Fractional CO2 laser treatment for burn scar improvement: A systematic review and meta-analysis

• Published in: Burns Vol. 47; no. 2; pp. 259 - 269
• Main Authors: Choi, Katherine J., Williams, Eva A., Pham, Christopher H., Collier, Zachary J., Dang, Justin, Yenikomshian, Haig A., Gillenwater, T. Justin
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01.03.2021
• Subjects: Burn; Laser; Photothermolysis; Scar; Burn; Photothermolysis; Scar; Laser
• ISSN: 0305-4179; 1879-1409
• DOI: 10.1016/j.burns.2020.10.026

•There is a growing interest to improve quality of life after burn injury.•Scarring and disfigurement after burn injury can cause pain, contracture, and significant psychological burden.•Traditional scar therapies are time-intensive and not always efficacious.•Recently, fractional CO2 laser therapy has emerged as a promising therapy for burn scar management. Burn injury can cause abnormal healing and pathologic scar formation that significantly impairs patients’ ability to return to baseline levels of functioning. Quality of life can be significantly diminished due to pain, stiffness, contracture, and the psychological burden of disfigurement. Traditional scar therapies such as silicone sheeting and compression garments are highly reliant on patient compliance, and have not demonstrated satisfactory efficacy. Even more invasive therapies such as intralesional medication delivery or surgical contracture release have high recurrence rates. Recently, fractional CO2 laser therapy has emerged as a promising treatment modality for burn scars, but there is a lack of recent studies that aggregates extant data to demonstrate outcomes after laser therapy. To address this, we conducted a systematic review and meta-analysis to determine the efficacy of fractional CO2 lasers in treating burn scars, and found that laser therapy alone yielded statistically significant improvements in scar profiles. There were very few reports of adverse effects, most treatments were provided as outpatient, and both patient and burn practitioners reported high satisfaction. By sharing our findings, we hope that more burn practitioners will consider adopting laser therapy as a safe and cost-effective first-line therapy for burn scar management.