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单一机构 10 年来对烧伤后行非剥脱性二氧化碳点阵激光治疗的儿童的经验:气压致皮肤抬高和回缩时间(Dermalab)的测量,包括标准化的主观和客观瘢痕评估。

A Single-Institution Experience About 10 Years With Children Undergoing Fractional Ablative Carbon Dioxide Laser Treatment After Burns: Measurement of Air Pressure-Induced Skin Elevation and Retraction Time (Dermalab) Including Standardized Subjective and Objective Scar Evaluation.

机构信息

Department for Pediatric Surgery, Klinikum Stuttgart/Olgahospital, Germany.

出版信息

J Burn Care Res. 2023 May 2;44(3):655-669. doi: 10.1093/jbcr/irac125.


DOI:10.1093/jbcr/irac125
PMID:36155789
Abstract

Laser treatment has gained more and more importance in the therapy of scars during the last years. Scientific work, especially in children, is scarce on this topic and mostly with an insufficient number of cases or only subjective descriptions. Our study included 77 children from 2012 to 2022 with scars after thermal injury. These were treated at least three times or more by CO2 laser or in combination with pulsed dyed laser (PDL). Beforehand, scar texture and elasticity were determined by a skin elasticity analysis system. Regarding the subjective evaluation, a questionnaire was given to the patients or their parents. Further criteria were the Patient and Observer Scar Assessment Scale (POSAS) and Vancouver Scar Scale (VSS). A statistically significant improvement in elasticity was demonstrated in all scars of any age after each laser treatment. In addition, a significant correlation was found between the number of laser treatments and an increase in elasticity. The assessments of scars after one or more laser sessions by the observer as well as the patient showed a decreasing score in all categories with an increase in the number of laser therapies. The VSS score also improved significantly after each laser session. The mean score before treatment was about 7, after the first laser session, the mean score was already below 6 with a statistical significance. Ninety-six percent of the patients or their parents were satisfied with the laser therapy, and 90% wished to repeat the procedure. This work confirms, by means of the objectification by the scar measurement, the previous scientific works concerning a scar therapy by laser and emphasizes particularly that this can also be used without problems with children with symptomatic scars, contractures, or with cosmetically relevant scars.

摘要

近年来,激光治疗在疤痕治疗中的重要性日益增加。关于这个主题的科学研究很少,尤其是在儿童中,而且大多数研究的病例数量不足,或者只是主观描述。我们的研究包括 2012 年至 2022 年间 77 名因热伤而留下疤痕的儿童。这些儿童至少接受了 3 次或更多次 CO2 激光或脉冲染料激光(PDL)联合治疗。在此之前,通过皮肤弹性分析系统确定了疤痕的质地和弹性。在主观评估方面,我们向患者或其家长发放了一份调查问卷。进一步的标准是采用患者和观察者瘢痕评估量表(POSAS)和温哥华瘢痕量表(VSS)。在所有年龄的疤痕中,每次激光治疗后都能显著改善弹性。此外,还发现激光治疗次数与弹性增加之间存在显著相关性。经观察者和患者评估,单次或多次激光治疗后,所有类别疤痕的评分均呈下降趋势,且随着激光治疗次数的增加而降低。每次激光治疗后,VSS 评分也显著提高。治疗前的平均评分为 7 分左右,第一次激光治疗后,平均评分已经低于 6 分,具有统计学意义。96%的患者或其家长对激光治疗满意,90%的患者希望重复该治疗。这项工作通过疤痕测量的客观化,证实了之前关于激光治疗疤痕的科学研究,并特别强调,即使是有症状性疤痕、挛缩或美容相关疤痕的儿童,也可以毫无问题地使用激光进行治疗。

相似文献

[1]
A Single-Institution Experience About 10 Years With Children Undergoing Fractional Ablative Carbon Dioxide Laser Treatment After Burns: Measurement of Air Pressure-Induced Skin Elevation and Retraction Time (Dermalab) Including Standardized Subjective and Objective Scar Evaluation.

J Burn Care Res. 2023-5-2

[2]
Ultrapulsed fractional ablative carbon dioxide laser treatment of hypertrophic burn scars: evaluation of an in-patient controlled, standardized treatment approach.

Lasers Med Sci. 2017-7

[3]
[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

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

J Burn Care Res. 2019-6-21

[5]
Hypertrophic Scar Improvement by Early Intervention With Ablative Fractional Carbon Dioxide Laser Treatment.

Lasers Surg Med. 2021-4

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

Zhonghua Shao Shang Za Zhi. 2018-9-20

[7]
Treatment of burn hypertrophic scar with fractional ablative laser-assisted drug delivery can decrease levels of hyperpigmentation.

Lasers Surg Med. 2023-7

[8]
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

[9]
A new CO2 laser technique for the treatment of pediatric hypertrophic burn scars: An observational study.

Medicine (Baltimore). 2016-10

[10]
The efficacy and safety of low-energy carbon dioxide fractional laser use in the treatment of early-stage pediatric hypertrophic scars: A prospective, randomized, split-scar study.

Lasers Surg Med. 2022-2

引用本文的文献

[1]
Combination therapy of pulsed dye laser and ablative fractional carbon dioxide laser for the treatment of pediatric postburn scar: a systematic review.

Lasers Med Sci. 2025-2-7

[2]
The Pathophysiology and Management of Pathologic Scarring-a Contemporary Review.

Adv Wound Care (New Rochelle). 2025-1

[3]
Prevention and Treatment of Burn Scar Contracture: A Practical Review.

Plast Reconstr Surg Glob Open. 2024-1-19

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