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Ablative CO 2 fractional resurfacing in treatment of thermal burn scars: an open‐label controlled clinical and histopathological study
Author(s) -
ElZawahry Bakr M,
Sobhi Rehab M,
Bassiouny Dalia A,
Tabak Sahar A
Publication year - 2015
Publication title -
journal of cosmetic dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.626
H-Index - 44
eISSN - 1473-2165
pISSN - 1473-2130
DOI - 10.1111/jocd.12163
Subject(s) - scars , medicine , dermis , histopathology , masson's trichrome stain , surgery , hypertrophic scars , dermatology , trichrome , fibrosis , pathology , h&e stain , immunohistochemistry
Summary Introduction Burn scars can cause permanent disfiguring problems with limited treatments available. Objectives To assess and correlate the clinical and histopathological effects of fractional CO 2 laser on thermal burns in a controlled study. Methods Fifteen patients 11 with hypertrophic and four with keloidal scars received three CO 2 fractional laser sessions every 4–6 weeks. Half of the scar was untreated as a control. Clinical evaluation by Vancouver, PSOAS scores, and photography before, monthly, and 3 months after the last laser session was performed. Ten patients were evaluated histopathologically by standard H&E, Masson trichrome, and Elastica von Gieson special stains. Results Hypertrophic scars ( HTS s) showed textural improvement and a significant decrease of Vancouver, POSAS observer, and patient scores by the end of follow‐up period in the laser‐treated area ( P = 0.011, 0.017 and 0.018, respectively) unlike keloidal scars. Histopathology revealed significant decrease in scar thickness in HTS s only ( P < 0.001) as well as a significant decrease in collagen bundle thickness and density in the upper dermis in both types of scars. Conclusions Fractional CO 2 laser is a possible safe and effective modality for the treatment of hypertrophic burn scars with improvement achieved both clinically and histopathologically.