Ultrasound guided fractional ablative CO2 protocolised laser settings: subjective, objective and patient rated outcomes.

Marcus Wagstaff¹, Tanja Klotz¹, Kathryn Heath¹, Brad Schmitt¹, Stuart Harper¹,
¹Royal Adelaide Hospital, Adelaide, South Australia, Australia

Abstract

Previously, the sole option for treating functionally and cosmetically debilitating burns scars was significant surgical revision. However, in 2004, fractional photothermolysis using lasers was introduced as a less invasive and resource-intensive alternative for scar treatment. Although there is a growing body of evidence supporting its efficacy and safety, no previous studies, to our knowledge, have examined scar thickness as a guide for laser settings, and few have combined objective scar assessments with clinician and patient-reported outcomes to compare laser-treated scars with non-laser-treated scars.
The objective of this prospective study was twofold: to evaluate the outcomes of CO2 fractional ablative lasers using a guide for laser settings based on ultrasound-measured scar depths, and to report on burn scar outcomes by employing a range of subjective and objective scar assessment tools, as well as patient-reported outcomes at baseline and at 1, 3, 6, and 12 months following laser treatment.
The study included adults with problematic burn scars who underwent laser treatment. Twenty-four scars were treated with lasers, while 13 non-lasered scar sites served as the patients’ own controls. Due to surgeon preference, the laser settings based on ultrasound-measured scar thickness differed from those provided by Lumenis, the manufacturer.
To maximize improvement, 10 patients received repeat laser treatments. Compared to baseline measurements, most scars exhibited improvements in clinician and patient-reported outcomes. Objectively, most patients demonstrated enhancements in scar thickness, colour, and pliability.
In conclusion, further investigation is required to determine whether laser treatment is more effective when settings are based on scar thickness. Nevertheless, CO2 ablative laser treatment effectively improves subjective and objective outcomes for burn scars.

Biography

Tanja has been working as a Burns OT for the past 20 years. After completing a Master of Clinical Science, which included conducting a systematic review on the impact of moisturizers on scars, she discovered that the available evidence was insufficient to guide clinicians dealing with burn scars. Consequently, she is currently pursuing a PhD to shed light on the effects of basic and commonly recommended moisturizers on burn scars. Alongside her academic endeavors, Tanja remains committed to her work on the burn unit at Royal Adelaide Hospital undertaking clinical and research work.