Plastic Surgery Research Council
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PSRC 60th Annual Meeting
Program and Abstracts

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The Use Of Co2 Fractional Photothermolysis For The Treatment Of Burn Scars
Benjamin Levi, MD, Amir Ibrahim, MD, Katie Mathews, BA, Brandon Wojcik, MD, Jason Gomez, BS, Shawn Fagan, MD, FACS, William Gerald Austen, Jr., MD, FACS, Jeremy Goverman, MD, FACS.
Massachusetts General Hospital, Boston, MA, USA.

PURPOSE: 450,000 burn injuries receive medical treatment annually in the United States alone. Survival from a massive burn is no longer the exception, but the expectation, as data from the American Burn Association National Burn Repository reports a 96.6% survival rate for all patients with burns. Emphasis is now being placed on the treatment and reconstruction of the morbidities associated with burn scars. Burn survivors are often left struggling with pruritic contractures and the unsightly appearance created by burn scars and split thickness skin grafts. A recent advancement in the treatment of burn scars has been the use of the carbon dioxide (CO2) laser to perform fractional photothermolysis. In this analysis we describe our results, and patient reported outcomes, with the use of fractional CO2 laser for the treatment of burn-related scarring.
METHODS: We performed a retrospective study of all patients who underwent CO2 laser procedures for treatment of symptomatic burn scars and skin grafts at one accredited regional burn center. Burn injury and laser treatment demographics, as well as complications, are reported. A questionnaire was administered to all patients and included patient reported outcome measures aimed at understanding the patient experience and their subjective response to treatment as well as the Short Form 36 (SF-36).
RESULTS: A total of 387 CO2 laser procedures were performed on 131 patients for the treatment of symptomatic burn scars and skin grafts between October 1, 2011 and May 1, 2014 (Ave 2.95 procedures/patient, Range 1-11). Average time between injury and first laser was 597.35 days (Range 60-13475). Average time between laser treatments (when multiple) was 117.73 days (Range 22-514). There were no infections requiring treatment with oral antibiotics. Patients reported reductions in neuropathic pain, tightness (contracture), and pruritis (54.0, 50.6, 49.0% respectively); and overall patient satisfaction with laser therapy was 96.7% (Figure 1a,b).

CONCLUSION: Fractional photothermolysis utilizing the carbon dioxide laser is a safe and effective modality for the treatment of symptomatic burn scars, donor sites, and skin grafts. Patient satisfaction with this procedure is high and complications are low. Significant improvements in scar appearance, pliability, tightness, neuropathic pain, and pruritis were commonly reported.


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