title: Ultrapulsed fractional ablative carbon dioxide laser treatment of hypertrophic burn scars: evaluation of an in-patient controlled, standardized treatment approach.
abstract: In this study, we aimed to quantify the effects of fractional ablative carbon dioxide laser therapy in the treatment of widespread hypertrophic burn scars. While many different pilot studies have described the potential of the technology and expert groups and current guidelines, alike, recommend its use, the level of evidence for the efficacy of fractional CO2-laser treatment for burn scars is currently very low. Ten patients (three male, seven female) with hypertrophic burn scars were treated with a single course of fractional CO2-laser therapy in an in-patient controlled setup, using a standardized treatment paradigm. Documentation was based on modern scar scales and questionnaires, like the Vancouver Scar Scale (VSS), Patient and Observer Scar Assessment Scale (POSAS), and Dermatology Life Quality Index (DLQI), as well as state of the art clinical measurements (PRIMOS, Cutometer). Over the course of 6 months after treatment, VSS and POSAS scores showed significant improvement in the rating of scar parameters, as did the quality of life rating according to the DLQI. In the treated scars, surface relief improved significantly, as Smaxdecreased by 1893 μm (-36.92%) (p = 0.0273) and Szby 1615 μm (-36.37%) (p = 0.0488). Scar firmness in treated scars could be reduced by 30% after one treatment session, as R0improved by 0.0797 mm (+30.38%) (p = 0.0212). Fractional ablative CO2-laser treatment is a safe and efficacious option for the treatment of hypertrophic burn scars. While more treatment sessions are required for satisfying results, significant improvement is already apparent after a single course of treatment.
authors.affiliation: Department of Dermatology and Allergy, Ludwig-Maximilian-University Munich, Frauenlobstr. 9-11, 80337, Munich, Germany.
authors.forename: Julian
authors.initials: J
authors.lastname: Poetschke
authors.affiliation: Department of Plastic, Reconstructive, Hand, and Burn Surgery, Bogenhausen Academic Hospital, Munich, Germany.
authors.forename: Ulf
authors.initials: U
authors.lastname: Dornseifer
authors.affiliation: Skin House, Milan, Italy.
authors.forename: Matteo Tretti
authors.initials: MT
authors.lastname: Clementoni
authors.affiliation: Department of Dermatology and Allergy, Ludwig-Maximilian-University Munich, Frauenlobstr. 9-11, 80337, Munich, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Reinholz
authors.affiliation: Department of Dermatology and Allergy, Ludwig-Maximilian-University Munich, Frauenlobstr. 9-11, 80337, Munich, Germany.
authors.forename: Hannah
authors.initials: H
authors.lastname: Schwaiger
authors.affiliation: Department of Dermatology and Allergy, Ludwig-Maximilian-University Munich, Frauenlobstr. 9-11, 80337, Munich, Germany.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Steckmeier
authors.affiliation: Department of Dermatology and Allergy, Ludwig-Maximilian-University Munich, Frauenlobstr. 9-11, 80337, Munich, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Ruzicka
authors.affiliation: Department of Dermatology and Allergy, Ludwig-Maximilian-University Munich, Frauenlobstr. 9-11, 80337, Munich, Germany. gerd.gauglitz@med.uni-muenchen.de.
authors.forename: Gerd G
authors.initials: GG
authors.lastname: Gauglitz
mesh_terms: D000328:Adult; D002056:Burns / Q000601:surgery*; D017439:Cicatrix, Hypertrophic / Q000601:surgery*; D005260:Female; D006801:Humans; D054020:Lasers, Gas / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Burn scar; Burn trauma; CO2 laser; DLQI; Fractional ablative laser; POSAS; PRIMOS; Vancouver Scar Scale; Widespread hypertrophic scarring