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Non-ablative fractional laser provides long-term improvement of mature burn scars

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Authors:
  • Taudorf, Elisabeth H ;
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    unknown
  • Danielsen, Patricia L ;
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    unknown
  • Paulsen, Ida F ;
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    unknown
  • Togsverd-Bo, Katrine ;
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    unknown
  • Dierickx, Christine ;
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  • Paasch, Uwe ;
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  • Haedersdal, Merete
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    Department of Clinical Medicine, Department of Clinical Medicine, Faculty of Health and Medical Sciences, Københavns Universitet
Subtitle:
A randomized controlled trial with histological assessment
DOI:
10.1002/lsm.22289
Abstract:
BACKGROUND AND OBJECTIVES: Non-ablative fractional laser-treatment is evolving for burn scars. The objective of this study was to evaluate clinical and histological long-term outcome of 1,540 nm fractional Erbium: Glass laser, targeting superficial, and deep components of mature burn scars. MATERIALS & METHODS: Side-by-side scar-areas were randomized to untreated control or three monthly non-ablative fractional laser-treatments using superficial and extra-deep handpieces. Patient follow-up were at 1, 3, and 6 months. Primary outcome was improvement in overall scar-appearance on a modified-Patient-and-Observer-Scar-Assessment-Scale (mPOSAS, 1 = "normal skin", 10 = "worst imaginable scar"). Secondary outcomes included histology, patient satisfaction (0-10), patient-assessed improvement, and safety. RESULTS: Study was completed by 17 of 20 randomized patients with normotrophic (n = 11), hypertrophic (n = 5) or atrophic (n = 1) scars. Scar-appearance improved from laser-treatments (P < 0.001 vs. untreated) and histology at 6 months supported collagen-remodeling. Improvement appeared continuously during the post-operative period (mPOSAS baseline: 7 [5-8], 6 months: 4 [3-5] P = < 0.001). At 6 months, patients were satisfied with treatment (6 [3-9]) and 82% reported improved scar-texture. Treatments caused mild to moderate pain (4 [2-7]). Adverse effects decreased during follow-up and at final assessment, discrete erythema, hyperpigmentation or imprints from laser-grid were present in 11 patients. No patients experienced worsening of scar-appearance. CONCLUSIONS: Combined superficial and deep non-ablative fractional laser-treatments induce long-term clinical and histological improvement of mature burn scars.
Type:
Journal article
Language:
English
Published in:
Lasers in Surgery and Medicine, 2015, Vol 47, Issue 2, p. 141-147
Keywords:
Adult; Burns; Cicatrix; Female; Follow-Up Studies; Humans; Laser Therapy; Lasers, Solid-State; Male; Middle Aged; Patient Satisfaction; Time Factors; Treatment Outcome; Young Adult; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
Main Research Area:
Medical science
Publication Status:
Published
Review type:
Peer Review
Submission year:
2015
Scientific Level:
Scientific
ID:
270334435

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