The efficacy and safety of fractional CO2 laser therapy in the treatment of burn scars: A meta-analysis |
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| Affiliation: | 1. Department of Plastic Surgery, The First Hospital of Jilin University, Chang Chun 130021, PR China;2. Department of Burns and Plastic Surgery, The First Hospital of Jilin University, Chang Chun 130021, PR China;1. Department of Physical Medicine and Rehabilitation, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea;2. Department of Rehabilitation Medicine, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Republic of Korea;1. Department of Surgery School of Medicine, Iran University of Medical Sciences, Iran;2. Department of General Surgery, School of Medicine, Burn Research Center, Shahid Motahari Burns Hospital, Iran University of Medical Sciences, Tehran, Iran;3. Department of Psychiatry School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran;4. Iran University of Medical Sciences, Tehran, Iran;5. Department of Plastic Surgery, School of Medicine, Burn Research Center, Shahid Motahari Burns Hospital, Iran University of Medical Sciences, Tehran, Iran;1. St Andrew’s Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford, UK;2. Centre for Trauma Sciences, Queen Mary University of London, UK;1. Department of Anesthesia and Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States;2. Doctors Collaborating to Help Children, Boston, MA, United States;3. Shriners Hospitals for Children - Boston, Boston, MA, United States;1. Department of Surgery, St. Agnes Hospital, Baltimore, MD, United States;2. Shriners Hospitals for Children - Boston, Boston, MA, United States;3. Department of Surgery, Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States;1. Shriners Hospitals for Children - Boston, Boston, MA, United States;2. Department of Surgery, Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States |
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| Abstract: | Although we have numerous publications about the effect of fractional CO2 laser therapy for burn scars, quantitative data about its efficacy and safety are sparse. The purpose of this meta-analysis was to assess the efficacy and safety of fractional CO2 laser therapy for the treatment of burn scars. Pertinent studies were identified by a search of PubMed, Embase and Web of Science up to 20 September 2020. Weighted mean difference (WMD) was conducted to combine the results, and a random-effect model was used to pool the results. Publication bias was estimated using Begg and Egger’s regression asymmetry test. Twenty articles were included. Our pooled results suggested that fractional CO2 laser therapy significantly improved the Vancouver Scar Scale (VSS) score (WMD = −3.24, 95%CI: −4.30, −2.18; P < 0.001). Moreover, the Patient and Observer Scar Assessment Scale (POSAS)-patient (WMD = −14.05, 95%CI: −22.44, −5.65; P = 0.001) and Observer (WMD = −6.31, 95%CI: −8.48, −4.15; P < 0.001) also showed significant improvements with the treatment of fractional CO2 laser therapy. Fractional CO2 laser significantly reduced scar thickness measured with ultrasonography (WMD = −0.54, 95%CI: −0.97, −0.10; P < 0.001). For other outcomes, including pigmentation, vascularity, pliability, and height of scar, vascularity and relief, laser therapy was associated with significant improvements. However, only the cutometer measure R2 (scar elasticity) (WMD = −0.06, 95%CI: −0.10, −0.01; P = 0.023) was significantly improved with the laser therapy, but cutometer measures R0 (scar firmness) (WMD = 0.03, 95%CI: −0.04, 0.09; P = 0.482) was not. Side effects and complications induced by fractional CO2 laser were mild and tolerable. Fractional CO2 laser therapy significantly improved both the signs and symptoms of burn scars. Considering potential limitations, more large-scale, well-designed RCTs are needed to verify our findings. |
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| Keywords: | Burn scars Meta-analysis |
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