title: The Use of CO2 Fractional Photothermolysis for the Treatment of Burn Scars.
abstract: A recent advancement in the treatment of burn scars has been the use of the carbon dioxide (CO2) laser to perform fractional photothermolysis. In this analysis, we describe our results and patient-reported outcomes with the use of fractional CO2 laser for the treatment of burn-related scarring. We performed a retrospective study of all patients who underwent CO2 laser procedures for treatment of symptomatic burn scars and skin grafts at one accredited regional burn center. Burn injury and laser treatment demographics, as well as complications, are reported. A questionnaire was administered to all patients and included patient-reported outcome measures aimed at understanding the patient experience and their subjective response to treatment. A total of 387 CO2 laser procedures were performed on 131 patients for the treatment of symptomatic burn scars and skin grafts between October 1, 2011, and May 1, 2014 (average, 2.95 procedures/patient; range, 1-11). Average time between injury and first laser was 597.35 days (range, 60-13,475). Average time between laser treatments (when multiple) was 117.73 days (range, 22-514). There were no infections requiring treatment with oral antibiotics. Overall patient satisfaction with laser therapy was 96.7%. Patients reported reductions in neuropathic pain, tightness (contracture), and pruritus (54.0, 50.6, and 49.0%, respectively). Fractional photothermolysis utilizing the CO2 laser is a safe and effective modality for the treatment of symptomatic burn scars, donor sites, and skin grafts. Patient satisfaction with this procedure is high, and complications are low. Significant improvements in scar appearance, pliability, tightness, neuropathic pain, and pruritus were commonly reported.
authors.affiliation: From the Division of Burns, Massachusetts General Hospital, Harvard Medical School.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Levi
authors.forename: Amir
authors.initials: A
authors.lastname: Ibrahim
authors.forename: Katie
authors.initials: K
authors.lastname: Mathews
authors.forename: Brandon
authors.initials: B
authors.lastname: Wojcik
authors.forename: Jason
authors.initials: J
authors.lastname: Gomez
authors.forename: Shawn
authors.initials: S
authors.lastname: Fagan
authors.forename: William Gerald
authors.initials: WG
authors.lastname: Austen
authors.forename: Jeremy
authors.initials: J
authors.lastname: Goverman
mesh_terms: D000328:Adult; D002056:Burns / Q000150:complications*; D017439:Cicatrix, Hypertrophic / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D054020:Lasers, Gas / Q000627:therapeutic use*; D008297:Male; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000009:adverse effects; D011795:Surveys and Questionnaires; D016896:Treatment Outcome