Carbon dioxide laser treatment in burn-related scarring: A prospective randomised controlled trial

Helen Douglas, Jessica Lynch, Karl-Anton Harms, Tadyn Krop, Lauren Kunath, Christine van Vreeswijk, Sarah McGarry, Mark W. Fear, Fiona M. Wood, Alexandra Murray, Suzanne Rea

Research output: Contribution to journalArticle

Abstract

Aim: To investigate the effect of ablative fractional CO2 laser (AFCO(2)L) on burns scar appearance and dermal architecture at 6 weeks and up to 3-years post-treatment.

Methods: Twenty adult patients with a burn-related scar were recruited. Inclusion criteria were a minimum scar area of 10 x 10 cm and Vancouver scar scale (VSS) score of >5 and >= 6 months since the time of injury. The region of scar was randomised to treatment/control zones. Treatment zones received 3 standardised laser treatments at 4- to 6-week intervals. All areas of scar received standard scar care. Outcome measures were recorded at baseline, 6-weeks post final treatment and up to 3 years post-treatment. Measures included blinded assessor VSS, Patient Scar Assessment Scale and histological tissue analysis.

Results: Nineteen and nine patients completed the short- and long-term studies, respectively. Clinical results revealed improvement in all scar areas over time. There was a statistically significant improvement in pain and itch in the treatment zone compared to the control zone at 6 weeks. Histological data revealed a significant increase in medium-sized collagen fibres at 6 weeks relative to the control site. Sub-group analysis according to scar age revealed greater histological improvement following laser treatment in immature scars relative to more mature scar.

Conclusions: Results demonstrate that 3 treatments of AFCO(2)L significantly improve scar pain, itch and dermal architecture at 6 weeks post-treatment. Histological results suggest greater potential in treating immature scar. Further investigation into the timing of laser treatment could help assist treatment protocols. (C) 2019 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)863-870
Number of pages8
JournalJOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY
Volume72
Issue number6
DOIs
Publication statusPublished - Jun 2019

Cite this

Douglas, Helen ; Lynch, Jessica ; Harms, Karl-Anton ; Krop, Tadyn ; Kunath, Lauren ; van Vreeswijk, Christine ; McGarry, Sarah ; Fear, Mark W. ; Wood, Fiona M. ; Murray, Alexandra ; Rea, Suzanne. / Carbon dioxide laser treatment in burn-related scarring : A prospective randomised controlled trial. In: JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY. 2019 ; Vol. 72, No. 6. pp. 863-870.
@article{8a133f0b8e0f4bc88305f8a0be84a500,
title = "Carbon dioxide laser treatment in burn-related scarring: A prospective randomised controlled trial",
abstract = "Aim: To investigate the effect of ablative fractional CO2 laser (AFCO(2)L) on burns scar appearance and dermal architecture at 6 weeks and up to 3-years post-treatment.Methods: Twenty adult patients with a burn-related scar were recruited. Inclusion criteria were a minimum scar area of 10 x 10 cm and Vancouver scar scale (VSS) score of >5 and >= 6 months since the time of injury. The region of scar was randomised to treatment/control zones. Treatment zones received 3 standardised laser treatments at 4- to 6-week intervals. All areas of scar received standard scar care. Outcome measures were recorded at baseline, 6-weeks post final treatment and up to 3 years post-treatment. Measures included blinded assessor VSS, Patient Scar Assessment Scale and histological tissue analysis.Results: Nineteen and nine patients completed the short- and long-term studies, respectively. Clinical results revealed improvement in all scar areas over time. There was a statistically significant improvement in pain and itch in the treatment zone compared to the control zone at 6 weeks. Histological data revealed a significant increase in medium-sized collagen fibres at 6 weeks relative to the control site. Sub-group analysis according to scar age revealed greater histological improvement following laser treatment in immature scars relative to more mature scar.Conclusions: Results demonstrate that 3 treatments of AFCO(2)L significantly improve scar pain, itch and dermal architecture at 6 weeks post-treatment. Histological results suggest greater potential in treating immature scar. Further investigation into the timing of laser treatment could help assist treatment protocols. (C) 2019 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.",
keywords = "CO2 laser, Ablative fractional laser, Burn, Scar, QUALITY-OF-LIFE, SCARS",
author = "Helen Douglas and Jessica Lynch and Karl-Anton Harms and Tadyn Krop and Lauren Kunath and {van Vreeswijk}, Christine and Sarah McGarry and Fear, {Mark W.} and Wood, {Fiona M.} and Alexandra Murray and Suzanne Rea",
year = "2019",
month = "6",
doi = "10.1016/j.bjps.2019.01.027",
language = "English",
volume = "72",
pages = "863--870",
journal = "Journal of plastic, reconstructive & aesthetic surgery",
issn = "0007-1226",
publisher = "Churchill Livingstone",
number = "6",

}

Carbon dioxide laser treatment in burn-related scarring : A prospective randomised controlled trial. / Douglas, Helen; Lynch, Jessica; Harms, Karl-Anton; Krop, Tadyn; Kunath, Lauren; van Vreeswijk, Christine; McGarry, Sarah; Fear, Mark W.; Wood, Fiona M.; Murray, Alexandra; Rea, Suzanne.

In: JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY, Vol. 72, No. 6, 06.2019, p. 863-870.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Carbon dioxide laser treatment in burn-related scarring

T2 - A prospective randomised controlled trial

AU - Douglas, Helen

AU - Lynch, Jessica

AU - Harms, Karl-Anton

AU - Krop, Tadyn

AU - Kunath, Lauren

AU - van Vreeswijk, Christine

AU - McGarry, Sarah

AU - Fear, Mark W.

AU - Wood, Fiona M.

AU - Murray, Alexandra

AU - Rea, Suzanne

PY - 2019/6

Y1 - 2019/6

N2 - Aim: To investigate the effect of ablative fractional CO2 laser (AFCO(2)L) on burns scar appearance and dermal architecture at 6 weeks and up to 3-years post-treatment.Methods: Twenty adult patients with a burn-related scar were recruited. Inclusion criteria were a minimum scar area of 10 x 10 cm and Vancouver scar scale (VSS) score of >5 and >= 6 months since the time of injury. The region of scar was randomised to treatment/control zones. Treatment zones received 3 standardised laser treatments at 4- to 6-week intervals. All areas of scar received standard scar care. Outcome measures were recorded at baseline, 6-weeks post final treatment and up to 3 years post-treatment. Measures included blinded assessor VSS, Patient Scar Assessment Scale and histological tissue analysis.Results: Nineteen and nine patients completed the short- and long-term studies, respectively. Clinical results revealed improvement in all scar areas over time. There was a statistically significant improvement in pain and itch in the treatment zone compared to the control zone at 6 weeks. Histological data revealed a significant increase in medium-sized collagen fibres at 6 weeks relative to the control site. Sub-group analysis according to scar age revealed greater histological improvement following laser treatment in immature scars relative to more mature scar.Conclusions: Results demonstrate that 3 treatments of AFCO(2)L significantly improve scar pain, itch and dermal architecture at 6 weeks post-treatment. Histological results suggest greater potential in treating immature scar. Further investigation into the timing of laser treatment could help assist treatment protocols. (C) 2019 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

AB - Aim: To investigate the effect of ablative fractional CO2 laser (AFCO(2)L) on burns scar appearance and dermal architecture at 6 weeks and up to 3-years post-treatment.Methods: Twenty adult patients with a burn-related scar were recruited. Inclusion criteria were a minimum scar area of 10 x 10 cm and Vancouver scar scale (VSS) score of >5 and >= 6 months since the time of injury. The region of scar was randomised to treatment/control zones. Treatment zones received 3 standardised laser treatments at 4- to 6-week intervals. All areas of scar received standard scar care. Outcome measures were recorded at baseline, 6-weeks post final treatment and up to 3 years post-treatment. Measures included blinded assessor VSS, Patient Scar Assessment Scale and histological tissue analysis.Results: Nineteen and nine patients completed the short- and long-term studies, respectively. Clinical results revealed improvement in all scar areas over time. There was a statistically significant improvement in pain and itch in the treatment zone compared to the control zone at 6 weeks. Histological data revealed a significant increase in medium-sized collagen fibres at 6 weeks relative to the control site. Sub-group analysis according to scar age revealed greater histological improvement following laser treatment in immature scars relative to more mature scar.Conclusions: Results demonstrate that 3 treatments of AFCO(2)L significantly improve scar pain, itch and dermal architecture at 6 weeks post-treatment. Histological results suggest greater potential in treating immature scar. Further investigation into the timing of laser treatment could help assist treatment protocols. (C) 2019 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

KW - CO2 laser

KW - Ablative fractional laser

KW - Burn

KW - Scar

KW - QUALITY-OF-LIFE

KW - SCARS

U2 - 10.1016/j.bjps.2019.01.027

DO - 10.1016/j.bjps.2019.01.027

M3 - Article

VL - 72

SP - 863

EP - 870

JO - Journal of plastic, reconstructive & aesthetic surgery

JF - Journal of plastic, reconstructive & aesthetic surgery

SN - 0007-1226

IS - 6

ER -