Dermal Remodeling of Burn Scar by Fractional CO2 Laser

Sang jun Lee, Dong Hye Suh, Ji Min Lee, Kye Yong Song, Hwa Jung Ryu

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: Ablative CO2 fractional lasers have recently been introduced for burn scar treatment because of pronounced clinical outcomes with fewer treatment sessions than nonablative fractional laser. Objective: This study was conducted to observe clinical as well as histologic changes of burn scars after treatment with CO2 fractional laser. Materials and Methods: Eleven patients (one female and 10 males, aged 31–59 years) with skin phototypes III to V with burn scars received 10 sessions of fractional CO2 laser treatments (UltraPulse® Encore; Lumenis, Santa Clara, CA, USA) over an average 5-week interval. Two passes were performed using the following parameters: deep FX mode, 12.5–30 mJ, with a density setting of 5–10 %. Clinical evaluations by three blinded dermatologists were obtained at baseline and at 6 months after the final treatment via photographs using the Vancouver scar scale (VSS). Skin biopsies were done on four patients before and after treatment. Results: All patients showed clinical improvement in their scars with significant decrease in VSS. Histologic findings showed the changes in the upper dermis with newly formed dermal papilla. This characteristic upper dermis change was presented as improvement in surface smoothness and skin tension clinically. Postinflammatory hyperpigmentation and itching sensation were the most common adverse effects. Conclusion: Burn scar treatment by fractional CO2 laser is effective by forming new collagen fibers mainly in the upper dermis. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Original languageEnglish
Pages (from-to)761-768
Number of pages8
JournalAesthetic Plastic Surgery
Volume40
Issue number5
DOIs
Publication statusPublished - 2016 Oct 1

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Gas Lasers
Cicatrix
Skin
Dermis
Therapeutics
Hyperpigmentation
Evidence-Based Medicine
Pruritus
Lasers
Collagen
Biopsy

Keywords

  • Burn scar
  • Dermal remodeling
  • Histology
  • Laser and light sources

ASJC Scopus subject areas

  • Surgery

Cite this

Dermal Remodeling of Burn Scar by Fractional CO2 Laser. / Lee, Sang jun; Suh, Dong Hye; Lee, Ji Min; Song, Kye Yong; Ryu, Hwa Jung.

In: Aesthetic Plastic Surgery, Vol. 40, No. 5, 01.10.2016, p. 761-768.

Research output: Contribution to journalArticle

Lee, Sang jun ; Suh, Dong Hye ; Lee, Ji Min ; Song, Kye Yong ; Ryu, Hwa Jung. / Dermal Remodeling of Burn Scar by Fractional CO2 Laser. In: Aesthetic Plastic Surgery. 2016 ; Vol. 40, No. 5. pp. 761-768.
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abstract = "Background: Ablative CO2 fractional lasers have recently been introduced for burn scar treatment because of pronounced clinical outcomes with fewer treatment sessions than nonablative fractional laser. Objective: This study was conducted to observe clinical as well as histologic changes of burn scars after treatment with CO2 fractional laser. Materials and Methods: Eleven patients (one female and 10 males, aged 31–59{\^A} years) with skin phototypes III to V with burn scars received 10 sessions of fractional CO2 laser treatments (UltraPulse{\^A}{\circledR} Encore; Lumenis, Santa Clara, CA, USA) over an average 5-week interval. Two passes were performed using the following parameters: deep FX mode, 12.5–30{\^A} mJ, with a density setting of 5–10{\^A} {\%}. Clinical evaluations by three blinded dermatologists were obtained at baseline and at 6{\^A} months after the final treatment via photographs using the Vancouver scar scale (VSS). Skin biopsies were done on four patients before and after treatment. Results: All patients showed clinical improvement in their scars with significant decrease in VSS. Histologic findings showed the changes in the upper dermis with newly formed dermal papilla. This characteristic upper dermis change was presented as improvement in surface smoothness and skin tension clinically. Postinflammatory hyperpigmentation and itching sensation were the most common adverse effects. Conclusion: Burn scar treatment by fractional CO2 laser is effective by forming new collagen fibers mainly in the upper dermis. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.",
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AB - Background: Ablative CO2 fractional lasers have recently been introduced for burn scar treatment because of pronounced clinical outcomes with fewer treatment sessions than nonablative fractional laser. Objective: This study was conducted to observe clinical as well as histologic changes of burn scars after treatment with CO2 fractional laser. Materials and Methods: Eleven patients (one female and 10 males, aged 31–59 years) with skin phototypes III to V with burn scars received 10 sessions of fractional CO2 laser treatments (UltraPulse® Encore; Lumenis, Santa Clara, CA, USA) over an average 5-week interval. Two passes were performed using the following parameters: deep FX mode, 12.5–30 mJ, with a density setting of 5–10 %. Clinical evaluations by three blinded dermatologists were obtained at baseline and at 6 months after the final treatment via photographs using the Vancouver scar scale (VSS). Skin biopsies were done on four patients before and after treatment. Results: All patients showed clinical improvement in their scars with significant decrease in VSS. Histologic findings showed the changes in the upper dermis with newly formed dermal papilla. This characteristic upper dermis change was presented as improvement in surface smoothness and skin tension clinically. Postinflammatory hyperpigmentation and itching sensation were the most common adverse effects. Conclusion: Burn scar treatment by fractional CO2 laser is effective by forming new collagen fibers mainly in the upper dermis. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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