Henry Li¹, Sally Ng¹, Jie Li², Yixin Zhang²

1 Monash Health, 246 Clayton Rd, Clayton, VIC, 3168, sallykhng@gmail.com

2 Department of Plastic and Reconstructive Surgery, Shanghai Ninth People Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China

Introduction:

Burn related scarring could lead to functional, aesthetic and psychological consequences for patients, leading to significant morbidity. Light-based therapies, laser-based therapies and radiofrequency have demonstrated promising results in improving the scar quality and reduce pruritis. The objective of this review is to summarise the current literature surrounding laser-based modalities for burn scar management.

Methods:

A review of the current literature was performed by searching PubMed, Medline and Embase databases with MeSH and keyword searches. Observational studies, case reports and series, comparative studies, randomised controlled trials and systematic reviews from between 1995 and 2019 were read, stratified by level of evidence and summarised.

Results and conclusion:

Initially, the immature burn scar is hypervascular, containing oxy-haemoglobin, collagen and water. Therapies that target these chromophores are hence useful in the immature scar. Intense pulsed light is useful in targeting the vasculature of scars and can treat immature scars. The treatment of mature burn scars with lasers involves targeting the dermal architecture. Therapies such as CO2 laser, PDL, Q-switched Nd:YAG and are useful for this. Radiofrequency has also been shown to be a useful adjunct in the management of scars. Light-based and laser-based therapies are effective in improving burn scars with minimal adverse effects and should be included in management protocols alongside other non-surgical options.

References:

1. Zuccaro J, Ziolkowski N, Fish J. A Systematic Review of the Effectiveness of Laser Therapy for Hypertrophic Burn Scars. Clin Plast Surg. 2017;44(4):767-79.
2. Hultman CS, Edkins RE, Lee CN, Calvert CT, Cairns BA. Shine on: Review of Laser- and Light-Based Therapies for the Treatment of Burn Scars. Dermatol Res Pract. 2012;2012:243651.
3. Sarkar A, Dewangan YK, Bain J, Rakshit P, Dhruw K, Basu SK, et al. Effect of intense pulsed light on immature burn scars: A clinical study. Indian J Plast Surg. 2014;47(3):381-5.
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9. Bowes LE, Nouri K, Berman B, Jimenez G, Pardo R, Rodriguez L, et al. Treatment of Pigmented Hypertrophic Scars with 585nm Pulsed Dye Laser and the 532nm Frequency-Doubled Nd:YAG in the Q-Switched and Variable Pulse Modes: A Comparative Study. Dermatol Surg. 2002; 28:714-719
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Biography:

Henry is a surgical resident at Monash Heath with an interest in plastic and reconstructive surgery.