Laser Strategies for Complex Scars: Experience from Establishing a Supra-Regional Laser Service for Burns and Complex Scarring

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Laser Management of Scars

Abstract

Laser scar management is a complex area that relies on the use of a number of different laser modalities to achieve a variety of modulatory effects on scar tissue. The challenges involved include the availability (and cost) of a range of lasers, clinical experience—especially with complex conditions such as burns, and hence patients tend to gravitate to regional and supra-regional referral centres where sufficient numbers of patients are treated. This chapter provides clinical examples of laser interventions for patients with a range of scars including complex burns scars, keloid scars, and how lasers can be used to improve scarring.

All images in this chapter are published with kind permission of (c) K.Shokrollahi (senior author), St Helens & Knowsley NHS Trust, 2018

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Abbreviations

ACO2 :

Abblative carbdon dixoide laser

FCO2 :

Fractionated carbdon dixoide laser

Hz:

Hertz

J:

Joules

PDL:

Pulsed dye laser

QS:

Q-switched

Rx:

Treatment

UK:

United Kingdom

References

  1. Gauglitz GG, Korting HC, Pavicic T, Ruzicka T, Jeschke MG. Hypertrophic scarring and keloids: pathomechanisms and current and emerging treatment strategies. Mol Med. 2011;17:113–25.

    Article  CAS  Google Scholar 

  2. McGoldrick RB, Theodorakopoulou E, Azzopardi EA, Murison M. Lasers and ancillary treatments for scar management part 2: keloid, hypertrophic, pigmented and acne scars. Scars Burn Heal. 2017;3:2059513116689805. https://doi.org/10.1177/2059513116689805.

    Article  PubMed  PubMed Central  Google Scholar 

  3. McGoldrick RB, Sawyer A, Davis CR, Theodorakopoulou E, Murison M. Lasers and ancillary treatments for scar management: personal experience over two decades and contextual review of the literature. Part I: burn scars. Scars Burn Heal. 2016;2:2059513116642090. https://doi.org/10.1177/2059513116642090.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Shokrollahi K, Linday KJ. Laser management of scars (Ch44). In: Whitaker, Shokrollahi, Dickson, editors. Oxford handbook of burns. Oxford: Oxford University Press; 2019.

    Google Scholar 

  5. British Burns Association Professional standards 2018 for adult and paediatric burn care. https://www.britishburnassociation.org/wpcontent/uploads/2018/11/BCSO-2018-FINAL-v28.pdf.

  6. Haina D, Landthaler M, Braun-Falco O, Waidelich W. Comparison of the maximum coagulation depth in human skin for different types of medical lasers. Lasers Surg Med. 1987;7(4):355–62. https://doi.org/10.1002/lsm.1900070411.

    Article  CAS  PubMed  Google Scholar 

  7. Shokrollahi K, Raymond E, Murison MSC. Lasers: principles and surgical applications. J Surg. 2004;2:28–34. https://doi.org/10.1016/S1743-9191(06)60023-X.

    Article  Google Scholar 

  8. Anderson RR, Parrish JA. Selective photothermolysis: precise microsurgery by selective absorption of pulsed radiation. Science. 1983;220(4596):524–27. https://doi.org/10.1126/science.6836297.

  9. Shokrollahi K, Raymond E, Murison MSC. Lasers: principles and surgical applications. The Journal of Surgery. 2014;28–34. https://doi.org/10.1016/S1743-9191(06)60023-X.

  10. Shokrollahi K. The laser test patch. Ann Plast Surg. 2016;77:373–5.

    Article  CAS  Google Scholar 

  11. Nehal KS, Levine VJ, Ross B, Ashinoff R. Comparison of high-energy pulsed carbon dioxide laser resurfacing and dermabrasion in the revision of surgical scars. Dermatol Surg. 1998;24:647–50.

    CAS  PubMed  Google Scholar 

  12. Becker DW. Use of the carbon dioxide laser in treating multiple cutaneous neurofibromas. Ann Plast Surg. 1991;26:582–6.

    Article  Google Scholar 

  13. Kilmer SL, Lee MS, Grevelink JM, Flotte TJ, Anderson RR. The Q-switched Nd:YAG laser effectively treats tattoos. A controlled, dose-response study. Arch Dermatol. 1993;129:971–8.

    Article  CAS  Google Scholar 

  14. Tan OT, Murray S, Kurban AK. Action spectrum of vascular specific injury using pulsed irradiation. J Invest Dermatol. 1989;92:868–71.

    Article  CAS  Google Scholar 

  15. Edström DW, Ros AM. The treatment of port-wine stains with the pulsed dye laser at 600 nm. Br J Dermatol. 1997;136:360–3.

    Article  Google Scholar 

  16. Al-Mohamady AE, Ibrahim SM, Muhammad MM. Pulsed dye laser versus long-pulsed Nd:YAG laser in the treatment of hypertrophic scars and keloid: a comparative randomized split-scar trial. J Cosmet Laser Ther. 2016;8:1–5.

    Google Scholar 

  17. Koike S, Akaishi S, Nagashima Y, Dohi T, Hyakusoku H, Ogawa R. Nd:YAG laser treatment for keloids and hypertrophic scars: an analysis of 102 cases. Plast Reconstr Surg Glob Open. 2015;2(12):e272.

    Article  Google Scholar 

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Acknowledgement

A number of patients treated had their initial burn care in other hospitals around the country, not at the burn/laser centre of the senior author. Their excellent treatment prior to the commencement of laser treatment is acknowledged and applauded.

Note: All patients featured in this chapter underwent laser treatment or surgery under the care of Professor Shokrollahi and consent provided in writing for publication.

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Shokrollahi, K., Taylor, L., Gill, P. (2020). Laser Strategies for Complex Scars: Experience from Establishing a Supra-Regional Laser Service for Burns and Complex Scarring. In: Shokrollahi, K. (eds) Laser Management of Scars. Springer, Cham. https://doi.org/10.1007/978-3-030-52919-2_4

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  • DOI: https://doi.org/10.1007/978-3-030-52919-2_4

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-52918-5

  • Online ISBN: 978-3-030-52919-2

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