Burns Unit, Concord Repatriation General Hospital, Sydney, Australia; ANZAC Research Institute, Concord Repatriation General Hospital, Sydney, Australia; Concord Clinical School, University of Sydney, Sydney, Australia.
School of Medicine, University of Notre Dame, Sydney, NSW 2010, Australia; University of New South Wales Department of Surgery, St George Hospital, Kogarah, Australia.
Burns. 2021 Jun;47(4):785-795. doi: 10.1016/j.burns.2020.10.002. Epub 2020 Oct 17.
Burn scars are a major clinical challenge. The aim of this study was to determine the effectiveness and safety of one treatment with the ablative fractional CO laser (AFL-CO) compared to standard burn scar treatment.
From December 2014 to October 2018 patients were prospectively recruited and treatment effects analyzed by assessing various outcome parameters from the date of first consultation and after treatment. A case control study was conducted looking at the impact of one AFL-CO treatment compared to a cohort subjected to conventional conservative treatment. Adverse effects were noted at follow up.
187 patients were included, with 167 in the AFL-CO, and 20 in the control cohort. Baseline demographics and scar characteristics showed no significant differences. Ultrasound measured scar thickness as well as the Vancouver Scar Scale (VSS) revealed a significant reduction in the treatment cohort, but no significant improvement in the control group. The POSAS-O was significantly improved in both cohorts. Subjective parameters (POSAS-P, DN4-Pain, and modified D4Pruritus scores) decreased significantly in the AFL-CO cohort but remained unchanged in the control group. The BSHS-B quality of life score increased significantly in the AFL-CO group, but worsened at the follow up of the untreated patients. Sub-domain analyses found the biggest differences in Affect, Body Image, Heat Sensitivity, Treatment and Work. Complications occurred in 5 patients (2.9%).
This study demonstrates that AFL-CO is an effective and safe treatment modality for burn scars improving thickness, symptoms and quality of life of burn survivors when compared to conventional scar treatment.
烧伤疤痕是一个主要的临床挑战。本研究的目的是确定单次消融性分数 CO2 激光（AFL-CO）治疗与标准烧伤疤痕治疗相比的有效性和安全性。
从 2014 年 12 月至 2018 年 10 月，前瞻性招募患者，并通过评估首次就诊和治疗后各种结局参数来分析治疗效果。进行了一项病例对照研究，比较了单次 AFL-CO 治疗与接受常规保守治疗的队列的影响。在随访时注意到不良反应。
共纳入 187 例患者，其中 AFL-CO 组 167 例，对照组 20 例。基线人口统计学和疤痕特征无显著差异。超声测量的疤痕厚度和温哥华疤痕量表（VSS）显示治疗组显著减少，但对照组无显著改善。POSAS-O 在两组均显著改善。主观参数（POSAS-P、DN4-疼痛和改良 D4-瘙痒评分）在 AFL-CO 组显著下降，但对照组无变化。BSHS-B 生活质量评分在 AFL-CO 组显著增加，但未治疗患者的随访时恶化。子域分析发现，Affect、Body Image、Heat Sensitivity、Treatment 和 Work 等方面的差异最大。5 例患者（2.9%）发生并发症。
与常规疤痕治疗相比，AFL-CO 是一种有效且安全的烧伤疤痕治疗方法，可改善烧伤幸存者的厚度、症状和生活质量。
