Ablative Fractional CO2 Laser for the Treatment of Severe Burn Scars: A Prospective Outcome Analysis and Nested Case-Control Study

Dr Andrea C Issler Fisher1,4,5, Dr Oliver Fisher2,3, Dr Frank Li1, A/Prof Peter Haertsch1,4, Dr Zhe Li1,4,5, Prof Peter Maitz1,4,5

1Concord Repatriation General Hospital, Concord, Australia, 2Department of Surgery UNSW, St. George Hospital, Kogarah, Australia, 3Department of Surgery, University of Notre Dame, Sydney, Australia, 4University of Sydney, Camperdown, Australia, 5ANZAC Research Institute, Concord Repatriation General Hospital, Concord, Australia


Purpose: To perform an extensive outcome analysis and nested-case control study of a burn cohort treated with the ablative fractional CO2 laser (AFL).

Methods: Since December 2014 patients were prospectively recruited and various outcome parameters collected from the date of first consultation and at each follow-up. In a second step a nested case-case control study was performed looking at the same outcome variables.

Results: So far 155 patients with 293 burn scars have been prospectively enrolled in this study. An interims analysis of 41 patients with 93 scars revealed: all analysed objective parameters dropped significantly. Scar thickness decreased from a median of 2.5 to 1.7mm (p<0.001). The VSS dropped from a median of 8 to 5 (p<0.001). The overall POSAS observer and patient decreased from a median 5 to 3 (p<0.001) & 9 to 4 (<0.001) respectively. Neuropathic pain and pruritus also decreased significantly (median 5 to 2 & 16 to 11;both p<0.001). Quality of life, as assessed by the BSHS-B, increased by 14 points (median 126 to 140;p<0.001). All of the identified changes following AFL were irrespective of scar maturation status (> vs < 2 years).

Conclusion: Results from this analysis confirm significant improvements in thickness, texture, colour, symptoms and quality of life of burn patients treated with the AFL. Results from the nested case-control study will be presented.


Following training in general surgery, burns & plastic surgery in Switzerland, Dr Issler-Fisher joined the Sydney University Burns Unit of Concord Repatriation General Hospital (CRGH) in Sydney in 2013, where she established and now runs the Burns Scar Clinic in 2015.

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