Surgical standard for treating traumatic burn injury scarring is to wait one year following the initial assault prior to beginning treatment. This study investigates the use of fractional ablative CO2 laser when begun within 3 months of a traumatic burn injury and it's impact on scar formation compared to the control. We hypothesized that early intervention would substantially mitigate the formation of scar tissue and help restore more normal appearing skin.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
19
Three treatments with a fractional ablative CO2 laser 8 weeks apart
Manchester Scar Scale
The sum total of the Manchester Scar Scale to assess the change in scar characteristics. The scale includes the following categories: Color, matte vs shiny, contour, distortion, and texture. Scales for color, contour, distortion, and texture are rated on a 1-4 scale with 1 being most normal and 4 being most abnormal. Matte vs shiny is rated on a 1 to 2 scale with 1 being matte and 2 being shiny. Assessments completed by blinded evaluators. A decrease in score indicates improvement in scar characteristics.
Time frame: From the day of the first treatment prior to intervention and at 6 months following the final treatment
Digital photography
Visual improvement as demonstrated in digital photography. Before and after photos identified by blinded evaluators
Time frame: From the day of the first treatment prior to intervention and at 6 months following the final treatment
Changes in scar characteristics such as dermal and epidermal character as well as vascular structure and organization assessed through histology.
Some patients elected to do optional biopsies for deeper evaluation of changes in skin structure. Biopsies were taken prior to treatment and 6 months following treatment to assess dermal and epidermal character as well as the size and organization of vasculature. Evaluation was done qualitatively.
Time frame: From the day of the first treatment prior to intervention and at 6 months following the final treatment
Optical Coherence Tomography
Patients were scanned using OCT for noninvasive skin imaging of both control and treatment areas
Time frame: From the day of the first treatment prior to intervention and at 6 months following the final treatment
Treatment Time
The total duration of each treatment was measured in minutes to assess treatment characteristics for large surface areas
Time frame: Treatment time was measured at each of the three treatments conducted on day 0, day 60, and day 120
Severity of post treatment cutaneous responses as evaluated by the investigator
Cutaneous responses including purpura, edema, erythema, hyperpigmentation, hypopigmentation, blistering and scarring were assessed following each treatment. Areas were rated on a 1-4 scale where 1 = none, 2 = mild, 3 = moderate, and 4 = severe.
Time frame: Post treatment response was assessed immediately post treatment at each of the three treatments conducted on day 0, day 60, and day 120
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