Rapid Healing of Scar-Associated Chronic Wounds After Ablative Fractional Resurfacing Rapid Healing of Scar-Associated Chronic Wounds

Shumaker PR, Kwan JM, Badiavas EV, et al. — Thu, 01 Nov 2012 00:00:00 GMT

Background

Skin compromised by traumatic scars and contractures can manifest decreased resistance to shearing and other forces, while increased tension and skin fragility contribute to chronic erosions and ulcerations. Chronic wounds possess inflammatory mediator profiles and other characteristics, such as the presence of biofilms, that can inhibit healing.

Observations

Three patients with multiple traumatic scars related to blast injuries initiated a course of ablative fractional laser therapy for potential mitigation of contractures, poor pliability, and textural irregularity. Patients also had chronic focal erosions or ulcerations despite professional wound care. All patients experienced incidental rapid healing of their chronic wounds within 2 weeks of their initial ablative fractional laser treatment. Healing was sustained throughout the treatment course and beyond and was associated with gradual enhancements in scar pliability, texture, durability, and range of motion.

Conclusions

The unique pattern of injury associated with ablative fractional laser treatment may have various potential wound-healing advantages. These advantages include the novel concept of photomicrodebridement, including biofilm disruption and the stimulation of de novo growth factor secretion and collagen remodeling. If confirmed, ablative fractional resurfacing could be a potent new addition to traditional wound and scar treatment paradigms.

High Prevalence of Stump Dermatoses 38 Years or More After Amputation Stump Dermatoses 38 Years After Amputation

Yang NB, Garza LA, Foote CE, et al. — Thu, 01 Nov 2012 00:00:00 GMT

Objective

To highlight the prevalence and impact of skin disease at the stump site in patients who have undergone amputation.

Design

A cross-sectional health questionnaire of Vietnam War veterans with stump dermatoses at least 38 years after major limb amputation.

Setting

A research registry of veterans with combat-related amputations who agreed to participate.

Participants

Recruitment began January 1, 2006, and ended December 31, 2009, with a registry of 416 veterans.

Main Outcome Measures

Results of a self-reported 35-item questionnaire. Participants were later contacted by telephone or asked to complete a Web survey.

Results

Of the 247 veterans, 119 (48.2%) reported at least 1 skin problem within the preceding year. The most common were skin breakdown (25.2%), rash (21.8%), and abrasion (21.0%). In addition, 25.2% experienced skin problems more than 50% of the time, and 37.1% had to alter or replace their prosthesis. Stump dermatoses limited or prevented prosthesis use in the preceding year for 55.6% and caused pain or discomfort at the stump site in 61.5%.

Conclusions

More than 38 years after major limb amputation, skin complications at the stump site continue to cause significant morbidities and contribute to prosthesis abandonment. The high prevalence of stump dermatoses stresses the importance of disease prevention, early management, and advanced treatment of skin disease.

JAMA Dermatology: Wound Healing Topic Collection

Rapid Healing of Scar-Associated Chronic Wounds After Ablative Fractional Resurfacing Rapid Healing of Scar-Associated Chronic Wounds

High Prevalence of Stump Dermatoses 38 Years or More After Amputation Stump Dermatoses 38 Years After Amputation