Shriners Hospital Mexico treats scars from burn sequelae

The CO₂ Laser Has Notably Improved the Appearance of Scars

Shriners Hospitals are known for supporting children with burns, in the specific case of the Shriners Hospitals of Mexico City, they treat injuries left by burns. There are several treatments to improve these kinds of injuries, with CO₂ laser therapy being one of the most recent used to improve the appearance of scars caused by burns.

Post-burn healing represents a significant clinical problem due to the number of patients who develop scars and the notoriously difficult treatment of these scars. They can limit social interaction, negatively affect self-esteem and daily activities Because thermally induced scars are typically recalcitrant to treatment due to their proliferative nature, their appropriate management is still a challenge.

Plastic surgeon Enrique Garavito directs the burn sequelae program applying CO₂ laser therapy. I was trained at the Shriners Hospital in Galveston, Texas, and here at our hospital in Mexico City by Dr. William Norbury, explains Garavito.

This treatment was initiated at the Shriners Hospital Mexico in September 2018, and the hospital has performed over 250 procedures to treat patients with multiple scars, using fractional CO₂ laser therapy.

To assess scars, we use POSAS (Patient and Observer Scar Assessment) which revealed improvements in 97% of cases. Lasers have had a great impact on the treatment of cosmetically disfiguring skin lesions, largely due to the pioneering work of several plastic surgeons,” comments Gravito.

The treatment

The treatment of burn scars include a multitude of chemical, physical and surgical options, and encompass conservative modalities such as steroid injections, pressure garments and application of silicone gel sheets, and there are more invasive measures, such as cryotherapy, radiation, and/or surgical excision. The laser energy is absorbed by three main chromophores: hemoglobin; melanin and water. The laser light is absorbed by the target chromophore, produces heat and destroys the target.


Scar removal
The fractional CO₂ laser system fires a laser beam that divides into several microscopic beams, producing minuscule dots or fractional treatment zones within the selected target area alone. Therefore, the laser heat only passes deeply through the area of fractional damage. This allows the skin to heal much faster than if the entire area were treated. During skin rejuvenation, a large amount of collagen is produced for this purpose; eventually the skin will look much healthier and younger. Almost every laser therapy requires repeated treatment to achieve the desired effect.

Which patients are candidates for this CO₂ laser therapy?

The application of laser therapy is limited to post-burn scars (hypertrophic or hyperpigmented scars, keloids, and to decrease pruritus or intense itching and erythema). “Patients undergoing laser treatment for scars require additional general sedation. Sedation is provided by an anesthesiologist,” Dr. Garavito explained.

Safety is paramount

Dr. Garavito explains that both staff and patient must wear specific safety glasses during treatment. Treatment around the eyes may require the use of a corneal eye shield. When using the CO₂ laser, the patient should be further protected with wet drapes or crumpled aluminum foil to reduce the risk of reflected laser light. “The Hospital fully complies with all safety requirements for using CO₂ laser treatment.”

“We are interested in continuing laser treatments and helping to assist more children with burn sequelae,” concluded Dr. Enrique Garavito.