Fractional CO 2 Laser Treatment Outcomes for Pediatric Hypertrophic Burn Scars

Sagar P. Patel, Ha Vi Nguyen, Diana Mannschreck, Richard Redett, Katherine B. Puttgen, F. Dylan Stewart

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Article numberirz046
Pages (from-to)386-391
Number of pages6
JournalJournal of Burn Care and Research
Volume40
Issue number4
DOIs
StatePublished - Jun 21 2019

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Hypertrophic Cicatrix
Carbon Monoxide
Lasers
Cicatrix
Pediatrics
Therapeutics
Burn Units
Tertiary Healthcare
Clinical Protocols
Carbon Dioxide
Pliability
Cohort Studies
Color
Prospective Studies
Guidelines

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine
  • Rehabilitation

Cite this

Patel, S. P., Nguyen, H. V., Mannschreck, D., Redett, R., Puttgen, K. B., & Stewart, F. D. (2019). Fractional CO 2 Laser Treatment Outcomes for Pediatric Hypertrophic Burn Scars. Journal of Burn Care and Research, 40(4), 386-391. [irz046]. https://doi.org/10.1093/jbcr/irz046

Fractional CO 2 Laser Treatment Outcomes for Pediatric Hypertrophic Burn Scars. / Patel, Sagar P.; Nguyen, Ha Vi; Mannschreck, Diana; Redett, Richard; Puttgen, Katherine B.; Stewart, F. Dylan.

In: Journal of Burn Care and Research, Vol. 40, No. 4, irz046, 21.06.2019, p. 386-391.

Research output: Contribution to journalArticle

Patel, SP, Nguyen, HV, Mannschreck, D, Redett, R, Puttgen, KB & Stewart, FD 2019, 'Fractional CO 2 Laser Treatment Outcomes for Pediatric Hypertrophic Burn Scars', Journal of Burn Care and Research, vol. 40, no. 4, irz046, pp. 386-391. https://doi.org/10.1093/jbcr/irz046
Patel, Sagar P. ; Nguyen, Ha Vi ; Mannschreck, Diana ; Redett, Richard ; Puttgen, Katherine B. ; Stewart, F. Dylan. / Fractional CO 2 Laser Treatment Outcomes for Pediatric Hypertrophic Burn Scars. In: Journal of Burn Care and Research. 2019 ; Vol. 40, No. 4. pp. 386-391.
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