Treatment of burn scar depigmentation by carbon dioxide laser-assisted dermabrasion and thin skin grafting

Permanent depigmentation occasionally develops after deep partial-thickness and full-thickness burn injuries, which heal by secondary intention. This problem can be solved by dermabrasion and thin split-thickness skin graftin g. However, mechanical dermabrasion is a bloody procedure that risks exposi ng medical professionals to infectious diseases transmitted by blood produc ts, and it is difficult to assess the extent of tissue ablation. In this st udy, dermabrasion of depigmented burn scar area was performed by using flas h-scanned carbon dioxide laser treatment, followed by thin split-thickness skin grafting. This method was applied to 13 patients on whom burn scar dep igmentation sites were located as follows: two in the facial area, four on the trunk, and seven on the extremities. Skin graft take was excellent in a ll patients except for one. The follow-up period for these patients ranged from 1 to 12 months, with an average of 8 months. Repigmentation appeared s oon after grafting, and no depigmentation occurred again in the treated are as. In conclusion, depigmented burn scar areas can be dermabraded in a shor t time; depth of tissue ablation can be well controlled; and a bloodless an d smooth raw surface can be created by using a flash-scanned carbon dioxide laser. These raw surfaces sustain thin skin grafts well.