title: Ablative CO2 fractional resurfacing in treatment of thermal burn scars: an open-label controlled clinical and histopathological study.
abstract: BACKGROUND
  Burn scars can cause permanent disfiguring problems with limited treatments available.
  
  
  OBJECTIVE
  To assess and correlate the clinical and histopathological effects of fractional CO2 laser on thermal burns in a controlled study.
  
  
  METHODS
  Fifteen patients 11 with hypertrophic and four with keloidal scars received three CO2 fractional laser sessions every 4-6 weeks. Half of the scar was untreated as a control. Clinical evaluation by Vancouver, PSOAS scores, and photography before, monthly, and 3 months after the last laser session was performed. Ten patients were evaluated histopathologically by standard H&E, Masson trichrome, and Elastica von Gieson special stains.
  
  
  RESULTS
  Hypertrophic scars (HTSs) showed textural improvement and a significant decrease of Vancouver, POSAS observer, and patient scores by the end of follow-up period in the laser-treated area (P = 0.011, 0.017 and 0.018, respectively) unlike keloidal scars. Histopathology revealed significant decrease in scar thickness in HTSs only (P < 0.001) as well as a significant decrease in collagen bundle thickness and density in the upper dermis in both types of scars.
  
  
  CONCLUSIONS
  Fractional CO2 laser is a possible safe and effective modality for the treatment of hypertrophic burn scars with improvement achieved both clinically and histopathologically.
authors.affiliation: Department of Dermatology, Kasr El-Aini University Hospital, Cairo University, Cairo, Egypt.
authors.forename: Bakr M
authors.initials: BM
authors.lastname: El-Zawahry
authors.affiliation: Department of Dermatology, Kasr El-Aini University Hospital, Cairo University, Cairo, Egypt.
authors.forename: Rehab M
authors.initials: RM
authors.lastname: Sobhi
authors.affiliation: Department of Dermatology, Kasr El-Aini University Hospital, Cairo University, Cairo, Egypt.
authors.forename: Dalia A
authors.initials: DA
authors.lastname: Bassiouny
authors.affiliation: Department of Pathology, Kasr El-Aini University Hospital, Cairo University, Cairo, Egypt.
authors.forename: Sahar A
authors.initials: SA
authors.lastname: Tabak
mesh_terms: D000293:Adolescent; D000328:Adult; D002056:Burns / Q000150:complications*; D017439:Cicatrix, Hypertrophic / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007627:Keloid / Q000473:pathology* / Q000601:surgery*; D054020:Lasers, Gas / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D017060:Patient Satisfaction; D016896:Treatment Outcome; D055815:Young Adult
keywords: CO2 laser; Elastica von Gieson; ablative; fractional; histopathologic; masson trichrome; scars; thermal burn