Sinha Sarthak, Baykan Altay, Hulin Karen, Baron Doug, Gabriel Vincent, Fraulin Frankie O G
Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada.
Section of Pediatric Surgery, Department of Surgery, University of Calgary, Calgary, AB T2N 1N4, Canada.
Eur Burn J. 2025 Feb 20;6(1):10. doi: 10.3390/ebj6010010.
Assessing hypertrophic scar (HTS) interventions is challenging because scars continue to undergo dynamic changes. A split-scar design can distinguish treatment effects from natural HTS evolution. Despite promising reports of ablative fractional CO lasers (AFCOLs) for HTS, split-scar evidence, particularly in pediatric scars, remains limited.
To explore the feasibility of a split-scar design in assessing AFCOL's impact on pediatric HTS and to identify potential trends in treatment outcomes.
Initially designed as a prospective single-center split-scar randomized controlled trial, our study transitioned to a feasibility trial due to recruitment challenges. Pediatric patients aged 1-17 years with HTS suitable for split-scar evaluation received three AFCOL treatments at 6-8-week intervals, with outcomes assessed using the Vancouver Scar Scale (VSS), SCAR-Q, and Cutometer.
Recruitment was limited by COVID-19 restrictions, concerns about general anesthesia for split-scar treatment, and low interest in divided-scar interventions, resulting in only 6 participants with 9 scars enrolled, far below the target sample size of 44. This small heterogeneous sample precluded meaningful clinical outcome analysis.
Our feasibility trial highlights challenges in conducting rigorous pediatric HTS studies and the need for careful interpretation of evidence due to potential publication bias. Future trials should focus on tailored recruitment and comprehensive reporting to improve feasibility and reliability.
评估增生性瘢痕（HTS）干预措施具有挑战性，因为瘢痕会持续发生动态变化。裂瘢痕设计可区分治疗效果与HTS的自然演变。尽管有关于剥脱性点阵CO2激光（AFCOLs）治疗HTS的前景良好的报告，但裂瘢痕证据，尤其是在儿童瘢痕方面，仍然有限。
探讨裂瘢痕设计在评估AFCOLs对儿童HTS影响中的可行性，并确定治疗结果的潜在趋势。
我们的研究最初设计为一项前瞻性单中心裂瘢痕随机对照试验，由于招募困难，转变为一项可行性试验。年龄在1至17岁、有适合裂瘢痕评估的HTS的儿科患者每隔6至8周接受三次AFCOL治疗，使用温哥华瘢痕量表（VSS）、瘢痕质量量表（SCAR-Q）和皮肤弹性测量仪评估结果。
招募受到COVID-19限制、对裂瘢痕治疗全身麻醉的担忧以及对裂瘢痕干预兴趣较低的限制，导致仅6名参与者、9处瘢痕入组，远低于44的目标样本量。这个小的异质性样本无法进行有意义的临床结果分析。
我们的可行性试验凸显了开展严格的儿科HTS研究的挑战，以及由于潜在的发表偏倚而需要对证据进行谨慎解读。未来的试验应侧重于针对性招募和全面报告，以提高可行性和可靠性。
