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激光在烧伤瘢痕治疗中的应用

Laser in the management of burn scars.

作者信息

Willows Brooke M, Ilyas Muneeb, Sharma Amit

机构信息

School of Medicine, University of Arizona, Phoenix, AZ, United States.

Department of Dermatology, Mayo Clinic Arizona, 13400 E. Shea Blvd. Scottsdale, AZ 85259, United States.

出版信息

Burns. 2017 Nov;43(7):1379-1389. doi: 10.1016/j.burns.2017.07.001. Epub 2017 Aug 4.

Abstract

BACKGROUND AND OBJECTIVE

Burn scars are associated with significant morbidity ranging from contractures, pruritus, and disfigurement to psychosocial impairment. Traditional therapies include silicone gel, compression garments, corticosteroid injections, massage therapy, and surgical procedures, however, newer and advanced therapies for the treatment of burn scars have been developed. Lasers, specifically ablative fractional lasers, show potential for the treatment of burn scars.

METHODS

Both MeSH and keyword searches of the PubMed, Medline and Embase databases were performed and relevant articles were read in full for the compilation of this review.

RESULTS

Fifty-one relevant observational studies, clinical trials, and systematic reviews published in English from 2006 to 2016 were reviewed and summarized.

CONCLUSION

Laser therapy is effective for the treatment of burn scar appearance, including measures such as pigmentation, vascularity, pliability, and thickness. Ablative fractional laser therapy, in particular, shows significant potential for the release of contractures allowing for improved range of motion of affected joints. Patients may benefit from the use of lasers in the treatment of burn scars, and the safety profile of lasers allows the benefits of treatment to outweigh the risks. Laser therapy should be included in burn scar treatment protocols as an adjuvant therapy to traditional interventions.

摘要

背景与目的

烧伤瘢痕会引发严重的健康问题,包括挛缩、瘙痒、毁容以及心理社会功能障碍。传统治疗方法包括硅胶凝胶、压力衣、皮质类固醇注射、按摩疗法和外科手术,然而,现已开发出更新、更先进的烧伤瘢痕治疗方法。激光,尤其是剥脱性分数激光,在烧伤瘢痕治疗方面显示出潜力。

方法

通过对PubMed、Medline和Embase数据库进行医学主题词(MeSH)和关键词检索,并阅读相关文章全文以撰写本综述。

结果

对2006年至2016年以英文发表的51项相关观察性研究、临床试验和系统评价进行了综述和总结。

结论

激光治疗对改善烧伤瘢痕外观有效,包括色素沉着、血管分布、柔韧性和厚度等方面。特别是剥脱性分数激光治疗在解除挛缩方面显示出巨大潜力,可改善受影响关节的活动范围。患者可能会从激光治疗烧伤瘢痕中受益,并且激光的安全性使得治疗的益处大于风险。激光治疗应作为传统干预措施的辅助疗法纳入烧伤瘢痕治疗方案中。

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