Laser ablation of burns: Initial clinical trial

Background. Scanning, high-powered carbon dioxide laser ablation of eschar may facilitate blood conservation in patients with burns. Methods. Twenty-one children with full-thickness burns that required serial excisions were enrolled in a Human Studies Committee approved protocol in which a full-thickness wound was ablated with a rapidly scanned continuous wave carbon dioxide laser system. A control wound was sharply excised and b oth wounds were immediately autografted. Endpoints were engraftment at 7 da ys and serial Vancouver scar scores. Results, The children had an average age of 8.3 +/- 1.2 years, weight of 36 .3 +/- 4.9 kg, and burn size of 40% +/- 5.1%. The study wounds were ablated with an average energy of 99.2 +/- 5.7 W; there was no bleeding from 19 su ccessfully ablated wounds. Initial engraftment averaged 94.7% +/- 3.5% in t he control sites and 94.7% +/- 3.3% in the study sites (P = 1.0). There was no significant difference in Vancouver scar scores at an average follow-up of 32.0 +/- 5.2 weeks. Conclusions. This Pilot study follows a successful trial of this this conce pt in a porcine model and demonstrates the technical feasibility of laser v aporization of burn eschar in humans with immediate autografting. Further r efinement of the technique is required before it can be generally recommend ed.