Burns : journal of the International Society for Burn Injuries
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Randomized Controlled Trial Clinical Trial
Pulsed dye laser treatment of burn scars. Alleviation or irritation?
Burn scars are very common in both children and adults, causing great morbidity and often pose a difficult management problem. This study investigated the efficacy of the dye laser in patients with symptomatic burn scars and analysed the impact of the laser treatment on scar redness, surface texture and pruritus. ⋯ The 585 nm flashlamp-pumped pulsed dye laser is an effective treatment for the intense pruritus often experienced during the healing process after a burn injury. This study has not shown other benefits, such as reduction in scar redness, height and textural improvement to be statistically significant. There is evidence that blood vessel diameters in hypertrophic scar tissue are much smaller than the vessels in port wine stains for which this laser was designed to treat. Therefore, by decreasing the pulse width, more vascular specific damage in the scar may be possible. It is likely that the beneficial effects demonstrated thus far result from changes to the chemical signals that regulate the scar growth and symptoms.
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External splinting has been acknowledged for many years as a useful approach for preventing and correcting burn contractures. Though this practice could be traced back many centuries, there is still a dearth of knowledge regarding a good splint to serve these purposes for axillary burns. ⋯ It acts as a splint that provides circumferential pressure for scar management, provides prolonged stretch to contracted tissue and acts as a serial cast in increasing the shoulder range. Most of all, it is very much user-friendly, thus enhancing compliance and giving a good outcome in axillary burns.
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Comparative Study
Laser Doppler imaging of burn scars: a comparison of wavelength and scanning methods.
Laser Doppler perfusion imaging (LDI) is a useful tool for the early clinical assessment of burn depth and prognostic evaluation of injuries that may require skin grafting. We have evaluated two commercially available laser Doppler imagers for the perfusion measurement of normal and burn scar tissue. ⋯ Both LDI scanners perform similar perfusion measurements. The results also indicate that red and near-infrared (NIR) wavelength photons provide similar blood flow information. The faster, continuous scanning method provides a clinical advantage without a significant loss of blood flow information. However, a critical evaluation of both instruments suggests that caution must be exercised when using these optical diagnostic techniques and that some knowledge of light-tissue interaction is required for the proper analysis and interpretation of clinical data.