721 Treatment of Hypertrophic Burn and Wound Scars Using a Novel Cold Laser System
Notice bibliographique
Résumé
Abstract Introduction Hypertrophic scars are seen in 70% of individuals after a burn. Survival from acute burns have psychosocial and functional challenges. Hypertrophic scars contain disorganized whorls of collagen, an increase in occluded blood vessels resulting in raised discoloration, inflamed dermis/epidermis and painful sequelae. Management of such scars have been limited to invasive and non-invasive management. One innovative technology is a non-invasive high-intensity laser operating at 1275 nm and 74 Watts, optimizing increased depth of penetration into the tissue utilizing photomechanical effects to biostimulate tissue to heal and regenerate. We present a series of 10 patients. Methods 10 patients were enrolled with hypertrophic scarring secondary to deep partial or full thickness burns. Hypertrophic areas were identified and numerical pain scale, Vancouver Scar Scale and the World Health Organization Quality of Life score were recorded. The non-contact, high-intensity laser was passed over the hypertrophic scars, continuously moving the laser over the entirety of the scar. Each area of hypertrophic scar tissue was lasered for progressively longer sessions, reaching a therapeutic time of 10 min in each section. Results Patients were utilizing previously known non-invasive therapies for scar reduction, such as, compression garments, scar treatment ointments, as well as steroid injection and non-medical therapies such as acupuncture. In our series, 90% of the patients reported decrease in scar pain, inflammation, pigmentation and improved pliability by the second treatment. Decreased scar height was identified by the eighth session, where conventional protocols could require months to years before any changes were observed. Changes in the scars were even identified after the normal time period identified for maximal improvement using conventional burn therapies. In a survey presented to patient, even pain was improved, identified with reduction in narcotic/NSAID use in patients undergoing the therapies. Conclusions Non-invasive high-intensity laser therapies are useful adjuncts for reduction of hypertrophic burn scars. Our case series presents a treatment option in patients that have functional, physical and cosmetic challenges. We anticipate broader applications for hypertrophic burn scar reduction utilizing adjunctive non-invasive laser therapy, reducing the need for invasive scar revision and limiting psychosocial strain. Applicability of Research to Practice In this case series, non-invasive high-intensity laser therapy provided timely decrease in hypertrophic scar characteristics in an outpatient setting. Thus, leading to decrease in invasive operative therapy and overall improvement in quality of life. Further studies are needed to elucidate other benefits and utility of the laser and possible evaluation of keloid scars.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».