Thesis (M.Sc.) - Cairo University -Faculty of Medicine - Department of Dermatology

Introduction: Fractional CO₂, has been shown to be effective in improving pigmentation, pruritus, pain, tightness of post burn scars, by breaking down the collagen with organized columns of microthermal injury, with the ability to heal in a more organized pattern. There is no consensus on the fractional laser parameters used in the treatment of post burn scars. The investigators adapted variable densities in the treatment of scars, some adopted the higher density, aiming at more ablation and release of the scar tension, while others used lower density to avoid the commonly reported side effects. Our aim of work was to compare effectiveness of different densities of fractional CO₂ laser in the treatment of post burn scars. Material and Methods: The study included 25 patients of both sex with post burn scars, with three separate post burn scars or large scars divided into three parts (A, B, C), that were randomly assigned to treatment with low, medium and high density fractional CO₂ laser. The degree of improvement was assessed clinically through Vancouver scar score and POSAS score and histologically through evaluation of collagen (Masson{u2019}s Trichrome stain) before and one month after end of therapy. Results: High density parameter showed significant improvement in VSS and POSAS assessment scores (P value <0.001), vascularity, pliability, relief and surface area are significantly improved with high density parameter (P value <0.001). Histopathological evaluation revealed a significant drop in the mean area percent of collagen in the three used parameters, with significant drop in collagen with high density parameter (P value <0.001)

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