Scar wars

  • E L Möller University of Cape Town http://orcid.org/0000-0002-3100-3314
  • R Martinez University of Cape Town
  • H Rode University of Cape Town
  • S Adams University of Cape Town
Keywords: burn scars, paediatric population, ablative fractional laser

Abstract

Background: Burn scars are common in the paediatric population. When involving the face, it diminishes quality of life. Ablative fractional laser (AFL) therapy is becoming the preferred choice for established scars due to its greater potential depth for thermal injury (4 mm), which leads to photothermolysis with subsequent neocollagenesis and collagen fibre realignment and remodelling. Combined with small z-plasties and topical steroids, it has been proven to: flatten and decrease the volume of scars, increase pliability and decrease pruritus and erythema. The purpose of the case series was to determine the clinical significance of a single session of AFL therapy, combined with small z-plasties and topical steroids on facial scars post burn injury.

Methods: Four cases of paediatric facial scarring post burns were selected to undergo a single treatment of AFL therapy, accompanied by small z-plasties and topical steroids. Modified Vancouver Scar Scores (MVSS) pre- and postoperatively at 3 and 6 months were evaluated.

Results: Improvement of all components of the MVSS was achieved after 6 months, with major improvement in scar pliability and symptomatology. The mean MVSS improved from 14 (range 12–16) preoperatively to 5 and 5.5 respectively at 3 and 6 months postoperatively. Non-parametric analysis with Friedman Two-Way ANOVA by Rank showed a statistical significance between the pre- and postoperative MVSS (p = 0.024).

Conclusion: AFL should form an integral part of the burn scar armamentarium.

Author Biographies

E L Möller, University of Cape Town

Division of Plastic and Reconstructive Surgery, Red Cross War Memorial Children’s Hospital, University of Cape Town, South Africa

R Martinez, University of Cape Town

Division of Paediatric and Burn Surgery, Red Cross War Memorial Children’s Hospital, University of Cape Town, South Africa

H Rode, University of Cape Town

Division of Paediatric and Burn Surgery, Red Cross War Memorial Children’s Hospital, University of Cape Town, South Africa

S Adams, University of Cape Town

Division of Plastic and Reconstructive Surgery, Red Cross War Memorial Children’s Hospital, University of Cape Town, South Africa

Published
2019-11-04
How to Cite
Möller, E., Martinez, R., Rode, H., & Adams, S. (2019). Scar wars. South African Journal of Surgery, 57(4), 41. Retrieved from http://sajs.redbricklibrary.com/index.php/sajs/article/view/3021
Section
Online Articles