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[Effect analysis of sequential laser application in treating the hypertrophic scars of burn children at early stage].

作者信息

Xie C H, Gao X X, Meng X L, Chen K X, Zhang X H, Zhou X, Yu J A

机构信息

Department of Burn Surgery, the First Hospital of Jilin University, Changchun 130061, China.

出版信息

Zhonghua Shao Shang Za Zhi. 2021 Apr 20;37(4):327-332. doi: 10.3760/cma.j.cn501120-20201214-00526.


DOI:10.3760/cma.j.cn501120-20201214-00526
PMID:33874703
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11917226/
Abstract

To explore the effects of sequential application of intensive pulsed light and carbon dioxide laser in treating the hypertrophic scars of burn children at early stage. A retrospective cohort before-after control study in the same patients was conducted. From January 2016 to December 2018, 145 burn children with hypertrophic scar at the early stage who met the inclusion criteria were admitted to the First Hospital of Jilin University, including 82 males and 63 females, aged 1 to 12 (3 (2, 6)) years. All the children were firstly treated with intense pulsed light therapy (no anesthesia or intravenous-inhalation combined anesthesia) at an interval of once per month, and then changed to carbon dioxide laser therapy (topical anesthesia or intravenous-inhalation combined anesthesia) when the degree of scar hyperemia was reduced, at an interval of once every 3 months, for a total of 3 times. Before the first intense pulsed light treatment (hereinafter referred to as before the first treatment) and 3 months after the last carbon dioxide laser treatment (hereinafter referred to as after the last treatment), scar scoring was evaluated by Vancouver Scar Scale (VSS), and scar hyperemia (denoted as hemoglobin level) was measured with Antera 3D camera. The times of intense pulsed light, the time of single treatment, the anesthesia method, and the time of intravenous-inhalation combined anesthesia of intense pulsed light and carbon dioxide laser treatment were analyzed. After the last treatment, Likert Scale was used to evaluate the efficacy satisfaction of both doctors and patients. Adverse reactions were recorded during the treatment. Data were statistically analyzed with Wilcoxon signed rank sum test, and paired sample test. The color, vascular distribution, thickness, and softness scores, and total score in VSS scoring of scars of children after the last treatment were significantly lower than those before the first treatment (=-6.05, -10.34, -9.84, -9.28, -10.43, <0.01). The hemoglobin level of scar of children after the last treatment was 1.86±0.24, significantly lower than 2.27±0.32 before the first treatment (=17.65, <0.01). A total of 411 times of intense pulsed light therapy were performed, (2.8±0.6) times per person, and the single treatment time was 35 (20, 45) s. There were 392 times (95.38%) without anesthesia, and 19 times (4.62%) with intravenous-inhalation combined anesthesia with time of 6 (5, 8) min. The single treatment time of carbon dioxide laser therapy was 5 (3, 10) min. There were 364 times (83.68%) of topical anesthesia and 71 times (16.32%) of intravenous-inhalation combined anesthesia with time of 10 (8, 15) min. After the last treatment, the efficacy satisfaction scores of doctors and patients were (4.3±0.7) and (3.8±1.0) points, respectively. Blisters occurred in 5 cases after intense pulsed light treatment, which were healed naturally after drainage. One child developed local skin infection, skin redness and swelling accompanied by purulent exudate after carbon dioxide laser treatment, which was improved after skin disinfection and external use of mupirocin ointment. No inflammatory pigmentation, worsening of hyperplasia of scar, erythema, or other skin adverse reactions or anesthetics-related adverse reactions occurred in any child. Sequential application of intense pulsed light and carbon dioxide laser to treat the hypertrophic scars of burn children at early stage can obviously improve the appearance and texture of scar, with higher satisfaction of doctors and patients and fewer adverse reactions.

摘要

相似文献

[1]
[Effect analysis of sequential laser application in treating the hypertrophic scars of burn children at early stage].

Zhonghua Shao Shang Za Zhi. 2021-4-20

[2]
[Clinical effects of sequential laser treatments on early stage hypertrophic burn scars].

Zhonghua Shao Shang Za Zhi. 2018-9-20

[3]
[A prospective randomized controlled clinical study on the treatment of hypertrophic scar after burn by fractional carbon dioxide laser combined with autologous fat injection].

Zhonghua Shao Shang Za Zhi. 2021-1-20

[4]
[Clinical comparative study of pulsed dye laser and ultra-pulsed fractional carbon dioxide laser in the treatment of hypertrophic scars after burns].

Zhonghua Shao Shang Za Zhi. 2018-9-20

[5]
[Effects of composite laser technique combined with multipoint microinjection of triamcinolone acetonide in the treatment of hypertrophic scars in burn children].

Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2022-9-20

[6]
[Clinical effects of a combination treatment with narrow-spectrum intense pulsed light and fractional carbon dioxide laser on hypertrophic scar pruritus].

Zhonghua Shao Shang Za Zhi. 2018-9-20

[7]
[Effect of pulsed dye laser in combination with ultra-pulsed fractional carbon dioxide laser in treating pediatric burn scars at early stage].

Zhonghua Shao Shang Za Zhi. 2020-5-20

[8]
[Clinical effect of fractional carbon dioxide laser in the treatment of contracture scars].

Zhonghua Shao Shang Za Zhi. 2021-8-20

[9]
[A prospective randomized controlled study on the effects of compound analgesia in ultra-pulsed fractional carbon dioxide laser treatment of post-burn hypertrophic scars in children].

Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2022-7-20

[10]
[Influence of parental compliance on the treatment of hypertrophic scars in burn children].

Zhonghua Shao Shang Za Zhi. 2021-5-20

引用本文的文献

[1]
Efficacy and safety of a dual-scan protocol for carbon dioxide laser in the treatment of split-thickness skin graft contraction in a red Duroc pig model.

Burns Trauma. 2021-12-31

本文引用的文献

[1]
A comparison of two scar massage protocols in pediatric burn survivors.

Burns. 2020-12

[2]
Pediatric burn contractures in low- and lower middle-income countries: A systematic review of causes and factors affecting outcome.

Burns. 2020-8

[3]
[Scar management strategy in children].

Zhonghua Shao Shang Za Zhi. 2019-10-20

[4]
Fractional CO2 Laser Treatment Outcomes for Pediatric Hypertrophic Burn Scars.

J Burn Care Res. 2019-6-21

[5]
Efficacy of Combined Intense Pulsed Light (IPL) With Fractional CO -Laser Ablation in the Treatment of Large Hypertrophic Scars: A Prospective, Randomized Control Trial.

Lasers Surg Med. 2019-10

[6]
[Clinical effects of sequential laser treatments on early stage hypertrophic burn scars].

Zhonghua Shao Shang Za Zhi. 2018-9-20

[7]
Pressure garment to prevent abnormal scarring after burn injury in adults and children: the PEGASUS feasibility RCT and mixed-methods study.

Health Technol Assess. 2018-6

[8]
Laser Therapy for Pediatric Burn Scars: Focusing on a Combined Treatment Approach.

J Burn Care Res. 2018-4-20

[9]
Early laser intervention to reduce scar formation - a systematic review.

J Eur Acad Dermatol Venereol. 2018-3-13

[10]
Laser advances in the treatment of burn and traumatic scars.

Semin Cutan Med Surg. 2017-12

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