Incidence and Management of Adverse Events After the Use of Laser Therapies for the Treatment of Hypertrophic Burn Scars

Clayton, John L.; Edkins, Renee E.; Cairns, Bruce A.; Hultman, C. Scott

doi:10.1097/sap.0b013e31827eac79

Cited by 42 publications

(26 citation statements)

References 22 publications

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“…Thus, 82% of patients reported improvement of scar appearance despite mild adverse effects. Still, the complication rates are somewhat higher than elsewhere reported [27,28], which may be explained by the application of multiple passes or high pulse energies. Moreover, visible imprints from laser grids have, to our knowledge, not previously been described.…”

Section: Discussioncontrasting

confidence: 42%

Non‐ablative fractional laser provides long‐term improvement of mature burn scars–A randomized controlled trial with histological assessment

et al. 2014

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Section: Discussioncontrasting

confidence: 42%

Non‐ablative fractional laser provides long‐term improvement of mature burn scars–A randomized controlled trial with histological assessment

et al. 2014

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“…A, Photograph taken just before first laser, approximately 4 months after burn. B, Photograph taken after five treatments (5,8,9,11, and 13 months after burn). before and after laser treatments to the forearm and upper extremity in the same patient.…”

Section: Short Form 36 Resultsmentioning

confidence: 99%

“…A total of 387 CO 2 laser procedures were performed on 131 patients for the treatment of symptomatic burn scars and skin grafts between October 1, 2011 and May 1, 2014 (average, 2.95 procedures per patient; range [1][2][3][4][5][6][7][8][9][10][11]. Patients were all adults with an average age of 43.0: 67 men and 64 women.…”

Section: Demographicsmentioning

confidence: 99%

“…More recently, the use of certain lasers, with and without surgical release, has been shown to be beneficial in the treatment of HTSs, as well as their associated symptoms. [5][6][7][8][9][10][11][12][13] Laser treatment of HTS, in particular pulsed dye and fractional CO 2 , has been shown to improve abnormal pigmentation, pruritus, pain, tightness, and the abnormal appearance of a previously meshed skin graft. 6,8,10,[14][15][16][17] Mechanistically, the idea has been proposed that the laser, like the knife in a Z-plasty, breaks up the disorganized collagen fibrils that create the contracture.…”

mentioning

confidence: 99%

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The Use of CO2 Fractional Photothermolysis for the Treatment of Burn Scars

Lévi¹,

Ibrahim²,

Mathews³

et al. 2016

Journal of Burn Care & Research

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A recent advancement in the treatment of burn scars has been the use of the carbon dioxide (CO2) laser to perform fractional photothermolysis. In this analysis, we describe our results and patient-reported outcomes with the use of fractional CO2 laser for the treatment of burn-related scarring. We performed a retrospective study of all patients who underwent CO2 laser procedures for treatment of symptomatic burn scars and skin grafts at one accredited regional burn center. Burn injury and laser treatment demographics, as well as complications, are reported. A questionnaire was administered to all patients and included patient-reported outcome measures aimed at understanding the patient experience and their subjective response to treatment. A total of 387 CO2 laser procedures were performed on 131 patients for the treatment of symptomatic burn scars and skin grafts between October 1, 2011, and May 1, 2014 (average, 2.95 procedures/patient; range, 1-11). Average time between injury and first laser was 597.35 days (range, 60-13,475). Average time between laser treatments (when multiple) was 117.73 days (range, 22-514). There were no infections requiring treatment with oral antibiotics. Overall patient satisfaction with laser therapy was 96.7%. Patients reported reductions in neuropathic pain, tightness (contracture), and pruritus (54.0, 50.6, and 49.0%, respectively). Fractional photothermolysis utilizing the CO2 laser is a safe and effective modality for the treatment of symptomatic burn scars, donor sites, and skin grafts. Patient satisfaction with this procedure is high, and complications are low. Significant improvements in scar appearance, pliability, tightness, neuropathic pain, and pruritus were commonly reported.

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“…Utilizing selective photothermolysis and fractional ablation to target hyperthrophic scar tissue provides a novel method to modulate the composition of the scar and may even result in reduction of scar restriction and contracture release [37]. Overall, laser therapy is associated with a low complication risk profile [38]. Laser therapy is usually initiated around 6–12 months.…”

Section: Treatment Of Hypertrophic Scarsmentioning

confidence: 99%

Scar Management of the Burned Hand

2017

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Unimpaired hand function is critical in almost all activities of daily living. Burn injury can result in hypertrophic scar formation that can lead to debilitating functional deficits and poor aesthetic outcomes. Initial algorithms of acute burn management involve early debridement and skin grafting and early mobilization to prevent formation of hypertrophic scarring and ultimately digit contractures. While non-operative modalities in the early phase of scar maturation are critical to minimize hypertrophic scar formation, surgical management is often indicated in order to restore hand function. The essential tenant of operative scar management is release of tension, which can often be achieved through local tissue rearrangement. Laser therapy has emerged as a central pillar of subsequent scar rehabilitation with several modalities that address scar texture, color, pruritis and thickness. These can be utilized in conjunction with local corticosteroid treatment and other emerging modalities to modulate the scar and achieve optimal hand function. These treatment tools provide an effective resource for the reconstructive surgeon to treat hypertrophic hand scars.

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Incidence and Management of Adverse Events After the Use of Laser Therapies for the Treatment of Hypertrophic Burn Scars

Cited by 42 publications

References 22 publications

Non‐ablative fractional laser provides long‐term improvement of mature burn scars–A randomized controlled trial with histological assessment

Non‐ablative fractional laser provides long‐term improvement of mature burn scars–A randomized controlled trial with histological assessment

The Use of CO2 Fractional Photothermolysis for the Treatment of Burn Scars

Scar Management of the Burned Hand

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