Combined reconstructive surgery with the ablative fractional CO2 laser following burn injuries: A Case-Series

Andrea C Issler-Fisher1, Ania Smialkowski2, Oliver M Fisher3, Peter Haertsch4, Peter KM Maitz5

1 Burns Unit, Concord Repatriation General Hospital, Hospital Rd, Concord NSW 2139, Australia; andrea.isslerfisher@gmail.com
2 Burns Unit, Concord Repatriation General Hospital, Hospital Rd, Concord NSW 2139, Australia; aniasmialkowski@yahoo.com.au
3 St. Vincent’s Centre for Applied Medical Research, 405 Liverpool St, Sydney NSW 2011, Australia; ofisher@gmx.ch
4Burns Unit, Concord Repatriation General Hospital, Hospital Rd, Concord NSW 2139, Australia; peterhaertsch@bigpond.com
5 Burns Unit, Concord Repatriation General Hospital, Hospital Rd, Concord NSW 2139, Australia; peter.maitz@sydney.edu.au

With improvements in the management of burn patients and the associated improved survival rates, burn scars can create significant morbidity. Besides the obvious stigma, patients often suffer from itchiness, neuropathic pain, and contractures. Until recently, the former two symptoms were difficult to treat with surgery and it was recommended to perform reconstructive procedures only if the burns scars were fully mature. However, the advent of the ablative fractional CO2 laser represents a milestone in burn and reconstructive surgery, as it enables the surgeon to address the scars more holistically, allows for earlier scar treatment and may help reduce the extent of reconstructive surgical procedures.

In this series of 15 patients, we present cases where ablative fractional burn scar resurfacing was combined with other reconstructive surgeries, such as z-plasties, nasal reconstructions and fat grafting in an attempt to address all facets of burn scar impairment, reduce the extent of reconstructive procedures and hence minimize associated surgical morbidity.

Key Words

burn scars, reconstructive surgery, ablative fractional CO2 laser

Biography

Doctor Andrea C. Issler-Fisher graduated from the Faculty of Medicine of the University of Zurich and was training in general, plastic, and burn surgery in Switzerland. In 2013 Dr Issler-Fisher was appointed fellow for burns & reconstructive surgery at the Burns Unit of Concord Repatriation General Hospital in Sydney, Australia. In 2015, Dr Issler-Fisher established the burns scar clinic at Concord Hospital under the guidance of Prof Peter Maitz. Her main interest is surgical and non-surgical remodelling of severe burn scars.

About ANZBA

ANZBA is a not for profit organisation and the peak body for health professionals responsible for the care of the burn injured in Australia and New Zealand. ANZBA encourages higher standards of care through education, performance monitoring and research.

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