PMID- 35943226
OWN - NLM
STAT- MEDLINE
DCOM- 20220810
LR  - 20220815
IS  - 1536-3708 (Electronic)
IS  - 0148-7043 (Linking)
VI  - 89
IP  - 2
DP  - 2022 Aug 1
TI  - Analysis of the Utility of CO2 and Pulse-Dye Lasers Together and Separately in 
      the Treatment of Hypertrophic Burn Scars.
PG  - 166-172
LID - 10.1097/SAP.0000000000003240 [doi]
AB  - INTRODUCTION: Hypertrophic burn scars (HTBSs) remain a significant source of 
      morbidity. Contemporary treatment has evolved to use CO2 lasers and/or pulse-dye 
      lasers (PDLs) to reduce scar thickness (ST) and erythema. This study seeks to 
      compare treatment efficacy with CO2 or PDL individually and in combination. 
      METHODS: Patients undergoing laser treatments for HTBSs were enrolled. Three 3 x 
      3 cm squares of HTBSs were randomized to receive treatment with CO2 laser, PDL or 
      CO2 + PDL. Patients underwent 3 treatments, 4 to 6 weeks apart and were followed 
      up over 3 to 6 months. Scar assessments occurred at each visit before treatment 
      and consisted of photographs, ultrasound, colorimetry, and the Patient and 
      Observer Scar Assessment Score. RESULTS: Twenty-five patients were enrolled. 
      Twenty completed 2 treatments (80%) and 11 completed all 3 treatments (44%). 
      Median initial ST was 0.3 cm. Median time since injury was 8 months. Hypertrophic 
      burn scars treated with CO2 or PDL showed a significant decrease in Patient and 
      Observer Scar Assessment Scale score from visit 1 to 3 (P = 0.01 and 0.01, 
      respectively). When separated by ST, thick scars (>/=0.3 cm) showed a significant 
      decrease in thickness between visit 1 and 2 using all laser modalities (CO2 + 
      PDL, P = 0.01; CO2, P = 0.02; PDL, P = 0.03). Thin scars (<0.3 cm) showed a 
      reduction in thickness by visit 3 after CO2 + PDL or PDL alone (P = 0.01 and 
      0.04, respectively). Separating scars by age, younger scars (<9 months) showed a 
      significant reduction in thickness between visit 1 and 2 for CO2 treatment (P = 
      0.04), and between visit 2 and 3 for CO2 + PDL treatment (P = 0.04). Hypertrophic 
      burn scars treated with PDL did not demonstrate a significant reduction in 
      thickness until visit 3 (P = 0.002). Older scars (>/=9 months) showed a significant 
      reduction in thickness between visit 1 and 2 only after CO2 + PDL (P = 0.01). 
      CONCLUSIONS: Hypertrophic burn scars of varying ages, etiologies, and thicknesses 
      were examined in this study with greater degree of early reduction seen in 
      thicker scars using all laser modalities of CO2, PDL or in combination. However, 
      there was no clinically meaningful benefit found with combination as compared 
      with individual treatment. These data support the use of laser to improve HTBS 
      but does not support one modality or combination of modalities over another.
CI  - Copyright (c) 2022 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Cooper, Laura E
AU  - Cooper LE
AD  - From the United States Army Institute for Surgical Research.
FAU - Nuutila, Kristo
AU  - Nuutila K
AD  - From the United States Army Institute for Surgical Research.
FAU - Kemp Bohan, Philip M
AU  - Kemp Bohan PM
AD  - Department of Surgery, San Antonio Military Medical Center, Ft. Sam Houston, San 
      Antonio, TX.
FAU - Diaz, Victoria
AU  - Diaz V
AD  - From the United States Army Institute for Surgical Research.
FAU - Batchinsky, Maria
AU  - Batchinsky M
AD  - From the United States Army Institute for Surgical Research.
FAU - Carlsson, Anders H
AU  - Carlsson AH
AD  - From the United States Army Institute for Surgical Research.
FAU - Cancio, Leopoldo C
AU  - Cancio LC
AD  - Department of Surgery, San Antonio Military Medical Center, Ft. Sam Houston, San 
      Antonio, TX.
FAU - Chan, Rodney K
AU  - Chan RK
LA  - eng
SI  - ClinicalTrials.gov/NCT04769089
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - Ann Plast Surg
JT  - Annals of plastic surgery
JID - 7805336
RN  - 142M471B3J (Carbon Dioxide)
SB  - IM
MH  - *Burns/complications/therapy
MH  - Carbon Dioxide
MH  - *Cicatrix, Hypertrophic/etiology/pathology/surgery
MH  - Humans
MH  - Hypertrophy
MH  - Infant
MH  - *Lasers, Dye/therapeutic use
MH  - *Lasers, Gas/therapeutic use
MH  - Treatment Outcome
COIS- Conflicts of interest: The views expressed in this article are those of the 
      author(s) and do not reflect the official policy or position of the U.S. Army 
      Medical Department, Department of the Army, DOD, or the U.S. Government.
EDAT- 2022/08/10 06:00
MHDA- 2022/08/11 06:00
CRDT- 2022/08/09 08:43
PHST- 2022/08/09 08:43 [entrez]
PHST- 2022/08/10 06:00 [pubmed]
PHST- 2022/08/11 06:00 [medline]
AID - 00000637-202208000-00008 [pii]
AID - 10.1097/SAP.0000000000003240 [doi]
PST - ppublish
SO  - Ann Plast Surg. 2022 Aug 1;89(2):166-172. doi: 10.1097/SAP.0000000000003240.