Laser Treatment of Traumatic Scars With an Emphasis on Ablative Fractional Laser Resurfacing Consensus Report

被引:237
作者
Anderson, R. Rox [1 ]
Donelan, Matthias B. [2 ]
Hivnor, Chad [3 ]
Greeson, Eric [3 ]
Ross, E. Victor [4 ]
Shumaker, Peter R. [5 ]
Uebelhoer, Nathan S. [5 ]
Waibel, Jill S. [6 ]
机构
[1] Massachusetts Gen Hosp, Wellman Ctr Photomed, Boston, MA 02114 USA
[2] Shriners Hosp Children, Dept Plast Surg, Boston, MA USA
[3] San Antonio Uniformed Hlth Educ Consortium, Lackland AFB, TX USA
[4] Scripps Clin Laser & Cosmet Dermatol Ctr, San Diego, CA USA
[5] Naval Med Ctr, Dept Dermatol, San Diego, CA 92134 USA
[6] Miami Dermatol & Laser Inst, Miami, FL USA
关键词
CARBON-DIOXIDE LASER; BURN SCARS; PHOTOTHERMOLYSIS; CONTRACTURES; IMPROVEMENT; CO2-LASER; THERAPY;
D O I
10.1001/jamadermatol.2013.7761
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100227 [皮肤病学];
摘要
IMPORTANCE Despite expert wound care and assiduous management with traditional therapy, poor cosmetic outcomes, restricted motion, and symptoms such as pain and itch are a pervasive problem of disfiguring and debilitating scars. The advent of ablative fractional photothermolysis within the past decade and its application to the treatment of traumatic scars represents a breakthrough in the restoration of function and cosmetic appearance for injured patients, but the procedure is not widely used. OBJECTIVE To provide a synthesis of our current clinical experience and available literature regarding the laser treatment of traumatic scars with an emphasis on fractional resurfacing. EVIDENCE REVIEW Eight independent, self-selected academic and military dermatology and plastic surgery physicians with extensive experience in the use of lasers for scar treatment assembled for a 2-day ad hoc meeting on January 19 and 20, 2012. Consensus was based largely on expert opinion, but relevant literature was cited where it exists. FINDINGS After consensus was appraised, we drafted the manuscript in sections during the course of several months. The draft was then circulated among all panel members for final review and comment. Our consensus is that laser treatment, particularly ablative fractional resurfacing, deserves a prominent role in future scar treatment paradigms, with the possible inclusion of early intervention for contracture avoidance and assistance with wound healing. CONCLUSIONS AND RELEVANCE Laser scar therapy, particularly fractional ablative laser resurfacing, represents a promising and vastly underused tool in the multidisciplinary treatment of traumatic scars. Changes to existing scar treatment paradigms should include extensive integration of fractional resurfacing and other combination therapies guided by future research.
引用
收藏
页码:187 / 193
页数:7
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