Abstract

GONZALEZ-PORTO, Sara A.; GONZALEZ-RODRIGUEZ, Alba; VILLAMARIN-BELLO, Nuria  and  POZO-LOSADA, Jesús Del. Fractional carbon dioxide laser associated with topic corticosteroid for the treatment of scar pruritus in burn patients. Cir. plást. iberolatinoam. [online]. 2017, vol.43, n.1, pp.69-75. ISSN 1989-2055.

Itch is a frequent sequelae in burns that might be disabling and hardly managed with medical treatment. We present a case of a burn patient with medical refractory pruritus and the result after treatment, consisting of laser assisted corticosteroid delivery. He was a severe burn patient with 70% total body surface area burned, with medical refractory pruritus and secondary skin lesions resulting from scratching, needing of sedation and intubation to control. One session of fractional carbon dioxide laser was performed, covering the treated area with an occlusive dressing soaked in triamcinolone acetonide dissolved with saline (20 mg/ml). Results were evaluated by using Burn Itch Questionnaire to assess the pruritus, and both Vancouver Scar Scale and Patient and Observer Scar Assessment Scale to assess the scar aesthetic result. We were able to control itch and stop scratching skin lesions, without any complication associated to the procedure. Laser assisted drug delivery was the mainstay concept of our patient treatment, where the ablative laser creates transepidermal channels that allow the corticosteroid to reach the dermis, and therefore the immediate effect of the drug. Both, this modality of treatment and new clinical concept are becoming an increasingly important tool for refractory pruritus management in burns.

Keywords : Burns; Pruritus; Burn sequelae; Scars; Laser.

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