covered joints, joint function was assessed by measuring the maximum range of motion (ROM). With laser therapy, scars became flatter and lighter; furthermore, pruritus, pain, and discomfort decreased significantly. POSAS scores significantly decreased after laser therapy, including the item scores for pain and pruritus. There were no instances of joint contracture, ROM reduction, apparent functional impairment, serious adverse events, or comorbidities. This study demonstrates the safety and efficiency of UltraPulse fractional CO2 laser treatment for extensive scarring.

Ultrasound measurement of traumatic scar and skin thickness: a scoping review of evidence across the translational pipeline of research-to-practice

“…The most common scar type measured was burn scars in both journal articles (n=43 articles; 52% of articles),17 22–24 27 47 57–59 61 62 64–67 71–75 81 82 84 111–130 and abstracts (n=23 abstracts; 64% of abstracts)28 30 86–88 91–94 96 98 102–106 131–135 (table 2). Most identified articles used ultrasound measurement of scar thickness as part of research initiatives, and were categorised as either phase II (n=50 articles; 61% of articles)17 22 26 31 46–49 51–56 61 63–65 67 69–71 74–76 78 81 83 84 111 112 114 115 117 124–127 129 130 136–145 or phase III (n=30 articles; 37% of articles) 23 24 27 29 50 57–60 62 66 68 72 73 77 79 80 82 85 116 118 120–123 128 146–149. on the research-to-practice pipeline 36.…”

Flexible application of scar tissue flaps in scar contracture release surgery: A retrospective study

“…Such as the autologous tissue flaps or skin graft. 12 These methods have their common disadvantage in that the donor area is damaged or has secondary dysfunction. It was hard for patients to accept, especially for limited donor sites (for example, extensive burns patients), and the prognosis often feels "Scar Moving.…”

“…The simplest and most effective way to eliminate contractures is to remove the scar, but the defect site is often much larger than the original site after the release, which requires the normal tissue to cover it. Such as the autologous tissue flaps or skin graft 12 . These methods have their common disadvantage in that the donor area is damaged or has secondary dysfunction.…”

“…In our cases, we experienced why these scar flaps can simultaneously release and repair the defect. It is characterized by cutting in different directions and entirely using the longitudinal lengthening and transverse shortening characteristics of Z‐plasty and V‐Y‐plasty to lengthen the axis of scar contracture for scar relaxation 12 . The change in the magnitude and direction of tension during the release of scar contracture is complicated and is a dynamic process varying with the choice of the incision.…”

“…It is characterized by cutting in different directions and entirely using the longitudinal lengthening and transverse shortening characteristics of Z-plasty and V-Y-plasty to lengthen the axis of scar contracture for scar relaxation. 12 The change in the magnitude and direction of tension during the release of scar contracture is complicated and is a dynamic process varying with the choice of the incision. Therefore, the number, size, shape, and position of the flap can be changed at any time; if necessary, Z-plasty can be added to the borderline of the wound so that the incision tension line can be dispersed and the contracted area can be relaxed to a greater extent.…”