112 Improvements in Burn Hypertrophic Scar After Fractional Ablative Laser Scar Revision

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S74-S75
Author(s):  
Taryn E Travis ◽  
Rebekah R Allely ◽  
Laura S Johnson ◽  
Jeffrey W Shupp
Keyword(s):  
Laser Therapy ◽  
Hypertrophic Scar ◽  
Post Injury ◽  
Scar Revision ◽  
Scar Assessment ◽  
Time Period ◽  
Wide Range ◽  
Baseline Evaluation ◽  
Ablative Laser ◽  
Fractional Ablative Laser

Abstract Introduction Fractional ablative laser therapy use is increasing for treating burn hypertrophic scar (HTS). However, standard components of a routine HTS evaluation prior to starting laser scar revision (LSR) and after each intervention have yet to be determined, and metrics for effective treatment have not been established. Methods Patients who entered a LSR program between September 2018 and September 2019, underwent at least two LSR treatments, and completed post-LSR scar evaluations for each of these treatments were included in the studied sample. Patients were treated with a fractional ablative CO2 laser. A single burn rehabilitation therapist conducted all pre- and post-procedure scar evaluations, which included the Patient and Observer Scar Assessment Scale (POSAS), Vancouver Scar Scale (VSS), Institutional Scar Comparison Scale (SCS), durometry, and active range of motion (AROM) measurements. Results From 9/2018 to 9/2019, 25 patients began the LSR program and underwent at least two treatments with post-laser scar assessments for each intervention. Patients underwent an average of 3±1 LSR sessions during the time period for a total of 84 sessions amongst the group. Patients averaged 51±14 years old (range 26–80), with all Fitzpatrick skin types represented (mode type 5). Average HTS age was 14±19 months post-injury (range 3–98 months post injury). After one session of LSR, 91% of patients improved in at least one scar assessment metric (average 3±1.4 areas). After two sessions, all patients showed improvement in at least one metric (average 3.6±1.2 areas). One LSR session was associated with a 10.8±31.9% improvement in AROM of a HTS-affected joint, and this increased to 38.1±41.4% after five LSR treatments (p=0.0002). Durometry readings demonstrated decreasing scar hardness compared to adjacent uninjured skin in 90% of patients, and 96% of patients experienced improvements in POSAS, VSS, and SCS scores during a treatment course. Conclusions Improvements in burn HTS can be achieved with fractional ablative laser therapy in a wide range of scar ages and skin types, as early as the first LSR session. These continue to increase as additional sessions are performed. Applicability of Research to Practice This work suggests necessary baseline evaluation components for patients undergoing LSR, as well as a timeline for expected clinical improvements. This data may inform conversations with burn survivors and providers when considering laser therapy for symptomatic HTS.

A Single Institution Experience with Standardized Objective and Subjective Scar Evaluation While Undergoing Fractional Ablative Carbon Dioxide Laser Treatment

2021 ◽  
Author(s):  
Taryn E Travis ◽  
Rebekah A Allely ◽  
Laura S Johnson ◽  
Jeffrey W Shupp
Keyword(s):  
Carbon Dioxide ◽  
Range Of Motion ◽  
Laser Treatment ◽  
Carbon Dioxide Laser ◽  
Burn Scar ◽  
Scar Revision ◽  
Scar Assessment ◽  
Active Range Of Motion ◽  
Before And After ◽  
Baseline Evaluation

Abstract Laser treatment of burn scar has increased in recent years. Standard components of scar evaluation during laser scar revision have yet to be established. Patients who began laser scar revision from January 2018-2020, underwent at least three treatments, and completed evaluations for each treatment were included. Patients underwent fractional ablative carbon dioxide laser scar revision and pre- and post-procedure scar evaluations by a burn rehabilitation therapist, including Patient and Observer Scar Assessment Scale, Vancouver Scar Scale, our institutional scar comparison scale, durometry, and active range of motion measurements. Twenty-nine patients began laser scar revision and underwent at least three treatments with evaluations before and after each intervention. All patients improved in at least one scar assessment metric after a single laser treatment. After second and third treatments, all patients improved in at least three scar assessment metrics. Range of motion was the most frequently improved. Durometry significantly improved after a third treatment. Patients and observers showed some agreement in their assessment of scar, but observers rated overall scar scores better than patients. Patients acknowledged substantial scar improvement on our institutional scar comparison scale. Burn scar improves with fractional ablative laser therapy in a range of scar ages and skin types, as early as the first session. Improvements continue as additional sessions are performed. This work suggests baseline evaluation components for patients undergoing laser, and a timeline for expected clinical improvements which may inform conversations between patients and providers when considering laser for symptomatic hypertrophic scar.

Fractional Ablative Laser Therapy is an Effective Treatment for Hypertrophic Burn Scars

2019 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Nathanial Miletta ◽  
Katherine Siwy ◽  
Chad Hivnor ◽  
Jason Clark ◽  
Joshua Shofner ◽  
...  
Keyword(s):  
Effective Treatment ◽  
Laser Therapy ◽  
Ablative Laser ◽  
Fractional Ablative Laser

Full ablative versus fractional ablative laser therapy for Dowling–Degos disease

2018 ◽  
Vol 51 (4) ◽  
pp. 321-324 ◽  
Author(s):  
Anna‐Theresa Seitz ◽  
Helen Sterz ◽  
Vincent Strehlow ◽  
Stephanie Nagel ◽  
Konstantin Dumann ◽  
...  
Keyword(s):  
Laser Therapy ◽  
Degos Disease ◽  
Ablative Laser ◽  
Fractional Ablative Laser

scholarly journals Zebrafish Blunt-Force TBI Induces Heterogenous Injury Pathologies That Mimic Human TBI and Responds with Sonic Hedgehog-Dependent Cell Proliferation across the Neuroaxis

Biomedicines ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 861
Author(s):  
James Hentig ◽  
Kaylee Cloghessy ◽  
Manuela Lahne ◽  
Yoo Jin Jung ◽  
Rebecca A. Petersen ◽  
...  
Keyword(s):  
Cell Proliferation ◽  
Proliferative Response ◽  
Injury Severity ◽  
Granule Cell Layer ◽  
Dependent Manner ◽  
Adult Zebrafish ◽  
Post Injury ◽  
Blunt Force ◽  
Shh Pathway ◽  
Wide Range

Blunt-force traumatic brain injury (TBI) affects an increasing number of people worldwide as the range of injury severity and heterogeneity of injury pathologies have been recognized. Most current damage models utilize non-regenerative organisms, less common TBI mechanisms (penetrating, chemical, blast), and are limited in scalability of injury severity. We describe a scalable blunt-force TBI model that exhibits a wide range of human clinical pathologies and allows for the study of both injury pathology/progression and mechanisms of regenerative recovery. We modified the Marmarou weight drop model for adult zebrafish, which delivers a scalable injury spanning mild, moderate, and severe phenotypes. Following injury, zebrafish display a wide range of severity-dependent, injury-induced pathologies, including seizures, blood–brain barrier disruption, neuroinflammation, edema, vascular injury, decreased recovery rate, neuronal cell death, sensorimotor difficulties, and cognitive deficits. Injury-induced pathologies rapidly dissipate 4–7 days post-injury as robust cell proliferation is observed across the neuroaxis. In the cerebellum, proliferating nestin:GFP-positive cells originated from the cerebellar crest by 60 h post-injury, which then infiltrated into the granule cell layer and differentiated into neurons. Shh pathway genes increased in expression shortly following injury. Injection of the Shh agonist purmorphamine in undamaged fish induced a significant proliferative response, while the proliferative response was inhibited in injured fish treated with cyclopamine, a Shh antagonist. Collectively, these data demonstrate that a scalable blunt-force TBI to adult zebrafish results in many pathologies similar to human TBI, followed by recovery, and neuronal regeneration in a Shh-dependent manner.

scholarly journals In Vivo Histopathologic Comparison of the Acute Injury Following Treatment With Five Fractional Ablative Laser Devices

2010 ◽  
Vol 30 (3) ◽  
pp. 457-464 ◽  
Author(s):  
J. P. Farkas ◽  
J. A. Richardson ◽  
C. F. Burrus ◽  
J. E. Hoopman ◽  
S. A. Brown ◽  
...  
Keyword(s):  
Acute Injury ◽  
Laser Devices ◽  
Ablative Laser ◽  
Fractional Ablative Laser

scholarly journals The use of CO2 ablative fractional laser, non-ablative picosecond fractional lasers 1064 nm and 755 nm and needle mesotherapy in combined therapy to reduce stretch marks and skin laxity. A clinical case

2021 ◽  
Vol 10 (5) ◽  
pp. 253-259
Author(s):  
Agnieszka Surgiel-Gemza ◽  
◽  
Krzysztof Gemza ◽  
◽  
◽  
...  
Keyword(s):  
Clinical Case ◽  
Combined Therapy ◽  
Surgical Results ◽  
Alexandrite Laser ◽  
Fractional Laser ◽  
Aesthetic Medicine ◽  
Skin Laxity ◽  
Stretch Marks ◽  
Ablative Laser ◽  
Fractional Ablative Laser

Stretch marks are a common problem and a challenge for cosmetologists and aesthetic medicine doctors. Due to the complex etiopathogenesis and difficulties in their reduction, specialists use various therapeutic methods. In this study, the described case confirms the effectiveness of selected combined therapy in reducing stretch marks and skin laxity. Impressive surgical results were obtained with the implementation of combined therapy consisting of the use of non-ablative Nd:YAG fractional laser and alexandrite laser in picosecond technology, CO2 fractional ablative laser and needle mesotherapy treatments.

scholarly journals Japan Scar Workshop (JSW) Scar Scale (JSS) for Assessing Keloids and Hypertrophic Scars

2020 ◽  
pp. 133-140
Author(s):  
Rei Ogawa
Keyword(s):  
Hypertrophic Scar ◽  
Assessment Tool ◽  
Treatment Method ◽  
Response To Therapy ◽  
Assessment Scale ◽  
Response To Treatment ◽  
Hypertrophic Scars ◽  
Scar Assessment ◽  
Appropriate Treatment

AbstractThe Vancouver scar scale, the Manchester scar scale, and the Patient and Observer Scar Assessment Scale (POSAS) are all very well-known scar evaluation methods. These tools are based on a number of scar variables, including color, height, and pliability. However, since all were mainly developed to evaluate burn scars, they are difficult to use in clinical practice for keloids and hypertrophic scars. This is because these pathological scars require both differential diagnosis and a way to evaluate their response to therapy. The Japan Scar Workshop (JSW) has sought to develop a scar assessment scale that meets these clinical needs. The first version of this scar assessment tool was named the JSW scar scale (JSS), and it was reported in 2011. In 2015, the revised second version was reported. The JSS consists of two tables. One is a scar classification table that is used to determine whether the scar is a normal mature scar, a hypertrophic scar, or a keloid. This grading system helps the user to select the most appropriate treatment method for the scar. The other table in the JSS is an evaluation table that is used to judge the response to treatment and for follow-up. Both tables contain sample images of each subjective keloid/hypertrophic scar item that allow the user to evaluate each item without hesitation.

Changes in the properties of the developing trophoblast of preimplantation mouse embryos as revealed by aggregation studies

Development ◽  
1977 ◽  
Vol 40 (1) ◽  
pp. 143-157
Author(s):  
Paul S. Burgoyne ◽  
Thomas Ducibella
Keyword(s):  
Inner Cell Mass ◽  
Cell Mass ◽  
Supporting Cell ◽  
Mouse Embryos ◽  
Mixed Cell ◽  
Time Period ◽  
Preimplantation Mouse Embryos ◽  
Wide Range ◽  
Preimplantation Mouse

Mouse embryos (8-cell to early blastocyst) were denuded with pronase, and apposed in pairs which represented a wide range of stage combinations. These pairs either formed aggregates which differentiated into double-sized blastocysts, or they failed to aggregate. The 8–16-cell stages would not envelop late morulae/early blastocysts to form layered aggregates. This must mean that as the embryo differentiates into a blastocyst, the outer surface of the trophoblast loses its capacity for supporting cell spreading. The aggregation data also demonstrate that embryos almost completely lose their potential for aggregation at a very discrete stage in development – namely, between 8 and 9 h before blastocoel formation. It is argued that this is the stage at which the zonular tight junctional seal is completed, and that it is this physical barrier which prevents aggregation. It has been argued previously that the zonular tight junctional seal allows the creation of the special microenvironment which is necessary for the determination of the inner cells as inner cell mass. The completion of this seal 8–9 h before it is required for the formation of a blastocoel would provide a suitable time period for this cell determination to occur. The results obtained also relate to the technique of chimera production. Since the aim of this technique is to generate mice with mixed cell populations, it is important that the blastocyst formed following aggregation should have both cell lines present in the inner cell mass. This can best be assured by using relatively late morula stages (75 h post-HCG injection) since these will have already segregated their inner cells, but the incomplete seal will still allow aggregation to take place.

The Top 50 Most Cited Publications in Meniscus Research

2021 ◽  
Author(s):  
Kyle N. Kunze ◽  
Aidan Haddad ◽  
Alexander E. White ◽  
Matthew R. Cohn ◽  
Robert F. LaPrade ◽  
...  
Keyword(s):  
Sports Medicine ◽  
Citation Rate ◽  
Cross Sectional Study ◽  
Collective Knowledge ◽  
Cross Sectional ◽  
Anterior Cruciate Ligaments ◽  
Time Period ◽  
Wide Range ◽  
Anterior Cruciate

AbstractInjuries to the menisci of the knee are common in orthopedic sports medicine. Bibliometric studies can identify the core literature on a topic and help further our collective knowledge for both clinical and educational purposes. The purpose of the current study was to (1) identify and describe the 50 most cited articles in meniscus research over an 80-year time period to capture a wide range of influential articles and (2) identify the “citation classics” and milestone articles related to the meniscus of the knee. The Science Citation Index Expanded subsection of the Web of Science Core Collection was systematically searched for the 50 most cited meniscus articles. Data pertaining to bibliometric and publication characteristics were extracted and reported using descriptive statistics. The top 50 articles were published between the years 1941 and 2014 and collectively cited 13,152 times. The median (interquartile [IQR]) number of total citations per article was 203.5 (167.0–261.8), while the median citation rate was 9.6 (7.4–13.9) citations per year. The most cited article was “Knee joint changes after meniscectomy,” published in 1948. The article with the highest citation rate of 78.4 citations per year was “The long-term consequence of anterior cruciate ligaments and meniscus injuries – osteoarthritis,” published in 2007. The majority of articles were clinical outcome studies (n = 28, 56%). The top 50 most cited meniscus articles represent a compilation of highly influential articles which may augment reading curriculums and provide a strong knowledge base for orthopaedic surgery residents and fellows. The decade with the most articles was the 2000s, representing a recent acceleration in meniscus-based research. This is a level IV, cross-sectional study.

Sign in / Sign up

Export Citation Format

Share Document