Division of Plastic and Reconstructive Surgery, Keck School of Medicine of University of Southern California, Los Angeles, CA, United States; Keck School of Medicine of University of Southern California, Los Angeles, CA, United States.
Division of Plastic and Reconstructive Surgery, Keck School of Medicine of University of Southern California, Los Angeles, CA, United States.
Burns. 2021 Mar;47(2):259-269. doi: 10.1016/j.burns.2020.10.026. Epub 2020 Nov 9.
Burn injury can cause abnormal healing and pathologic scar formation that significantly impairs patients' ability to return to baseline levels of functioning. Quality of life can be significantly diminished due to pain, stiffness, contracture, and the psychological burden of disfigurement. Traditional scar therapies such as silicone sheeting and compression garments are highly reliant on patient compliance, and have not demonstrated satisfactory efficacy. Even more invasive therapies such as intralesional medication delivery or surgical contracture release have high recurrence rates. Recently, fractional CO laser therapy has emerged as a promising treatment modality for burn scars, but there is a lack of recent studies that aggregates extant data to demonstrate outcomes after laser therapy. To address this, we conducted a systematic review and meta-analysis to determine the efficacy of fractional CO lasers in treating burn scars, and found that laser therapy alone yielded statistically significant improvements in scar profiles. There were very few reports of adverse effects, most treatments were provided as outpatient, and both patient and burn practitioners reported high satisfaction. By sharing our findings, we hope that more burn practitioners will consider adopting laser therapy as a safe and cost-effective first-line therapy for burn scar management.
烧伤会导致异常愈合和病理性瘢痕形成,显著降低患者恢复基线功能水平的能力。疼痛、僵硬、挛缩以及毁容带来的心理负担会使生活质量显著下降。传统的瘢痕治疗方法,如硅酮贴和压力衣,高度依赖于患者的依从性,且疗效并不理想。即使是更具侵入性的治疗方法,如瘢痕内药物注射或手术松解,其复发率也很高。最近,点阵 CO2 激光治疗已成为治疗烧伤瘢痕的一种有前途的治疗方法,但缺乏汇总现有数据以展示激光治疗后结果的近期研究。为了解决这个问题,我们进行了一项系统评价和荟萃分析,以确定点阵 CO2 激光治疗烧伤瘢痕的疗效,结果发现激光治疗单独使用可显著改善瘢痕外观。仅有极少数不良反应的报告,大多数治疗都是在门诊进行的,患者和烧伤医生的满意度都很高。通过分享我们的发现,我们希望更多的烧伤医生将考虑采用激光治疗作为烧伤瘢痕管理的一种安全且具有成本效益的一线治疗方法。
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