Dr Tim Wang¹, Dr  Aruna Wijewardena¹, Dr Bishoy Soliman¹, Dr Jeon Cha¹

¹Royal North Shore Hospital, Sydney, Australia

Abstract:

Background: Microneedling is an established non-ablative dermatological scar optimisation technique increasingly being applied to burns scars. Efficacy is proposed mainly due to neovascularisation and collagen induction or as a vehicle for transcutaneous drug delivery. Exact protocol and efficacy varies widely within the literature. Microneedling may present to be a useful adjunct in the management of burns scars with measurable clinical results with little recovery.

Objective: Evaluate the current best evidence on the physiology, technique and efficacy of microneedling in burns scars. Secondarily, we aim to evaluate the potential complications with microneedle therapy.

Results: Seven articles described the use of microneedle therapy in burns scars. Protocols varied widely in the length of needle, type of dermaroller, peri-operative skin preparation and number of treatments. All studies reported an improvement in scar appearance, symptoms (tightness/firmness) and patient satisfaction. This was supported by an improvement in Vancouver Scar Scale (VSS) scores for vascularity, pliability, height and overall Patient and Observer Scar Assessment Scale (POSAS) score.(Suca et al., Aust et al., 2010, KIM et al., 2010, Busch et al., 2016, Kubiak and Lange, 2017, Sezgin and Ozmen, 2018, Golnaz et al., 2019) Permanent adverse reactions are uncommon but transient erythema, herpes simplex re-activation and post-inflammatory hyperpigmentation have been described.

Conclusion: Microneedling is an effective adjunct in the multimodality management of burns scars improving scar thickness, pliability and patient satisfaction. Further comparative trials are required to standardise protocols and compare its efficacy versus ablative methods.

Biography:

Consultant Plastic and Burns Surgeon with interest in trauma, microsurgery, peripheral nerve surgery and burns