Health Problem: The 2 most problematic abnormal scars include keloids and hypertrophic scars, which may cause contracture leading to dysfunction and disfigurement. The incidence of hypertrophic scarring is estimated to occur in 91% of burn injuries.
Technology Description: Fractional carbon dioxide and erbium-doped yttrium aluminum garnet lasers are commonly used for treatment of excessive scarring. Laser therapy may be used to improve erythema, texture, pliability, and pain associated with burn and traumatic scars.
Controversy: There is no standard treatment for hypertrophic scars and keloids that result in functional impairment. Surgical excision can release scar tension and improve functionality; however, it is associated with a high rate of recurrence. Fractional laser therapy represents a safe treatment option; however, the efficacy and longevity of this method are not known. Additionally, the optimal type of laser and treatment parameters are unknown.
- Is fractional laser treatment effective at improving function associated with burn or traumatic scars?
- How does fractional laser treatment compare with other treatments for burn or traumatic scars for improving functional outcomes?
- Is fractional laser treatment safe?
- Have definitive patient selection criteria been identified for fractional laser therapy?
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