Influence of scar age, laser type and laser treatment intervals on paediatric burn scars: a systematic review and meta-analysis

Yangmyung Ma; Sabrina P Barnes; Yung-Yi Chen; Naiem Moiemen; Janet M Lord; Amanda V Sardeli

doi:10.1093/burnst/tkad046

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Influence of scar age, laser type and laser treatment intervals on paediatric burn scars: a systematic review and meta-analysis

更新时间：2024-04-19

- Influence of scar age, laser type and laser treatment intervals on paediatric burn scars: a systematic review and meta-analysis
- Influence of scar age, laser type and laser treatment intervals on paediatric burn scars: a systematic review and meta-analysis
- Burns & Trauma 2024年12卷第1期
- 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：
  
  AVS is funded by a Newton International Fellowship and YYC is supported by the Scar Free Foundation.
- DOI：10.1093/burnst/tkad046
  中图分类号：
- 纸质出版日期：2024，
  
  网络出版日期：2024-2-2，
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Yangmyung Ma, Sabrina P Barnes, Yung-Yi Chen, 等. Influence of scar age, laser type and laser treatment intervals on paediatric burn scars: a systematic review and meta-analysis[J]. Burns & Trauma, 2024,12(1).

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, 等. Influence of scar age, laser type and laser treatment intervals on paediatric burn scars: a systematic review and meta-analysis[J]. Burns & Trauma, 2024,12(1). DOI： 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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