Dr Maria Shilova^1,2, A/Prof Bronwyn Griffin^1,2, Prof Roy Kimble¹, Miss Lucinda McMillan³, Miss Laura Kimble³, Miss Esther Cho², Mr Justin Clark⁴

¹Queensland Children’s Hospital, Brisbane, Australia, ²Griffith University, Brisbane, Australia, ³University of Queensland, Brisbane, Australia, ⁴Institute for Evidence-Based Healthcare, Gold Coast, Australia

Abstract:

Introduction

Laser-assisted drug delivery is an increasingly common adjunct therapy in the laser treatment of hypertrophic scars. This entails the topical application of a substance onto a scar after it has been treated with a fractional ablative laser. Such lasers create columns of ablated tissue in the skin, thereby facilitating the penetration of the substance into the scar. Several studies have investigated the efficacy of laser-assisted delivery of steroids, 5-fluorouracil and other compounds as a scar treatment. These studies are significantly heterogenous in their methodology and outcome reporting. A systematic scoping review was undertaken to investigate what compounds are currently used for laser-assisted drug delivery, what evidence is available for the efficacy of each compound, and what outcome measures are used to assess the efficacy of laser-assisted drug delivery.

Methods

A comprehensive search strategy was developed according to Joanna Briggs Institute recommendations for systematic scoping review design. The PRISMA scoping review guidelines was followed in literature searching and screening. Any article discussing laser-assisted delivery of a compound to treat scars in humans was included.

Results

Forty-six suitable articles were identified, ranging from randomised controlled trials to case studies. The majority of studies (31/46) used a corticosteroid-based substance. Other compounds used included moist exposed burn ointment, botulinum toxin, allantoin, emu oil, verapamil hydrochloride, 5-aminolevulinic acid, asiaticoside, liquid silicone and platelet-rich plasma. The reporting of laser-assisted drug delivery methodology and of study outcomes varied greatly.

Discussion

This scoping review has systematically identified which compounds are used for laser-assisted drug delivery and has identified multiple points of variation in methodology and result reporting in current literature. This will inform clinicians about current laser-assisted drug delivery evidence, and assist in directing future research in the field of laser-assisted drug delivery by identifying gaps in the existing literature.

Biography:

Dr Maria Shilova is a Principal House Officer at the Paediatric Surgery, Urology, Burns and Trauma Unit at the Queensland Children’s Hospital in Brisbane. She is currently undertaking a Master of Philosophy research project in creating an evidence-based algorithm for using laser to treat hypertrophic scars.