- 标题
- 摘要
- 关键词
- 实验方案
- 产品
-
Randomized, Controlled Early Intervention of Dynamic Mode Fractional Ablative CO <sub/>2</sub> Laser on Acute Burn Injuries for Prevention of Pathological Scarring
摘要： This study challenges the currently accepted treatment parameters of waiting 1 year following burn injury to treat the resultant scarring. It assesses the impact of treating burn and trauma wounds at less than 3 months of injury on scar formation, providing a new temporal paradigm to patients in the prevention and minimization of scar formation. This randomized clinical trial included 19 patients with moderate‐to‐severe acute burn injuries less than 3 months from injury. The treatment areas underwent three fractional ablative CO2 laser treatments at 8‐week intervals. The primary outcomes were improvement in the Manchester Scar Scale (MSS) and photography. Secondary outcomes were optical coherence tomography (OCT), treatment time, immediate post‐treatment response, and histology. Upon blinded evaluation, 100% of treatment areas were correctly identified when compared with control. MSS scores before and after treatment were totaled with an averaged sum of 13.33 per scar at baseline to 8.39 after treatment, a 63% average improvement versus control (P < 0.001). Histology and OCT demonstrated a re‐organization of the underlying skin structure. The average treatment time was 18 minutes. Immediate post‐treatment responses were limited to mild‐to‐moderate erythema. Early intervention with ablative fractional laser on acute traumatic wounds resulted in significant decrease of scar formation compared with untreated areas on the same wounds, providing an impactful new time course to treat severe burn and trauma injuries.
关键词： scar prevention,fractional ablative laser,burn scars,scars,wound healing
更新于2025-09-19 17:13:59
-
Commentary on the Photomicrodebridement of Unstable Burn Scars Using Ablative Fractional CO2 Laser
摘要： Brown and colleagues describe a case of a 25% total body surface area burn patient with a course complicated by contractures, scar hypertrophy, and chronic skin breakdown despite grafts, multiple release procedures, and wound care. The authors treated her hypertrophic scars and open wounds with photomicrodebridement using ablative fractional (AF) carbon dioxide (CO2) laser (10,600 nm, UltraPulse; Lumenis, Ltd, DeepFx Hand Piece, 100 mJ/cm2, 3% density) followed by topical Kenalog 10 mg/ml and a bandage with betamethasone. Response was “dramatic” with evidence of almost complete wound closure by Day 10.
关键词： Photomicrodebridement,Laser-assisted drug delivery,Betamethasone,Kenalog,Unstable Burn Scars,Ablative Fractional CO2 Laser
更新于2025-09-12 10:27:22
-
High- Versus Low-Density Fractional Laser in the Treatment of Hypertrophic Postburn Scars
摘要： BACKGROUND Fractional CO2 laser has been shown effective in improving pigmentation, pruritus, and tightness of hypertrophic burn scars. However, there is no consensus on the optimal treatment parameters. OBJECTIVE To compare effectiveness of different densities of fractional CO2 laser in the treatment of mature hypertrophic burn scars. MATERIALS AND METHODS The study included 25 patients, each with 3 or more mature hypertrophic burn scars. Scars were randomly assigned to treatment with low-, medium-, and high-density fractional CO2 laser. Each scar received 3 sessions of laser at 1-month interval. The degree of improvement was assessed clinically using Vancouver Scar Scale (VSS) and Patient and Observer Scar Assessment Scale (POSAS) scores, and histologically through evaluation of collagen (Masson’s Trichrome stain) before and 1 month after end of therapy. RESULTS High-density parameters showed significant higher improvement in VSS and POSAS assessment scores (p-value < .001). Pliability and relief are the most improved parameters. Histopathological evaluation revealed a significant drop in the mean area percent of collagen in the 3 used parameters, with highest improvement with high-density laser treatment (p-value < .001). CONCLUSION High-density fractional CO2 laser treatment provides more improvement in burn scars both clinically and histopathologically.
关键词： hypertrophic burn scars,collagen,Fractional CO2 laser,Patient and Observer Scar Assessment Scale,Vancouver Scar Scale
更新于2025-09-12 10:27:22
-
Efficacy of fractional carbon dioxide laser therapy for burn scars: a meta-analysis
摘要： Background: The present study evaluates the effectiveness of fractional carbon dioxide (CO2) laser for the treatment of burn scars. Method: Literature search was conducted in electronic databases and studies were selected by following pre-determined eligibility criteria. Random effect meta-analyses were performed to achieve the effect size of the changes (mean difference (MD) between post-treatment and pretreatment values) in selected scar assessment scale scores and other important outcome measures. Results: 14 studies were included. Treatment of burn scars with fractional CO2 laser significantly improved Vancouver Scar Scale (MD (cid:1)3.01 [95% confidence interval (CI) (cid:1)3.79, (cid:1)2.22]; p ? .00001), Patient and Observer Scar Assessment Scale (POSAS)– Patient (MD (cid:1)14.38 [95% CI (cid:1)17.62, (cid:1)11.13]; p ? .00001, POSAS – Observer (MD (cid:1)8.81 [9% CI (cid:1)11.60, (cid:1)6.02]; p ? .00001 and Scar Assessment Scale (MD 1.64 [95% CI 0.49, 2.78]; p ? .005) scores especially with regards to pigmentation, vascularity, pliability, and height of scar. Pain and pruritis also improved with this treatment. Scar thickness measured with ultrasonography decreased non-significantly (MD (cid:1)0.48 [95% CI (cid:1)1.04, 0.09]; p ? .1) whereas cutometer measures, R0 (scar firmness) and R2 (scar elasticity) did not change meaningfully. Conclusion: Fractional CO2 laser therapy is a valuable tool for the treatment of burn scars which has potential for reducing scar severity.
关键词： keloidal,hypertrophic,Burn scars,fractional carbon dioxide laser
更新于2025-09-12 10:27:22
-
Treatment of Hypertrophic Burn and Traumatic Scars With a 2,940-nm Fractional Ablative Erbium-doped Yttrium Aluminium Garnet Laser
摘要： BACKGROUND In recent years, fractional ablative lasers at low density have proven to be the centerpiece in a multimodality approach to treating hypertrophic burn scars. OBJECTIVE To determine the safety and efficacy of fractional ablative erbium-doped yttrium aluminium garnet (Er:YAG) laser in the treatment of hypertrophic burn scars. METHODS Eleven patients received 3 fractional ablative Er:YAG laser to hypertrophic burn scars at 400 to 800 mm, density 11%, no coagulation, and single pass at 4-week intervals. RESULTS Overall, average improvement was noted to be 2.27 of 3 as determined by blinded observers. A significant improvement was noted in all measured parameters including dyschromia, atrophy hypertrophy, vascularity, and texture. CONCLUSION This is a pilot study showing the safety and efficacy of fractional ablative Er:YAG laser treatment is a safe and effective treatment modality in the treatment of hypertrophic scars.
关键词： laser therapy,scar treatment,fractional ablative Er:YAG laser,hypertrophic burn scars
更新于2025-09-12 10:27:22
-
Ablative fractional resurfacing with laser‐facilitated steroid delivery for burn scar management: Does the depth of laser penetration matter?
摘要： Background and Objective: To investigate whether the depth of ablative fractional CO2 laser (CO2‐AFL) penetration of pathological burn scars influences clinical outcomes. Study Design/Materials and Methods: All patients presenting to the Concord Repatriation General Hospital (CRGH) Scar Clinic received ultrasound measurement at the thickest point of their burn scars. Subsequently, the effect of various CO2‐AFL settings (energy which correlates to penetration depths) on different outcome parameters was analysed. Patients were divided into five groups depending on minimal scar penetration depth. Results: Seventy‐eight patients (158 scars) had complete data allowing for analysis. Median scar thickness was 3,400 μm and median laser scar penetration depth was 900 μm. Scar penetration categories were as follows: 0–25% (n = 40), 25–50% (n = 67), 50–75% (n = 31), 75–100% (n = 8), >100% (n = 3) of scar thickness. The median reduction in maximum scar thickness was 800 μm following one treatment (P < 0.001). However, this effect depended on scar penetration depth, whereby scars that were penetrated ≥75% showed no significant improvement in scar thickness and those penetrated >100% indicated a tendency to become worse. Other assessed outcome parameters included: the Vancouver Scar Scale, the Patient and Observer Scar Assessment Scale, a neuropathic pain score (DN4 Pain Questionnaire), and a pruritus score (modified D4 Pruritus Score). All these factors showed significant improvement in the categories up to 75% scar penetration depth. Conclusions: CO2‐AFL scar penetration depth significantly influences subjective and objective pathologic burn scar modulation. The penetration depth of 51–75% achieves the greatest reduction in scar thickness.
关键词： ablative fractional CO2 laser,scar assessment scores,burn scars,scar thickness,depth of laser penetration
更新于2025-09-11 14:15:04
-
Fractional CO2 laser ablation of porcine burn scars after grafting: Is deeper better?
摘要： Introduction: Fractional CO2 lasers have been used in clinical settings to improve scarring following burn injury. Though used with increasing frequency, the appropriate laser settings are not well defined and overall efficacy of this therapy has not been definitively established. As it has been proposed that for thick hypertrophic scars proportionally greater fluence and thus deeper ablation into the scar tissue would be most effective, the goal of this study was to examine the role of ablation depth on scar outcomes in a highly-controlled porcine model for burn scars-after grafting. Methods: Properties of laser ablated wells were quantified on ex vivo pig skin as a function of laser energy (20, 70 or 150mJ). Full-thickness burn wounds were created on the dorsum of red Duroc pigs with the eschar excised and grafted with a split-thickness autograft meshed and expanded 1.5:1. After four weeks of healing, sites were treated with either 20, 70, or 150 mJ pulse energy from a fractional CO2 laser at 5% density or left untreated as a control. Sites were treated every four weeks with three total sessions. Scar area, pigmentation, erythema, roughness, histology, and biomechanics were evaluated prior to each laser treatment at day 28, 56, and 83, as well as four weeks after the final laser treatment, day 112. Additional biopsies were collected at day 112 for gene expression analysis. Results: The depth of the laser ablated wells increased with increasing pulse energy while the width of the wells was smaller in the 20mJ group and not significantly different in the 70 and 150mJ groups. Scar properties (area, color, biomechanics) were not significantly altered by laser therapy at any of the laser energies tested versus controls. Average scar roughness was improved by laser therapy in a dose dependent manner with scars treated with 150mJ of energy having the smoothest surface; however, these changes were not statistically significant. Assessment of matrix metalloproteinase 9 gene expression showed a slight upregulation in scars treated with 70 or 150 mJ versus control scars and scars treated with 20mJ pulse energy. Conclusion: The current study demonstrated that the properties of the ablative well (depth and width) are not linearly correlated with laser pulse energy, with only a small increase in well depth at energies between 70 and 150 mJ. Overall, the study suggests that there is little difference in outcomes as a function of laser energy. Fractional CO2 laser therapy did not result in any statistically significant benefit to scar properties assessed by quantitative, objective measures, thus highlighting the need for additional clinical investigation of laser therapy efficacy with non-treated controls and objective measures of outcome.
关键词： Power,Fractional CO2 laser,Porcine model,Quantitative assessment,Burn scars
更新于2025-09-11 14:15:04