29 The Effectiveness of Laser Therapy for Hypertrophic Burn Scars in Pediatric Patients: A Prospective Investigation

Abstract

Abstract Introduction Laser therapy has emerged as a valuable treatment option for hypertrophic burn scars over the past decade. Improvements in scar symptoms have been found using the ablative fractional carbon dioxide laser (AFCL) as well as the pulsed dye laser (PDL). However, research regarding the use of laser therapy among pediatric burn patients remains limited. Thus, the aim of this study was to investigate the effectiveness of using laser therapy to improve hypertrophic burn scars in a pediatric population using a comprehensive set of subjective and objective scar assessment tools. Methods A single-center, prospective observational study was carried out at a tertiary pediatric hospital. Twenty participants with hypertrophic burn scars that had not received previous laser treatment were included. Laser procedures were administered at approximately two-month intervals and each participant attended five study visits over the course of one year. A comprehensive set of scar assessment tools including the Vancouver Scar Scale, the Patient and Observer Scar Assessment Scale, conventional ultrasound, ultrasound elastography, and a multi-parameter skin analysis device were used to evaluate scar properties at each study visit. Results Seventy-one laser procedures were carried out with most participants receiving treatment with both the AFCL and the PDL at the same session (83%). All participants underwent at least three laser procedures with no complications noted. From baseline to study completion, statistically significant improvements in all scar measures, both subjective and objective, were observed (p < 0.05). More specifically, improvements in overall scarring and in specific scar properties including thickness (p < 0.05), stiffness (p < 0.05), and color (p < 0.05) were found. Conclusions To our knowledge, this is the most comprehensive study to date to evaluate the effect of laser treatment on hypertrophic burn scars in a pediatric population. Our findings suggest that laser therapy is a highly beneficial treatment for burn-injured children that should be integrated into current scar treatment practices. In addition to obtaining strong evidence to support the use of laser therapy, we utilized rigorous scar assessment and laser treatment protocols that can be easily adopted by other clinicians.