Prospective Evaluation of Fractional CO2 Laser Treatment of Mature Burn Scars
Prospective Evaluation of Fractional CO2 Laser Treatment of Mature Burn Scars
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DOI：
10.1097/bcr.0000000000000383
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发表时间：
2016-11-01
影响因子：
1.4
通讯作者：
Pagella, Patrick
中科院分区：
文献类型：
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作者：
Blome-Eberwein, Sigrid;Gogal, Christina;Pagella, Patrick
作者对分式CO2激光治疗成熟烧伤疤痕进行了一项前瞻性研究，比较了客观和主观疤痕测量，评估了同一患者治疗前后至少一种治疗和一种对照疤痕。经机构审查委员会批准后，具有成熟明显烧伤疤痕的烧伤幸存者被邀请进入研究。在办公室环境中进行了一系列三次CO2激光治疗，使用局部麻醉霜，剂量为40至90 mJ，每平方厘米100至150个斑点。在治疗前和治疗后至少1个月对治疗组和对照组的疤痕进行主观和客观的疤痕生理和外观测量。共有80个疤痕，48个治疗疤痕和32个对照疤痕被纳入研究。治疗期间疼痛平均评分为4.7/10，治疗后5分钟疼痛平均评分为2.4/10。所有治疗过的疤痕均有改善。客观测量的厚度、感觉、红斑和色素沉着在治疗后明显改善(P =.001,.001，。004年,and.001)。弹性有所改善，但无统计学意义。独立观察员的温哥华疤痕评分从8分提高到6分；两组患者自我报告的疼痛和瘙痒保持不变。部分CO2激光治疗在烧伤疤痕的治疗中是一个很有前途的实体。我们的研究结果显示，在同一时间段内，治疗疤痕和未治疗的对照疤痕在客观测量上存在显著差异。在疤痕治疗研究中，患者/观察者和温哥华疤痕量表可能不够敏感，无法检测到结果的差异。
The authors conducted a prospective study of fractional CO2 laser treatment of mature burn scars, comparing objective and subjective scar measurements evaluating at least one treatment and one control scar on the same patient pre- and post treatments. After institutional review board approval, burn survivors with mature blatant burn scars were invited to enter the study. A series of three fractional CO2 laser treatments was performed in an office setting, using topical anesthetic cream, at 40 to 90 mJ, 100 to 150 spots per cm2. Subjective and objective measurements of scar physiology and appearance were performed before and at least 1 month after the treatment series on both the treated and the control scar. A total of 80 scars, 48 treatment and 32 control scars, were included in the study. Treatment pain score averaged at 4.7/10 during and at 2.4/10 5 minutes after the treatment. All treated scars showed improvement. Objectively measured thickness, sensation, erythema, and pigmentation improved significantly in the treated scars (P =.001,.001,.004, and.001). Elasticity improved, but without statistical significance. Vancouver scar scale assessments by an independent observer improved from 8 to 6; patient self-reported pain and pruritus remained unchanged in both groups. Fractional CO2 laser treatment is a promising entity in the treatment of burn scars. Our study results show significant differences in objective measurements between the treated scars and the untreated control scars over the same time period. In scar treatment studies, the patient/observer and Vancouver scar scales may not be sensitive enough to detect outcome differences.