gms | German Medical Science

Fractional CO₂ laser treatment is one of the few interventions capable of treating burn scars. A study published in the Journal of Lasers in Surgery and Medicine showed the histologic changes induced after fractional CO₂ treatment. This is a prospective study of fractional CO₂ laser treatment of mature burn scars, comparing objective and subjective scar measurements evaluating at least one treatment and one control scar on the same patient pre- and post treatments.

Burn survivors with mature Burn scars were invited to enter the study. Fractional CO₂ Laser treatments were performed in an office setting at 40 to 90 mJ , 100–150 spots per cm². Three treatments were performed in at least 4 week intervals. Subjective and objective measurements were performed before and at least one month after the treatment series on both, the treated and the control scar. IRB approval was obtained.

Results: A total of 80 scars, 48 treatment and 32 control scars, were included in the study. There was mild irritation and swelling post treatment in the treated scars. No blister formation or infection was noted. Treatment pain score averaged at 4.7/10 during and at 2.4/10 5 minutes after the treatment. By day 3 no more noticeable discomfort was reported.

All treated scars showed improvement. Objectively measured thickness, sensation, erythema and pigmentation improved significantly in the treated scars (p=0.001, 0.001, 0.004 and 0.001). Vancouver scar scale assessments by an independent observer improved from 8 to 6, self-reported pain and pruritus remained unchanged in both groups.

Fractional CO₂ laser treatment is a promising entity in the treatment of burn scars. Our results show significant differences in objective measurements between the treated scars and the untreated control scars. The patient observer- as well as the Vancouver scar scales seem questionable as a reliable assessment tool in scar treatment studies.