Improvement of Burn Scars Treated With Fractional Ablative CO2 Lasers—A Systematic Review and Meta-analysis Using the Vancouver Scar Scale

Dr Patrick Mahar1,2, Dr Anneliese Spinks3, A/Prof Heather Cleland4, A/Prof Philip Bekhor1,2, Dr Jill Waibel5, Mr Cheng Lo4, Prof Gregory Goodman6

1The Royal Children’s Hospital , Melbourne, Australia, 2Skin Health Institute, Melbourne, Australia, 3Queensland Centre for Mental Health Research, Brisbane, Australia, 4Victorian Adult Burns Service, Alfred Health, Melbourne, Australia, 5Miami Dermatology & Laser Institute, Miami, USA, 6Dermatology Institute of Victoria, Melbourne, Australia


Fractional ablative CO2 laser is being used increasingly to treat burn scars; however, objective measures of outcome success vary widely. This systematic review and meta-analysis extracts and pools available data to assess the outcomes of patients with burn scars treated with fractional ablative CO2 laser. A search of MEDLINE, EMBASE, and the gray literature was performed. The review included studies that reported patients with a confirmed diagnosis of scarring as a result of a burn injury, who were treated with fractional ablative CO2 laser and whose progress was recorded using the Vancouver Scar Scale (VSS). Eight studies were included in the systematic review and meta-analysis. Treatment regimens varied amongst studies, as did patient outcomes. Pooled data revealed an average VSS improvement of 29% across 282 patients following fractional CO2 ablative laser treatment. Although the heterogeneity of treatment regimens across studies limits this systematic review’s ability to provide specific treatment recommendations, the overall trend towards improvement of burns scars treated with fractional CO2 laser based on the VSS encourages further exploration of this modality as a therapeutic tool.


Dr Patrick Mahar is an adult and paediatric dermatologist with an interest in laser treatment of burn scars.

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