Effectiveness and safety of ablative fractional CO 2 laser for the treatment of burn scars: A case-control study

• Published in: Burns : journal of the International Society for Burn Injuries 2021-06, Vol.47 (4), p.785
• Main Authors: Issler-Fisher, Andrea C, Fisher, Oliver M, Haertsch, Peter A, Li, Zhe, Maitz, Peter K M
• Format: Article
• Language: English
• Subjects: Adult; Analysis of Variance; Burns - complications; Burns - physiopathology; Case-Control Studies; Cicatrix - etiology; Cicatrix - physiopathology; Cicatrix - surgery; Female; Humans; Lasers, Gas - standards; Lasers, Gas - therapeutic use; Male; Middle Aged; Statistics, Nonparametric; Treatment Outcome
• ISSN: 1879-1409
• DOI: 10.1016/j.burns.2020.10.002

Burn scars are a major clinical challenge. The aim of this study was to determine the effectiveness and safety of one treatment with the ablative fractional CO laser (AFL-CO ) compared to standard burn scar treatment. From December 2014 to October 2018 patients were prospectively recruited and treatment effects analyzed by assessing various outcome parameters from the date of first consultation and after treatment. A case control study was conducted looking at the impact of one AFL-CO treatment compared to a cohort subjected to conventional conservative treatment. Adverse effects were noted at follow up. 187 patients were included, with 167 in the AFL-CO , and 20 in the control cohort. Baseline demographics and scar characteristics showed no significant differences. Ultrasound measured scar thickness as well as the Vancouver Scar Scale (VSS) revealed a significant reduction in the treatment cohort, but no significant improvement in the control group. The POSAS-O was significantly improved in both cohorts. Subjective parameters (POSAS-P, DN4-Pain, and modified D4Pruritus scores) decreased significantly in the AFL-CO cohort but remained unchanged in the control group. The BSHS-B quality of life score increased significantly in the AFL-CO group, but worsened at the follow up of the untreated patients. Sub-domain analyses found the biggest differences in Affect, Body Image, Heat Sensitivity, Treatment and Work. Complications occurred in 5 patients (2.9%). This study demonstrates that AFL-CO is an effective and safe treatment modality for burn scars improving thickness, symptoms and quality of life of burn survivors when compared to conventional scar treatment.