Laser Treatment of Traumatic Scars and Contractures: 2020 International Consensus Recommendations

报销 医学 疤痕 肌肉挛缩 外科 医疗保健 政治学 法学
作者
Meghan Seago,Peter R. Shumaker,Leah K. Spring,Murad Alam,Firas Al‐Niaimi,R. R. Anderson,Ofir Artzi,Ardeshir Bayat,Daniel Cassuto,Henry H. Chan,Christine Dierickx,Matthias B. Donelan,Gerd G. Gauglitz,Boncheol Goo,Greg J. Goodman,Geoffrey C. Gurtner,Merete Hædersdal,Andrew C. Krakowski,Woraphong Manuskiatti,William B. Norbury,Rei Ogawa,David M. Ozog,Uwe Paasch,E. Victor Ross,Matteo Tretti Clementoni,Jill Waibel
出处
期刊:Lasers in Surgery and Medicine [Wiley]
卷期号:52 (2): 96-116 被引量:115
标识
DOI:10.1002/lsm.23201
摘要

Background and Objectives There is currently intense multidisciplinary interest and a maturing body of literature regarding laser treatments for traumatic scars, but international treatment guidelines and reimbursement schemes have not yet caught up with current knowledge and practice in many centers. The authors intend to highlight the tremendous potential of laser techniques, offer recommendations for safe and efficacious treatment, and promote wider patient access guided by future high‐quality research. Study Design/Materials and Methods An international panel of 26 dermatologists and plastic and reconstructive surgeons from 13 different countries and a variety of practice backgrounds was self‐assembled to develop updated consensus recommendations for the laser treatment of traumatic scars. A three‐step modified Delphi method took place between March 2018 and March 2019 consisting of two rounds of emailed questionnaires and supplementary face‐to‐face meetings. The panel members approved the final manuscript via email correspondence, and the threshold for consensus was at least 80% concurrence among the panel members. Results The manuscript includes extensive detailed discussion regarding a variety of laser platforms commonly used for traumatic scar management such as vascular lasers and ablative and non‐ablative fractional lasers, special considerations such as coding and laser treatments in skin of color, and 25 summary consensus recommendations. Conclusions Lasers are a first‐line therapy in the management of traumatic scars and contractures, and patients without access to these treatments may not be receiving the best available care after injury. Updated international treatment guidelines and reimbursement schemes, additional high‐quality research, and patient access should reflect this status. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.
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