Fractional carbon dioxide laser for facial scarring due to windscreen glass shatter injury.

Abstract

Facial injuries due to flying windscreen glass pieces are common in road accident and require surgical intervention by plastic surgeons to debride, suture, and dress the injuries. Posthealing patients visit dermatologists for further treatment of residual scar tissue. Interestingly, tiny papules or small nodular scars seen on otherwise level background which persists for beyond 3months (scar modeling time) may actually harbor small fragments of glass. Such lesions can only be treated by fractional CO2 therapy. Two patients who had papules and small nodular lesions on the accident scarred areas were subjected to fractional CO2 laser (ultraPulse, Lumenis)with moderate fluence and high density, once and observed over a period of 12weeks. On targeting the papules and small nodules, tiny particles of glass appeared out of the broken lesions. Irrespective of the surgery done on accident victims involving windshield glass injuries, fractional CO2 may be considered at a later stage, especially with presence of papules interspersed in the area of facial scars.