title: Ablative fractional laser resurfacing helps treat restrictive pediatric scar contractures.
abstract: Conventional management of debilitating pediatric scar contractures, including hand therapy and surgery, may often be beset by delayed treatment, suboptimal results, and additional surgical morbidity. Ablative fractional laser resurfacing is an emerging adjunctive procedural option for scar contractures because of its promising efficacy and safety profile. However, its use to improve function has not been studied in the pediatric population. Herein we report 2 pediatric patients with recalcitrant scar contractures, causing persistent functional deficits, treated with an ablative fractional laser protocol. Both patients experienced rapid and cumulative subjective and objective improvements in range of motion and function as measured by an independent occupational therapist without reported complications. We highlight ablative fractional laser resurfacing as a novel and promising tool in the management of function-limiting scar contractures in children and propose that the technique be incorporated into existing scar treatment paradigms, guided by future research.
authors.affiliation: Division of Pediatric and Adolescent Dermatology, and akrakowski@rchsd.org.
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Krakowski
authors.affiliation: University of California San Diego School of Medicine, San Diego, California; and.
authors.forename: Alina
authors.initials: A
authors.lastname: Goldenberg
authors.affiliation: Division of Pediatric and Adolescent Dermatology, and.
authors.forename: Lawrence F
authors.initials: LF
authors.lastname: Eichenfield
authors.affiliation: Occupational Therapy, Rady Children's Hospital, San Diego, California;
authors.forename: Jill-Peck
authors.initials: JP
authors.lastname: Murray
authors.affiliation: Department of Dermatology, Naval Medical Center, San Diego, California.
authors.forename: Peter R
authors.initials: PR
authors.lastname: Shumaker
mesh_terms: D000293:Adolescent; D002056:Burns / Q000601:surgery*; D002675:Child, Preschool; D017439:Cicatrix, Hypertrophic / Q000601:surgery*; D003286:Contracture / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006227:Hand Deformities, Acquired / Q000601:surgery*; D006801:Humans; D053685:Laser Therapy; D054020:Lasers, Gas / Q000627:therapeutic use*; D008297:Male
keywords: carbon dioxide; contracture; fractional; function; hand; laser; pediatric; scar; therapy