852 A Novel Approach to Treating Minor Burn Scar Contractures in Children Using Laser Surgical Cuts
Notice bibliographique
Résumé
Abstract Introduction Minor burn scar contractures can be successfully treated with conservative approaches including Carbon Dioxide (CO2) laser therapy. While previous research has mainly focused on using the CO2 laser in a fractional mode to create a stamped pattern of holes (Figure A), less is known about how altering this pattern may affect the overall outcome of the contracture. Given this knowledge gap, our research group sought to investigate a new laser technique in which a series of lines, referred to as “laser surgical cuts,” are created across the length of the scar (Figure B). Thus, the aim of this pilot study was to evaluate the effectiveness of using this novel, laser surgical cuts technique to treat minor burn scar contractures in pediatric patients. Methods This prospective pilot study was carried out in the outpatient setting at our pediatric hospital. Only patients that had a minor burn scar contracture that crossed a joint on their palm and/or digits and who had consented to receive treatment with laser therapy were eligible to participate. Prior to treatment, a trained occupational and/or physiotherapist assessed each participant’s contracture by examining at least one of the following characteristics depending on the contracture’s location and extent of involvement: 1) range of motion (ROM), 2) digit length, 3) hand-span. Treatment consisted of one session of laser therapy during which surgical cuts were created across the length of the contracture followed by casting for approximately one week. Following cast removal, the initial contracture assessment was repeated and pre-post measures were compared. Results Seven patients participated in this study. All injuries were the result of contact burns and the mean age at assessment was 5.1 years. Overall, patients with flexion contractures (n = 4) experienced a mean improvement in ROM by 22.5° (SD 14.4). Patients with discrepancies in digit length (n = 4) experienced a mean improvement of 9.4% (pre = 5.3 cm, SD 1.6; post = 5.8 cm, SD 1.6) while those with discrepancies in hand-span (n = 3) experienced a mean improvement of 13.7% (pre = 14.6 cm, SD 3.4, post = 16.6 cm, SD 3.0). Conclusions We have shown that using the CO2 laser to create surgical cuts can improve minor contractures in burn-injured children. Further, we hypothesize that improvements in ROM, digit length, and hand-span are the result of a decrease in the mechanical tension across the contracture following treatment. Based on the positive findings obtained from this pilot study, a larger study with long-term follow-up is needed to determine if treatment with laser surgical cuts is more effective than using traditional, fractional CO2 laser settings. Applicability of Research to Practice Ultimately, if this novel laser technique is proven to be highly effective, the need for future contracture release surgeries may be reduced.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
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 | 0,001 |
| 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 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 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 ».