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

作者信息

Yin Zhe, Zhang Xiu-Hang, He Yi-Yi, Cai Duo, Zhou Xin, Li Yu-Tang, Yu Qing-Hua, Yu Jia-Ao, Chen Xin-Xin

机构信息

The First Hospital of Jilin University, Changchun, China.

出版信息

Lasers Med Sci. 2025 Feb 7;40(1):77. doi: 10.1007/s10103-025-04333-x.


DOI:10.1007/s10103-025-04333-x
PMID:39918788
Abstract

This study aims to determine the effectiveness of combining pulsed dye laser (PDL) and ablative fractional carbon dioxide laser (AFCL) in the treatment of scars in pediatric patients, as well as to identify appropriate treatment parameters, initial treatment timing, and treatment intervals through a systematic literature review. A literature search was conducted between April 6, 2014 and April 6, 2024 in four databases to select studies on the effects of the combination of carbon dioxide fractional laser and pulsed dye laser therapy in children hypertrophic burn scars. This systematic literature review included 497 participants across 8 studies, with individual study sample sizes ranging from 17 to 125 participants. 7 studies reported the gender distribution of participants, with a higher proportion of males (60%, n = 264) than females (40%, n = 170). The average age of the patients was 7.18 years, and scald (62%, n = 235) were identified as the primary cause of scar. The combination therapy of 595 nm PDL and 10,600 nm AFCL significantly improved Vancouver Scar Scale (VSS) / Patient and Observer Scar Assessment Scale (POSAS) score. Study treatment intervals were approximately 1-2 months for simultaneous treatment and 1 month for PDL and 3 months for AFCL for sequential treatment. Two studies investigated the efficacy of early laser therapy (< 3 months), the AFCL laser energy parameters ranged from 30 mJ-50 mJ, significantly lower than the rest of the studies of laser energy parameters, which ranged from 50 mJ-120 mJ. The PDL energy density parameters showed little difference from study to study and were in the range of 5-12 J/cm. Complications after treatment (4%, n = 22), with rash being the most common (50%, n = 11). Rational use of PDL combined with AFCL (lower laser energy, increase density parameters, shorten treatment intervals (< 1 month)) can safely and effectively treat hypertrophic scars in pediatric burn patients and is superior to single-type laser therapy in efficacy. Significant disorganization was observed among studies suggesting the need to explore high-level evidence-based clinical research that may improve treatment outcomes.

摘要

相似文献

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

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本文引用的文献

[1]
The efficacy, satisfaction, and safety of carbon dioxide (CO2) fractional laser in combination with pulsed dye laser (PDL) versus each one alone in the treatment of hypertrophic burn scars: a single-blinded randomized controlled trial.

Lasers Med Sci. 2024-2-20

[2]
Efficacy of pulsed dye laser combined with fractional CO laser in the treatment of pediatric burn scars.

Lasers Surg Med. 2023-7

[3]
Becoming Experts in Their Own Treatment: Child and Caregiver Engagement With Burn Scar Treatments.

Qual Health Res. 2023-5

[4]
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

[5]
Experimental comparative study of the effect of fractional CO laser combined with pulsed dye laser versus each laser alone on the treatment of hypertrophic scar of rabbit ears.

J Cosmet Dermatol. 2022-3

[6]
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

[7]
Paraffin wax bath therapy versus therapeutic ultrasound in management of post burn contractures of small joints of hand.

Int J Burns Trauma. 2021-6-15

[8]
Ablative fractional CO laser surgery improving sleep quality, pain and pruritus in adult hypertrophic scar patients: a prospective cohort study.

Burns Trauma. 2021-7-27

[9]
Noninvasive Objective Tools for Quantitative Assessment of Skin Scarring.

Adv Wound Care (New Rochelle). 2022-3

[10]
Effects of combined Pulsed Dye Laser and Fractional CO Laser treatment of burn scars and correlation with plasma levels of collagen type I, MMP-2 and TIMP-1.

Burns. 2021-9

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