title: Rapid healing of scar-associated chronic wounds after ablative fractional resurfacing.
abstract: BACKGROUND
  Skin compromised by traumatic scars and contractures can manifest decreased resistance to shearing and other forces, while increased tension and skin fragility contribute to chronic erosions and ulcerations. Chronic wounds possess inflammatory mediator profiles and other characteristics, such as the presence of biofilms, that can inhibit healing.
  
  
  METHODS
  Three patients with multiple traumatic scars related to blast injuries initiated a course of ablative fractional laser therapy for potential mitigation of contractures, poor pliability, and textural irregularity. Patients also had chronic focal erosions or ulcerations despite professional wound care. All patients experienced incidental rapid healing of their chronic wounds within 2 weeks of their initial ablative fractional laser treatment. Healing was sustained throughout the treatment course and beyond and was associated with gradual enhancements in scar pliability, texture, durability, and range of motion.
  
  
  CONCLUSIONS
  The unique pattern of injury associated with ablative fractional laser treatment may have various potential wound-healing advantages. These advantages include the novel concept of photomicrodebridement, including biofilm disruption and the stimulation of de novo growth factor secretion and collagen remodeling. If confirmed, ablative fractional resurfacing could be a potent new addition to traditional wound and scar treatment paradigms.
authors.forename: Peter R
authors.initials: PR
authors.lastname: Shumaker
authors.forename: Julia M
authors.initials: JM
authors.lastname: Kwan
authors.forename: Evangelos V
authors.initials: EV
authors.lastname: Badiavas
authors.forename: Jill
authors.initials: J
authors.lastname: Waibel
authors.forename: Stephen
authors.initials: S
authors.lastname: Davis
authors.forename: Nathan S
authors.initials: NS
authors.lastname: Uebelhoer
mesh_terms: D000328:Adult; D001753:Blast Injuries / Q000150:complications*; D002908:Chronic Disease; D002921:Cicatrix / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D003094:Collagen / Q000378:metabolism; D003286:Contracture / Q000209:etiology / Q000473:pathology; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D016059:Range of Motion, Articular; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D003094:Collagen