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Combination treatment utilizing fractional ablative and continuous wave CO 2 lasers for hypertrophic burn scars

Authors
 Jung Hwan Lee  ;  Chan Eol Seo  ;  Woo Jin Song  ;  Min Ju Kwon  ;  Yang Seo Park  ;  Jang Hyu Ko  ;  Jong Won Hong  ;  Myung Chul Lee 
Citation
 BURNS, Vol.47(5) : 1084-1093, 2021-08 
Journal Title
BURNS
ISSN
 0305-4179 
Issue Date
2021-08
MeSH
Adult ; Burns* / complications ; Carbon Dioxide / therapeutic use* ; Cicatrix, Hypertrophic* / etiology ; Cicatrix, Hypertrophic* / pathology ; Cicatrix, Hypertrophic* / surgery ; Female ; Humans ; Lasers, Gas* / therapeutic use ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult
Keywords
Burn ; Combination laser ; Hypertrophic scar ; Quality of life ; Scar laser
Abstract
Background: Hypertrophic scars are devastating outcomes of severe burn injuries, producing physical and mental burdens. Adequate treatment is of benefit to relieve these burdens. Laser therapy has shown scar reducing effects. In this study, we compared outcomes after combination of two different lasers or single laser treatment to treat severe hypertrophic burn scars.

Methods: Forty patients with hypertrophic burn scars were included in one of two therapeutic groups: continuous wave CO2 laser and fractional ablative CO2 laser group (group 1, n = 20) or fractional ablative CO2 laser alone group (group 2, n = 20). Hypertrophic scars were evaluated by the observer-rated Vancouver Scar Scale (VSS) before and after treatment and by patient-completed questionnaires after treatment. Comparative analyses were performed before and after treatment, and time-dependent improvement was also analyzed.

Results: Forty patients (54 hypertrophic scars) completed the laser treatment protocols. Group 1 exhibited significantly more improvement in VSS vascularity, pliability, and height indices than group 2 (p < 0.05). Time-dependent analysis of total VSS scores suggested that group 1 experienced more improvement during a shorter treatment period (p < 0.05). For patient-reported outcomes, group 1 noted better grades than group 2 in four indices, namely scar appearance, scar thickness, pain, and pruritus (p < 0.05).

Conclusion: Effective scar reduction was achieved using combination laser treatment, with significant improvement in multiple observer- and patient-reported outcomes. The shorter treatment period of the combination method can be a merit, as prolonged hypertrophic scars may increase morbidity. Nonetheless, cautious treatment protocols are necessary to avoid undesirable sequelae related to laser application.
Full Text
https://www.sciencedirect.com/science/article/pii/S0305417920305647
DOI
10.1016/j.burns.2020.10.015
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Plastic and Reconstructive Surgery (성형외과학교실) > 1. Journal Papers
Yonsei Authors
Hong, Jong Won(홍종원) ORCID logo https://orcid.org/0000-0002-7762-0940
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/190488
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