![]() ![]() Superficial burns that do not reach the reticular dermis rarely lead to abnormal scarring and do not generally cause complications. 11 Such is the case of burns affecting the deep layers of the dermis, for example, second- or third-degree burns, which may require laser treatment. 10 The main devices used in the treatment of burn scars are summarized in Table 1.īurn scars generally result in abnormal healing of the skin in more than 70% of cases owing to abnormalities in thickness, texture, erythema, and pigmentation. ![]() Lasers are classified according to their mechanism of action as ablative/nonablative and fractional/nonfractional. 8 While lasers do not necessarily replace surgery, they can reduce the area to be treated, thus leading to fewer postsurgical complications. Therefore, they are included in some treatment protocols alongside modestly successful conservative approaches and surgical interventions, which may be very effective but are associated with high morbidity. They are minimally invasive, carry a low risk of adverse effects, and are associated with rapid recovery. In recent years, lasers have proven effective in the treatment of burn injuries. 6 These approaches must often be combined with surgery, which can range from resection of the scar with closure of the wound to transverse incision, Z-plasty, flaps, and skin grafting. 5Ī variety of conservative treatments have traditionally been administered to manage burn scars, including silicone gel, corticosteroid injections, pressure therapy, and therapeutic massages. Moreover, the strong emotional component associated with this type of lesion can be stigmatizing, especially in lesions affecting the face and neck, and lead to anxiety, depression, and low self-esteem. 4 Contractures and disfigurement have a huge impact on function, reduce mobility, and cause pain and itching. ![]() 3Ĭomplications resulting from burn scars can have a considerable effect on patient quality of life. Most burns affected <20% of the body surface and mainly involved the skin, thus highlighting the role of the dermatologist. ![]() In 2017, the worldwide prevalence of burn injuries exceeded 1000 per 100 000 inhabitants. 1,2 However, laser treatment for the sequelae of burns has received less attention, and the option is not available in most hospitals. 1 Lasers have been widely studied in specific types of scar, such as those resulting from acne, surgery, and injury, as well as keloids. Laser devices have proven very useful for the treatment of scars. Revisamos la evidencia de estos dispositivos para el tratamiento de las cicatrices por quemaduras y aportamos una propuesta de algoritmo terapéutico. La hiperpigmentación puede mejorar con láseres de pigmento en modalidades de pulso corto (nano- y picosegundos). El láser de colorante pulsado es especialmente útil ante las cicatrices de quemaduras recientes con componente eritematoso y para prevenir el desarrollo de cicatrices hipertróficas posteriores. El láser más utilizado es el láser CO 2 para tratar el grosor de la cicatriz, alteraciones texturales, y la posible contractura asociada, restaurando la movilidad de estos pacientes cuando se encuentra alterada. Sin embargo, su uso en los departamentos de dermatología hospitalarios todavía está poco extendido. Los dispositivos láser se han mostrado eficaces para su tratamiento, por encima de los tratamientos tópicos y complementarios a la cirugía, sin generar tanta morbilidad. Las cicatrices por quemadura suponen una elevada morbilidad en forma de contracturas, desfiguración corporal y prurito, así como un elevado impacto emocional que disminuye la calidad de vida de estos pacientes. In this article, we review the evidence for the use of laser therapy for burn scars and propose a treatment algorithm. Pigment laser treatments with short pulse durations (nanoseconds or picoseconds) can improve hyperpigmentation. Pulsed dye laser treatments are particularly useful for reducing erythema in recent burn scars and preventing subsequent hypertrophy. Carbon dioxide laser is the most widely used device for reducing scar thickness, improving textural abnormalities, and treating associated contractures, which may restore the mobility of these patients when it is altered. The use of lasers in hospital dermatology departments, however, is still limited. It is superior to topical treatments and can be used in conjunction with surgery, helping to reduce morbidity. Laser therapy has proven effective in this setting. Burn scars cause high morbidity in the form of contractures, body disfigurement, and itching, as well as a high emotional impact that adversely affects patient quality of life. ![]()
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