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Lasers in Medical Science

, Volume 32, Issue 5, pp 1031–1040 | Cite as

Ultrapulsed fractional ablative carbon dioxide laser treatment of hypertrophic burn scars: evaluation of an in-patient controlled, standardized treatment approach

  • Julian Poetschke
  • Ulf Dornseifer
  • Matteo Tretti Clementoni
  • Markus Reinholz
  • Hannah Schwaiger
  • Stephanie Steckmeier
  • Thomas Ruzicka
  • Gerd G. GauglitzEmail author
Original Article

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 S max decreased by 1893 μm (−36.92%) (p = 0.0273) and S z by 1615 μm (−36.37%) (p = 0.0488). Scar firmness in treated scars could be reduced by 30% after one treatment session, as R 0 improved 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.

Keywords

Burn trauma Burn scar Widespread hypertrophic scarring CO2 laser Fractional ablative laser PRIMOS POSAS Vancouver Scar Scale DLQI 

Notes

Compliance with ethical standards

Conflict of interest

Gerd G. Gauglitz serves as speaker and advisor for Lumenis. All other authors declare no conflict of interest.

Role of founding source

No outside funding was received for this study.

Ethical approval

This study was approved by the ethics committee of the medical faculty of the Ludwig-Maximilian-University (LMU), Munich, Germany, and it complies with the standards set within the Helsinki Declaration of 1964 and its consecutive revisions.

Informed consent

Informed consent regarding participation in the study, laser treatment, and study-related documentation was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag London 2017

Authors and Affiliations

  • Julian Poetschke
    • 1
  • Ulf Dornseifer
    • 2
  • Matteo Tretti Clementoni
    • 3
  • Markus Reinholz
    • 1
  • Hannah Schwaiger
    • 1
  • Stephanie Steckmeier
    • 1
  • Thomas Ruzicka
    • 1
  • Gerd G. Gauglitz
    • 1
    Email author
  1. 1.Department of Dermatology and AllergyLudwig-Maximilian-University MunichMunichGermany
  2. 2.Department of Plastic, Reconstructive, Hand, and Burn SurgeryBogenhausen Academic HospitalMunichGermany
  3. 3.Skin HouseMilanItaly

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