Non-ablative fractional laser provides long-term improvement of mature burn scars: A randomized controlled trial with histological assessment

TY - JOUR

T1 - Non-ablative fractional laser provides long-term improvement of mature burn scars

T2 - A randomized controlled trial with histological assessment

AU - Taudorf, Elisabeth H

AU - Danielsen, Patricia L

AU - Paulsen, Ida F

AU - Togsverd-Bo, Katrine

AU - Dierickx, Christine

AU - Paasch, Uwe

AU - Haedersdal, Merete

N1 - © 2014 Wiley Periodicals, Inc.

PY - 2015/2/1

Y1 - 2015/2/1

N2 - Background and Objectives: Non-ablative fractional laser-treatment is evolving for burn scars. The objective of this study was to evaluate clinical and histological long-term outcome of 1,540 nm fractional Erbium: Glass laser, targeting superficial, and deep components of mature burn scars. Materials & Methods: Side-by-side scar-areas were randomized to untreated control or three monthly non-ablative fractional laser-treatments using superficial and extra-deep handpieces. Patient follow-up were at 1, 3, and 6 months. Primary outcome was improvement in overall scar-appearance on a modified-Patient-and-Observer-Scar-Assessment-Scale (mPOSAS, 1 = "normal skin", 10 = "worst imaginable scar"). Secondary outcomes included histology, patient satisfaction (0-10), patient-assessed improvement, and safety. Results: Study was completed by 17 of 20 randomized patients with normotrophic (n = 11), hypertrophic (n = 5) or atrophic (n = 1) scars. Scar-appearance improved from laser-treatments (P < 0.001 vs. untreated) and histology at 6 months supported collagen-remodeling. Improvement appeared continuously during the post-operative period (mPOSAS baseline: 7 [5-8], 6 months: 4 [3-5] P = < 0.001). At 6 months, patients were satisfied with treatment (6 [3-9]) and 82% reported improved scar-texture. Treatments caused mild to moderate pain (4 [2-7]). Adverse effects decreased during follow-up and at final assessment, discrete erythema, hyperpigmentation or imprints from laser-grid were present in 11 patients. No patients experienced worsening of scar-appearance. Conclusions: Combined superficial and deep non-ablative fractional laser-treatments induce long-term clinical and histological improvement of mature burn scars.

AB - Background and Objectives: Non-ablative fractional laser-treatment is evolving for burn scars. The objective of this study was to evaluate clinical and histological long-term outcome of 1,540 nm fractional Erbium: Glass laser, targeting superficial, and deep components of mature burn scars. Materials & Methods: Side-by-side scar-areas were randomized to untreated control or three monthly non-ablative fractional laser-treatments using superficial and extra-deep handpieces. Patient follow-up were at 1, 3, and 6 months. Primary outcome was improvement in overall scar-appearance on a modified-Patient-and-Observer-Scar-Assessment-Scale (mPOSAS, 1 = "normal skin", 10 = "worst imaginable scar"). Secondary outcomes included histology, patient satisfaction (0-10), patient-assessed improvement, and safety. Results: Study was completed by 17 of 20 randomized patients with normotrophic (n = 11), hypertrophic (n = 5) or atrophic (n = 1) scars. Scar-appearance improved from laser-treatments (P < 0.001 vs. untreated) and histology at 6 months supported collagen-remodeling. Improvement appeared continuously during the post-operative period (mPOSAS baseline: 7 [5-8], 6 months: 4 [3-5] P = < 0.001). At 6 months, patients were satisfied with treatment (6 [3-9]) and 82% reported improved scar-texture. Treatments caused mild to moderate pain (4 [2-7]). Adverse effects decreased during follow-up and at final assessment, discrete erythema, hyperpigmentation or imprints from laser-grid were present in 11 patients. No patients experienced worsening of scar-appearance. Conclusions: Combined superficial and deep non-ablative fractional laser-treatments induce long-term clinical and histological improvement of mature burn scars.

KW - Adult

KW - Burns

KW - Cicatrix

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Laser Therapy

KW - Lasers, Solid-State

KW - Male

KW - Middle Aged

KW - Patient Satisfaction

KW - Time Factors

KW - Treatment Outcome

KW - Young Adult

U2 - 10.1002/lsm.22289

DO - 10.1002/lsm.22289

M3 - Journal article

C2 - 25154734

SN - 0196-8092

VL - 47

SP - 141

EP - 147

JO - Lasers in Surgery and Medicine

JF - Lasers in Surgery and Medicine

IS - 2

ER -