Safe, comfortable, tolerated and efficient – the first series of IV sedation free CO2 laser for adolescent patients undergoing chronic burns scar therapy in the outpatient setting
Hugo Loveday1, Bec Schrale1, Gabby Pulbrook1, Andrew Castley1,2, 1Royal Hobart Hospital 2FRACS (Plast)
Abstract
Laser therapy is becoming a universal and integral component of scar management in burns survivors. Selective ablation of tissue can be performed on symptomatic, hypertrophic and contracted chronic burns scars to improve function. Traditionally, this has been performed in operating theatres under sedation or general anaesthesia. However, wait times can be extended and the resource cost if elective theatres is high. Many adult burns services in Australia have started performing laser for burns in the outpatient setting under topical local anaesthetic. The advantages of performing the procedure on outpatients include a shorter wait time, a lower cost to the health service, and elimination of the risks, albeit low, of sedation and general anaesthesia. In mixed adult and paediatric statewide burns services, such as the Tasmanian Burns Service at the Royal Hobart Hospital, elective surgery access is particularly limited. We present a series of 11 adolescent patients at the Wellington Clinics of the Royal Hobart Hospital undergoing CO2 laser for burns scar therapy in the outpatient setting under topical local anaesthesia. The procedure was well tolerated, with only one patient aborting the procedure. Patients are screened for suitability, consent along with their guardian, and are concurrently listed on the elective surgery waitlist, so they are not disadvantaged if they do not want to proceed in the outpatient setting. This series endorses reduced time to treatment for adolescent patients can be comfortably achieved in outpatient setting with reduced perioperative risk and cost of treatment, while also reducing time to treatment.
Biography
Dr Hugo Loveday is an unaccredited Plastic Surgery Registrar at the Royal Hobart Hospital, and a part of the mixed adult and paediatric statewide burns service.