Oral Presentation ANZBA Annual Scientific Meeting 2025

Ablative Laser Therapy for Hypertrophic Burn Scars: A 12-year Practice and Outcome Review    (23060)

Natalia Ziolkowski 1 , Inge Spronk 2 , Dale W Edgar 2 3 4 5 , Suzanne Rea 2 , Fiona Wood 2 , Helen Douglas 2
  1. Fiona Stanley Hospital; Hamilton Health Sciences; McMaster University, Murdoch, WA, Australia
  2. State Adult Burns Unit WA, Fiona Stanley Hospital, Murdoch, WA, Australia
  3. Burn Injury Research Unit, Faculty of Medicine and Dentistry, University of Western Australia, Crawley, WA, Australia
  4. Fiona Wood Foundation, Murdoch, WA, Australia
  5. Institute for Health Research, Burn Injury Research Node, The University of Notre Dame Australia, Fremantle, WA, Australia

Introduction: Ablative fractional CO2 lasers (AFCO2L) has been shown to improve hypertrophic burn scars (HBS). The purpose of this study was to review the 12-year patient cohort who received AFCO2L for HBS and identify independent factors associated with the application of AFCO2L.

Methods: This retrospective HRE-approved study included all patients who received AFCO2L at the Western Australian Statewide Adult Burns Unit from 2013 to 2024. Multivariate analyses were conducted to identify patient and burn factors associated with receiving AFCO2L. Patient subsets completed the Patient and Observer Scar Assessment Scale (POSAS 2.0), SF-36, and Itch Surveys. Their scar quality outcomes were compared over time using pre-post-laser analyses. 

Results: The study involved 837 individuals who received 4005 laser sessions. Patients receiving AFCO2L tended to be female (454 patients,54.2%) with a median age of 31 (IQR: 21 to 45), without comorbidities (690,82.4%). Most lived in the metro region (621,74.2%), were completed as outpatients (66%), and were Fitzpatrick 2 (387,46.2%). Individuals who were more likely to receive AFCO2L were: younger (p<0.001), female (p<0.001), had a higher percentage TBSA burned (p<0.001), multiple anatomic areas affected (p=0.001), longer time to wound healing (p<0.001), and surgery (p<0.001). The subset analysis of POSAS scores after one laser showed significant reduction in itch scores (mean: 4.0 [1 x laser] v 5.3 [pre-laser]; p=0.018) and colour (mean: 7.1 [1 x laser] v 8.5 [pre]; p=0.02).

Conclusions: The study results demonstrated that AFCO2L is an efficacious treatment modality that can be targeted to specific burn patient profiles and improve scar quality and symptomology of HBS.