Efficacy of intense pulsed light for the treatment of burn scar dyschromias: A pilot study to assess patient satisfaction, safety, and willingness to pay

Charles Scott Hultman, Jonathan S. Friedstat, Renee E. Edkins

Research output: Contribution to journalArticle

Abstract

Introduction: No treatment algorithms exist to reliably treat burn scar dyschromias. Intense pulsed light (IPL) has been used successfully to treat hyperpigmentation disorders, but has not been studied extensively in the treatment of burn scars. The purpose of this investigation was to assess clinical efficacy and patient satisfaction with IPL for the treatment of burn scar dyschromia. Methods: Patients with burn scar dyschromias were treated using the Lume 1 platform (Lumenis) to target pigmented lesions, using fluences between 10 and 22 joules/cm 2 and filters ranging from 560 to 650 nm. At the conclusion of the study, providers assessed changes in burn scar dyschromia, whereas patients were queried regarding satisfaction and perceived efficacy, using a 1 to 5 Likert scale. The patients, who were not charged for the IPL treatment, were queried regarding willingness to pay. Results: Twenty patients (mean age, 35.4 years; mean total body surface area, 27.6%; mean composite Fitzpatrick score, 3.9) underwent IPL treatment of burn scar dyschromias, an average of 3.2 years after injury. Mean fluence was 15.4 J/cm 2 (range, 10-22 J/cm 2 ), and the most common filter used was 590 nm (range, 560-650 nm). Mean area treated was 90.7 cm 2 , with a range of 4 to 448 cm 2 . Complications included pain (4), hyperpigmentation (1), and blistering (2). Sixteen patients noted mild to moderate improvement, reporting a 4.5 for efficacy and a 4.4 for satisfaction. Regarding willingness to pay, patients would spend a mean of U.S. $7429 to completely remove their scars, but only a median of U.S. $350 to get the actual results that they received. Mean length of follow-up was 3.8 months, with a standard deviation of 2.2 months. Conclusions: Patients perceived IPL as an efficacious modality in the treatment of burn scar dyschromia, with a high level of satisfaction, despite the potential for morbidity. However, we are reluctant to recommend IPL for routine treatment of burn scar dyschromias, given only minimal improvement observed, potential for complications, and a willingness to pay that is lower than the cost of providing care.

Original languageEnglish (US)
Pages (from-to)S204-S208
JournalAnnals of plastic surgery
Volume74
DOIs
StatePublished - Jun 1 2015
Externally publishedYes

Fingerprint

Patient Safety
Patient Satisfaction
Cicatrix
Light
Hyperpigmentation
Therapeutics
Body Surface Area
Morbidity
Costs and Cost Analysis
Pain
Wounds and Injuries

Keywords

  • Burn scar
  • Dyschromia
  • Intense pulsed light

ASJC Scopus subject areas

  • Surgery

Cite this

Efficacy of intense pulsed light for the treatment of burn scar dyschromias : A pilot study to assess patient satisfaction, safety, and willingness to pay. / Hultman, Charles Scott; Friedstat, Jonathan S.; Edkins, Renee E.

In: Annals of plastic surgery, Vol. 74, 01.06.2015, p. S204-S208.

Research output: Contribution to journalArticle

@article{a7397ed588c3458397d5854e1b7abb30,
title = "Efficacy of intense pulsed light for the treatment of burn scar dyschromias: A pilot study to assess patient satisfaction, safety, and willingness to pay",
abstract = "Introduction: No treatment algorithms exist to reliably treat burn scar dyschromias. Intense pulsed light (IPL) has been used successfully to treat hyperpigmentation disorders, but has not been studied extensively in the treatment of burn scars. The purpose of this investigation was to assess clinical efficacy and patient satisfaction with IPL for the treatment of burn scar dyschromia. Methods: Patients with burn scar dyschromias were treated using the Lume 1 platform (Lumenis) to target pigmented lesions, using fluences between 10 and 22 joules/cm 2 and filters ranging from 560 to 650 nm. At the conclusion of the study, providers assessed changes in burn scar dyschromia, whereas patients were queried regarding satisfaction and perceived efficacy, using a 1 to 5 Likert scale. The patients, who were not charged for the IPL treatment, were queried regarding willingness to pay. Results: Twenty patients (mean age, 35.4 years; mean total body surface area, 27.6{\%}; mean composite Fitzpatrick score, 3.9) underwent IPL treatment of burn scar dyschromias, an average of 3.2 years after injury. Mean fluence was 15.4 J/cm 2 (range, 10-22 J/cm 2 ), and the most common filter used was 590 nm (range, 560-650 nm). Mean area treated was 90.7 cm 2 , with a range of 4 to 448 cm 2 . Complications included pain (4), hyperpigmentation (1), and blistering (2). Sixteen patients noted mild to moderate improvement, reporting a 4.5 for efficacy and a 4.4 for satisfaction. Regarding willingness to pay, patients would spend a mean of U.S. $7429 to completely remove their scars, but only a median of U.S. $350 to get the actual results that they received. Mean length of follow-up was 3.8 months, with a standard deviation of 2.2 months. Conclusions: Patients perceived IPL as an efficacious modality in the treatment of burn scar dyschromia, with a high level of satisfaction, despite the potential for morbidity. However, we are reluctant to recommend IPL for routine treatment of burn scar dyschromias, given only minimal improvement observed, potential for complications, and a willingness to pay that is lower than the cost of providing care.",
keywords = "Burn scar, Dyschromia, Intense pulsed light",
author = "Hultman, {Charles Scott} and Friedstat, {Jonathan S.} and Edkins, {Renee E.}",
year = "2015",
month = "6",
day = "1",
doi = "10.1097/SAP.0000000000000447",
language = "English (US)",
volume = "74",
pages = "S204--S208",
journal = "Annals of Plastic Surgery",
issn = "0148-7043",
publisher = "Lippincott Williams and Wilkins",

}

TY - JOUR

T1 - Efficacy of intense pulsed light for the treatment of burn scar dyschromias

T2 - A pilot study to assess patient satisfaction, safety, and willingness to pay

AU - Hultman, Charles Scott

AU - Friedstat, Jonathan S.

AU - Edkins, Renee E.

PY - 2015/6/1

Y1 - 2015/6/1

N2 - Introduction: No treatment algorithms exist to reliably treat burn scar dyschromias. Intense pulsed light (IPL) has been used successfully to treat hyperpigmentation disorders, but has not been studied extensively in the treatment of burn scars. The purpose of this investigation was to assess clinical efficacy and patient satisfaction with IPL for the treatment of burn scar dyschromia. Methods: Patients with burn scar dyschromias were treated using the Lume 1 platform (Lumenis) to target pigmented lesions, using fluences between 10 and 22 joules/cm 2 and filters ranging from 560 to 650 nm. At the conclusion of the study, providers assessed changes in burn scar dyschromia, whereas patients were queried regarding satisfaction and perceived efficacy, using a 1 to 5 Likert scale. The patients, who were not charged for the IPL treatment, were queried regarding willingness to pay. Results: Twenty patients (mean age, 35.4 years; mean total body surface area, 27.6%; mean composite Fitzpatrick score, 3.9) underwent IPL treatment of burn scar dyschromias, an average of 3.2 years after injury. Mean fluence was 15.4 J/cm 2 (range, 10-22 J/cm 2 ), and the most common filter used was 590 nm (range, 560-650 nm). Mean area treated was 90.7 cm 2 , with a range of 4 to 448 cm 2 . Complications included pain (4), hyperpigmentation (1), and blistering (2). Sixteen patients noted mild to moderate improvement, reporting a 4.5 for efficacy and a 4.4 for satisfaction. Regarding willingness to pay, patients would spend a mean of U.S. $7429 to completely remove their scars, but only a median of U.S. $350 to get the actual results that they received. Mean length of follow-up was 3.8 months, with a standard deviation of 2.2 months. Conclusions: Patients perceived IPL as an efficacious modality in the treatment of burn scar dyschromia, with a high level of satisfaction, despite the potential for morbidity. However, we are reluctant to recommend IPL for routine treatment of burn scar dyschromias, given only minimal improvement observed, potential for complications, and a willingness to pay that is lower than the cost of providing care.

AB - Introduction: No treatment algorithms exist to reliably treat burn scar dyschromias. Intense pulsed light (IPL) has been used successfully to treat hyperpigmentation disorders, but has not been studied extensively in the treatment of burn scars. The purpose of this investigation was to assess clinical efficacy and patient satisfaction with IPL for the treatment of burn scar dyschromia. Methods: Patients with burn scar dyschromias were treated using the Lume 1 platform (Lumenis) to target pigmented lesions, using fluences between 10 and 22 joules/cm 2 and filters ranging from 560 to 650 nm. At the conclusion of the study, providers assessed changes in burn scar dyschromia, whereas patients were queried regarding satisfaction and perceived efficacy, using a 1 to 5 Likert scale. The patients, who were not charged for the IPL treatment, were queried regarding willingness to pay. Results: Twenty patients (mean age, 35.4 years; mean total body surface area, 27.6%; mean composite Fitzpatrick score, 3.9) underwent IPL treatment of burn scar dyschromias, an average of 3.2 years after injury. Mean fluence was 15.4 J/cm 2 (range, 10-22 J/cm 2 ), and the most common filter used was 590 nm (range, 560-650 nm). Mean area treated was 90.7 cm 2 , with a range of 4 to 448 cm 2 . Complications included pain (4), hyperpigmentation (1), and blistering (2). Sixteen patients noted mild to moderate improvement, reporting a 4.5 for efficacy and a 4.4 for satisfaction. Regarding willingness to pay, patients would spend a mean of U.S. $7429 to completely remove their scars, but only a median of U.S. $350 to get the actual results that they received. Mean length of follow-up was 3.8 months, with a standard deviation of 2.2 months. Conclusions: Patients perceived IPL as an efficacious modality in the treatment of burn scar dyschromia, with a high level of satisfaction, despite the potential for morbidity. However, we are reluctant to recommend IPL for routine treatment of burn scar dyschromias, given only minimal improvement observed, potential for complications, and a willingness to pay that is lower than the cost of providing care.

KW - Burn scar

KW - Dyschromia

KW - Intense pulsed light

UR - http://www.scopus.com/inward/record.url?scp=84957412606&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84957412606&partnerID=8YFLogxK

U2 - 10.1097/SAP.0000000000000447

DO - 10.1097/SAP.0000000000000447

M3 - Article

C2 - 25803326

AN - SCOPUS:84957412606

VL - 74

SP - S204-S208

JO - Annals of Plastic Surgery

JF - Annals of Plastic Surgery

SN - 0148-7043

ER -