Ablative CO2 fractional resurfacing in treatment of thermal burn scars: an open-label controlled clinical and histopathological study.

INTRODUCTION

Burn scars can cause permanent disfiguring problems with limited treatments available.

OBJECTIVES

To assess and correlate the clinical and histopathological effects of fractional CO2 laser on thermal burns in a controlled study.

METHODS

Fifteen patients 11 with hypertrophic and four with keloidal scars received three CO2 fractional laser sessions every 4-6 weeks. Half of the scar was untreated as a control. Clinical evaluation by Vancouver, PSOAS scores, and photography before, monthly, and 3 months after the last laser session was performed. Ten patients were evaluated histopathologically by standard H&E, Masson trichrome, and Elastica von Gieson special stains.

RESULTS

Hypertrophic scars (HTSs) showed textural improvement and a significant decrease of Vancouver, POSAS observer, and patient scores by the end of follow-up period in the laser-treated area (P = 0.011, 0.017 and 0.018, respectively) unlike keloidal scars. Histopathology revealed significant decrease in scar thickness in HTSs only (P < 0.001) as well as a significant decrease in collagen bundle thickness and density in the upper dermis in both types of scars.

CONCLUSIONS

Fractional CO2 laser is a possible safe and effective modality for the treatment of hypertrophic burn scars with improvement achieved both clinically and histopathologically.