Ablative fractional laser resurfacing helps treat restrictive pediatric scar contractures

AUTHORS: Krakowski AC¹, Gold­enberg A², Eichenfield LF¹, Murray JP³, Shumak­er PR⁴

RESEARCH SITES: ¹Division of Pediatric and Adolescent Dermatology, Rady Children’s Hospital, San Diego, CA, ²University of California San Diego School of Medicine, San Diego, CA, ³Occupational Therapy, Rady Children’s Hospital, San Diego, CA, ⁴Department of Dermatology, Naval Medical Center, San Diego, CA

PUBLICATION: Pediatrics Vol. 134 No. 6, pp. e1700- 1705

YEAR: 2014

Conventional management of debilitating pediatric scar contractures, including hand therapy and surgery, may often be beset by delayed treatment, suboptimal results, and additional surgical morbidity. Ablative fractional laser resurfacing is an emerging adjunctive procedural option for scar contractures because of its promising efficacy and safety profile. However, its use to improve function has not been studied in the pediatric population. Herein we report 2 pediatric patients with recalcitrant scar contractures, causing persistent functional deficits, treated with an ablative fractional laser protocol. Both patients experienced rapid and cumulative subjective and objective improvements in range of motion and function as measured by an independent occupational therapist without reported complications. We highlight ablative fractional laser resurfacing as a novel and promising tool in the management of function-limiting scar contractures in children and propose that the technique be incorporated into existing scar treatment paradigms, guided by future research.