Influence of scar age, laser type and laser treatment intervals on paediatric burn scars: a systematic review and meta-analysis
- Burns & Trauma Vol. 12, Issue 1, (2024)
- 作者机构：
1. College of Medical and Dental Sciences, University of Birmingham
2. Hull York Medical School
3. Department of Burns and Plastic Surgery, Queen Elizabeth Hospital Birmingham
4. Scar Free Foundation Centre for Burns Research, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham
5. National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham
- 作者简介：
- 基金信息：
DOI：10.1093/burnst/tkad046
CLC：Published：2024，
Published Online：2 February 2024，
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Yangmyung Ma, Sabrina P Barnes, Yung-Yi Chen, Naiem Moiemen, Janet M Lord, Amanda V Sardeli, Influence of scar age, laser type and laser treatment intervals on paediatric burn scars: a systematic review and meta-analysis, Burns & Trauma, Volume 12, 2024, tkad046, https://doi.org/10.1093/burnst/tkad046
Yangmyung Ma, Sabrina P Barnes, Yung-Yi Chen, Naiem Moiemen, Janet M Lord, Amanda V Sardeli, Influence of scar age, laser type and laser treatment intervals on paediatric burn scars: a systematic review and meta-analysis, Burns & Trauma, Volume 12, 2024, tkad046, https://doi.org/10.1093/burnst/tkad046 DOI：
摘要
Abstract
BackgroundLaser therapy has emerged to play a valuable role in the treatment of paediatric burn scars; however
there is heterogeneity in the literature
particularly concerning optimal timing for initiation of laser therapy. This study aims to investigate the effect of factors such as scar age
type of laser and laser treatment interval on burn scar outcomes in children by meta-analysis of previous studies.MethodsA literature search was conducted across seven databases in May 2022 to understand the effects of laser therapy on burn scar outcomes in paediatric patients by metanalysis of standardized mean difference (SMD) between pre- and post-laser intervention. Meta-analyses were performed using the Comprehensive Meta-Analysis software version 4.0. Fixed models were selected when there was no significant heterogeneity
and the random effects model was selected for analysis when significant heterogeneity was identified. For all analyses
a p-value < 0.05 was considered significant.ResultsSeven studies were included in the meta-analysis with a total of 467 patients. Laser therapy significantly improved Vancouver Scar Scale (VSS)/Total Patient and Observer Scar Assessment Scale (Total POSAS)
vascularity
pliability
pigmentation and scar height of burn scars. Significant heterogeneity was found between the studies and thus subgroup analyses were performed. Early laser therapy (<12 months post-injury) significantly improved VSS/POSAS scores compared to latent therapy (>12 months post-injury) {SMD −1.97 [95% confidence interval (CI) = −3.08; −0.87]
p < 0.001 vs −0.59 [95%CI = −1.10; −0.07]
p = 0.03} as well as vascularity {SMD −3.95 [95%CI = −4.38; −3.53]
p < 0.001 vs −0.48 [95%CI = −0.66; −0.30]
p < 0.001}. Non-ablative laser was most effective
significantly reducing VSS/POSAS
vascularity
pliability and scar height outcomes compared to ablative
pulse dye laser and a combination of ablative and pulse dye laser. Shorter treatment intervals of <4 weeks significantly reduced VSS/POSAS and scar height outcomes compared to intervals of 4 to 6 weeks.ConclusionsEfficacy of laser therapy in the paediatric population is influenced by scar age
type of laser and interval between laser therapy application. The result of this study particularly challenges the currently accepted initiation time for laser treatment. Significant heterogeneity was observed within the studies
which suggests the need to explore other confounding factors influencing burn scar outcomes after laser therapy.
关键词
Keywords
Laser therapyHypertrophic burn scarsScar outcomesScar agePaediatric
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