TY - JOUR
T1 - Fractional CO 2 Laser Treatment Outcomes for Pediatric Hypertrophic Burn Scars
AU - Patel, Sagar P.
AU - Nguyen, Ha Vi
AU - Mannschreck, Diana
AU - Redett, Richard J.
AU - Puttgen, Katherine B.
AU - Stewart, F. Dylan
N1 - Publisher Copyright:
© American Burn Association 2019. All rights reserved.
PY - 2019/6/21
Y1 - 2019/6/21
N2 - Carbon dioxide ablative fractional laser (CO 2 -AFL) therapy has not been widely adopted in pediatric burn care given limited outcomes literature and no established guidelines on laser treatment protocols. We present our experience to further elucidate the clinical role of CO 2 -AFL therapy for pediatric hypertrophic burn scars. We conducted a prospective cohort study of pediatric burn patients undergoing CO 2 -AFL treatment of hypertrophic, symptomatic burn scars at a tertiary care regional burn center during a 2-year period. Scars were assessed before each treatment using the Patient and Observer Scar Assessment Scale (POSAS), a validated, subjective, comprehensive scar assessment tool. We treated 49 pediatric patients for a total of 180 laser sessions. Burn severity was full thickness (63.6%) or deep partial thickness (47.7%). Observer-rated POSAS scores revealed statistically significant improvements in pigment, thickness, relief, pliability, and surface area after one treatment with continued improvement until the last laser session. Patient-rated POSAS revealed statistically significant improvements in color, stiffness, thickness, and irregularity after laser treatments. Total POSAS improved from 89.6 ± 17.5 to 76.6 ± 16.8 (P <.0001) after one treatment with further improvement to 69.2 ± 14.9 (P <.0001) at the final laser session. We found convincing evidence that CO 2 -AFL therapy improves hypertrophic burn scars on both patient- and observer-rated scales confirming statistical and clinical significance to both providers and families. These findings demonstrate that CO 2 -AFL can improve hypertrophic burn scars in pediatric patients providing a lower risk alternative to invasive therapies and a more immediate, efficacious alternative to more conservative scar treatments.
AB - Carbon dioxide ablative fractional laser (CO 2 -AFL) therapy has not been widely adopted in pediatric burn care given limited outcomes literature and no established guidelines on laser treatment protocols. We present our experience to further elucidate the clinical role of CO 2 -AFL therapy for pediatric hypertrophic burn scars. We conducted a prospective cohort study of pediatric burn patients undergoing CO 2 -AFL treatment of hypertrophic, symptomatic burn scars at a tertiary care regional burn center during a 2-year period. Scars were assessed before each treatment using the Patient and Observer Scar Assessment Scale (POSAS), a validated, subjective, comprehensive scar assessment tool. We treated 49 pediatric patients for a total of 180 laser sessions. Burn severity was full thickness (63.6%) or deep partial thickness (47.7%). Observer-rated POSAS scores revealed statistically significant improvements in pigment, thickness, relief, pliability, and surface area after one treatment with continued improvement until the last laser session. Patient-rated POSAS revealed statistically significant improvements in color, stiffness, thickness, and irregularity after laser treatments. Total POSAS improved from 89.6 ± 17.5 to 76.6 ± 16.8 (P <.0001) after one treatment with further improvement to 69.2 ± 14.9 (P <.0001) at the final laser session. We found convincing evidence that CO 2 -AFL therapy improves hypertrophic burn scars on both patient- and observer-rated scales confirming statistical and clinical significance to both providers and families. These findings demonstrate that CO 2 -AFL can improve hypertrophic burn scars in pediatric patients providing a lower risk alternative to invasive therapies and a more immediate, efficacious alternative to more conservative scar treatments.
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U2 - 10.1093/jbcr/irz046
DO - 10.1093/jbcr/irz046
M3 - Article
C2 - 31225898
AN - SCOPUS:85068553294
SN - 1559-047X
VL - 40
SP - 386
EP - 391
JO - Journal of Burn Care and Research
JF - Journal of Burn Care and Research
IS - 4
M1 - irz046
ER -