Efficacy of fractional carbon dioxide laser therapy for burn scars: a meta-analysis

Abstract

Background The present study evaluates the effectiveness of fractional carbon dioxide (CO2) laser for the treatment of burn scars. Method Literature search was conducted in electronic databases and studies were selected by following pre-determined eligibility criteria. Random effect meta-analyses were performed to achieve the effect size of the changes (mean difference (MD) between post-treatment and pretreatment values) in selected scar assessment scale scores and other important outcome measures. Results 14 studies were included. Treatment of burn scars with fractional CO2 laser significantly improved Vancouver Scar Scale (MD −3.01 [95% confidence interval (CI) −3.79, −2.22]; p ˂ .00001), Patient and Observer Scar Assessment Scale (POSAS)– Patient (MD −14.38 [95% CI −17.62, −11.13]; p ˂ .00001, POSAS – Observer (MD −8.81 [9% CI −11.60, −6.02]; p ˂ .00001 and Scar Assessment Scale (MD 1.64 [95% CI 0.49, 2.78]; p = .005) scores especially with regards to pigmentation, vascularity, pliability, and height of scar. Pain and pruritis also improved with this treatment. Scar thickness measured with ultrasonography decreased non-significantly (MD −0.48 [95% CI −1.04, 0.09]; p = .1) whereas cutometer measures, R0 (scar firmness) and R2 (scar elasticity) did not change meaningfully. Conclusion Fractional CO2 laser therapy is a valuable tool for the treatment of burn scars which has potential for reducing scar severity.