Prophylactic Treatment of Deep Dermal Burn Scar to Prevent Hypertrophic Scarring Using the Pulsed Dye Laser: A Preliminary Study

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Abstract
The pulsed dye laser, by selectively targeting blood vessels, has been used to treat established hypertrophic scars with good effect. This prospective clinical study aims to assess the feasibility of treating deep dermal burn wounds prophylactically before the formation of hypertrophic scars. Patients with burn wounds that took longer than 2 weeks to heal were primarily recruited. Each patient's burn area was divided into a treated area and a negative control. The area was laser treated with the pulsed dye laser (Chromos 585; SLS, Wales) twice at 6 weekly intervals. The appearance of the wound at both sites was inspected visually and scored at 6 weeks, and at 3, 6, and 9 months. Five patients with six burn sites (forearm, arm, and back) were treated. Treated areas achieved better scarring at 6 weeks (p = 0.04, paired t-test) and at 3 months (p = 0.003, paired t-test). The difference, however, became insignificant at 6 and 9 months. No notable side effects were seen in all patients. Prophylactic treatment of burn wounds with the pulsed dye laser is effective in hastening the resolution of scarring. In the authors’ opinion, this treatment may revolutionize the traditional method of hypertrophic burn scar prevention, and should be considered early, especially for patients who are prone to hypertrophic scarring, and in areas where hypertrophic scarring are common.