University of California, San Diego, La Jolla, California; Rady Children's Hospital, San Diego, California; and
University of California, Irvine, Irvine, California.
Pediatrics. 2015 Jan;135(1):e207-10. doi: 10.1542/peds.2014-1779. Epub 2014 Dec 22.
Recessive dystrophic epidermolysis bullosa (RDEB) is a devastating genodermatosis characterized by generalized skin fragility, severe blistering, and wounding that heals with mutilating scarring. Patients are in constant need of effective wound therapies as they often succumb to aggressive metastatic squamous cell carcinomas or to sepsis that may develop from their chronic wounds. Herein, we demonstrate accelerated wound healing with use of a fractionated CO2 laser protocol in a 22-year-old man with RDEB. His 9-month-old, non-healing wound decreased from 7 cm in diameter to 2 cm in diameter (a 92% reduction in wound surface area) within 4 weeks of a single laser treatment, and he had near-complete re-epithelialization within 4 weeks of his second laser treatment without blistering or other adverse effects. This novel intervention of using fractionated CO2 for photo-microdebridement could help revolutionize wound care for patients who have RDEB and whose chronic wounds serve as one of their greatest sources of morbidity and mortality. Dissemination to a pediatric audience is critical so that laser protocols might be more thoroughly investigated and incorporated into wound management strategies for this uniquely vulnerable population.
隐性营养不良型大疱性表皮松解症（RDEB）是一种严重的遗传性皮肤病，其特征为全身皮肤脆弱、严重水疱和创伤，愈合后会留下严重的畸形瘢痕。由于患者经常因侵袭性转移性鳞状细胞癌或慢性创伤引起的败血症而死亡，因此他们需要有效的创伤治疗。在此，我们展示了使用 CO2 激光分割术治疗 RDEB 患者的加速创伤愈合效果。一名 22 岁的 RDEB 患者的 9 个月大的未愈合创面，在单次激光治疗后 4 周内从直径 7 厘米缩小到 2 厘米（创面面积减少 92%），在第二次激光治疗后 4 周内几乎完全上皮化，没有水疱或其他不良反应。使用 CO2 激光分割术进行光微切除术的这种新方法可能会彻底改变 RDEB 患者的创伤护理，这些患者的慢性创伤是其发病率和死亡率的最大来源之一。向儿科受众传播这一方法至关重要，以便更全面地研究激光方案，并将其纳入这一特殊脆弱人群的创伤管理策略中。
