Dr Geoffrey Lee¹, Dr Sally  Ng¹, Dr Sophia  Dahm¹

¹Alfred Health, Melbourne, Australia

Abstract:

Introduction: Hypertrophic scarring is a common and debilitating consequence of burn scars (1, 2).  This study assesses the use of ablative fractional Carbon Dioxide (CO2) and Intense Pulsed Light (IPL) lasers in the treatment of hypertrophic burn scars at the Victorian Adult Burns Services.

Methods: Patients were recruited from a hypertrophic burn scar waitlist and completed a Patient and Observer Scar Assessment Scale (POSAS) prior to and 6 weeks after laser therapy. The Nordlys® (IPL) and CO2RE® (CO2) systems from Candela Medical were used, with a range of settings used depending on the assessment of the burn scar.  The differences between scores were calculated for the total POSAS score, pain, itch, colour, stiffness, thickness, irregularity and the overall opinion of the scar. Statistical analysis was completed using a paired, two-tailed student T test.

Results: A total of 31 patients were recruited for this trial with a range of scar locations, surface areas and mechanism of burn injury. The calculated difference in mean showed a significant reduction for the overall POSAS score (1.928, p<0.0001), pain (1.39,p=0.0002), itch (1.84,p=0.0002), colour (1.97,p<0.0001), stiffness (2.47,p<0.0001), thickness (2.1,p<0.0001), irregularity (1.89,p<0.0001) and overall opinion (1.58,p=0.0003).

Conclusion: Laser therapy presents a minimally invasive procedure that can be completed under topical anaesthetic and has shown to be effective following a single treatment of combined CO2 and IPL laser therapy.

References:

1. Lawrence JW, Mason ST, Schomer K, Klein MB. Epidemiology and impact of scarring after burn injury: a systematic review of the literature. J Burn Care Res. 2012;33(1):136-46.
2. Van Loey NE, Van Son MJ. Psychopathology and psychological problems in patients with burn scars: epidemiology and management. Am J Clin Dermatol. 2003;4(4):245-72.

Biography:

Plastic Surgery Registrar at the Alfred Hospital