title: Laser treatment of traumatic scars with an emphasis on ablative fractional laser resurfacing: consensus report.
abstract: OBJECTIVE
  Despite expert wound care and assiduous management with traditional therapy, poor cosmetic outcomes, restricted motion, and symptoms such as pain and itch are a pervasive problem of disfiguring and debilitating scars. The advent of ablative fractional photothermolysis within the past decade and its application to the treatment of traumatic scars represents a breakthrough in the restoration of function and cosmetic appearance for injured patients, but the procedure is not widely used.
  
  
  OBJECTIVE
  To provide a synthesis of our current clinical experience and available literature regarding the laser treatment of traumatic scars with an emphasis on fractional resurfacing.
  
  
  METHODS
  Eight independent, self-selected academic and military dermatology and plastic surgery physicians with extensive experience in the use of lasers for scar treatment assembled for a 2-day ad hoc meeting on January 19 and 20, 2012. Consensus was based largely on expert opinion, but relevant literature was cited where it exists.
  
  
  RESULTS
  After consensus was appraised, we drafted the manuscript in sections during the course of several months. The draft was then circulated among all panel members for final review and comment. Our consensus is that laser treatment, particularly ablative fractional resurfacing, deserves a prominent role in future scar treatment paradigms, with the possible inclusion of early intervention for contracture avoidance and assistance with wound healing.
  
  
  CONCLUSIONS
  Laser scar therapy, particularly fractional ablative laser resurfacing, represents a promising and vastly underused tool in the multidisciplinary treatment of traumatic scars. Changes to existing scar treatment paradigms should include extensive integration of fractional resurfacing and other combination therapies guided by future research.
authors: Wellman Center for Photomedicine, Massachusetts General Hospital, Boston.
authors: R Rox
authors: RR
authors: Anderson
authors: Department of Plastic Surgery, Shriner's Hospital for Children, Boston, Massachusetts.
authors: Matthias B
authors: MB
authors: Donelan
authors: San Antonio Uniformed Health Education Consortium, Lackland Air Force Base, Texas.
authors: Chad
authors: C
authors: Hivnor
authors: San Antonio Uniformed Health Education Consortium, Lackland Air Force Base, Texas.
authors: Eric
authors: E
authors: Greeson
authors: Scripps Clinic Laser and Cosmetic Dermatology Center, San Diego, California.
authors: E Victor
authors: EV
authors: Ross
authors: Department of Dermatology, Naval Medical Center, San Diego, California.
authors: Peter R
authors: PR
authors: Shumaker
authors: Department of Dermatology, Naval Medical Center, San Diego, California.
authors: Nathan S
authors: NS
authors: Uebelhoer
authors: Miami Dermatology and Laser Institute, Miami, Florida.
authors: Jill S
authors: JS
authors: Waibel
mesh_terms: D002921:Cicatrix / Q000473:pathology / Q000628:therapy*; D003357:Cosmetic Techniques; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D017410:Practice Guidelines as Topic; D014945:Wound Healing