The Use of Fractional Ablative CO2 Laser vs Control on Acute Traumatic Injuries to Prevent Scar Formation

Burns Clinical Trial

Official title:

Early Intervention of Fractional Ablative CO2 Laser With or Without 830 nm LED Phototherapy for Acute Burn Injuries

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03888703
• Other study ID #: SAIRB-13-0045
• Status: Completed
• Phase: N/A
• Start date: May 4, 2015
• Est. completion date: May 5, 2017

Study information

• Verified date: March 2019
• Source: Miami Dermatology and Laser Institute
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Surgical standard for treating traumatic burn injury scarring is to wait one year following the initial assault prior to beginning treatment. This study investigates the use of fractional ablative CO2 laser when begun within 3 months of a traumatic burn injury and it's impact on scar formation compared to the control. We hypothesized that early intervention would substantially mitigate the formation of scar tissue and help restore more normal appearing skin.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 19
• Est. completion date: May 5, 2017
• Est. primary completion date: May 5, 2017
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years to 80 Years

Eligibility

Inclusion Criteria:

• Subject is between 18 and 80 years of age with burn injuries suffered within the prior 3 months

• Subject is a healthy Male or Female

• Fitzpatrick Skin Type I - IV

• Subject must have moderate - severe burn damage of sufficient bilateral area involving either the face, trunk, arms or legs

• Subject must be able to read, understand and sign the Informed Consent Form

• Subject must be willing and able to adhere to the treatment and follow-up schedule and post-treatment care instructions

• Subject must be willing to have limited sun exposure for the duration of the study, including the follow-up period

• Subject is willing to have photographs taken of the treated area which will be used de-identified in evaluations and may be used de-identified in presentations and/or publications

• For female candidates - they may be post-menopausal, surgically sterilized, or using a medically acceptable form of birth control during the entire course of the study.

• Female candidates with child bearing potential - willing to take pregnancy test and result must be negative.

Exclusion Criteria:

• Subject is less than 18 or greater than 80 years of age.

• Subject has Fitzpatrick Skin Type V - VI

• Subject is Pregnant or planning to become pregnant during the study duration

• Subject is breast feeding during the study duration

• Subject has an active skin infection, dermatitis or a rash in the treatment area

• Subject has a history of immunosuppression/immune deficiency disorders or currently using immunosuppressive medications

• Subject has a known bleeding disorder

• Subject has a known photosensitivity to the study laser wavelength, history of ingesting medications known to induce photosensitivity, or history of seizure disorders due to light.

• Subject has a known collagen, vascular disease or scleroderma

• Subject has undergone any surgery or other procedures in the treatment area within 6 months of treatment which are still healing.

• Subject is suffering from significant concurrent illness, such as insulin-dependent diabetes, peripheral vascular disease or peripheral neuropathy

• Subject is undergoing systemic chemotherapy for the treatment of cancer

• Subject has lesions suspicious for malignancy

• The systemic use of isotretinoin (Accutane®) or other retinoid derivatives within 6 months of study participation

• Any use of gold therapy for disorders such as rheumatologic disease or lupus

• The subject is excessively tanned in areas to be treated or unable/unlikely to refrain from tanning during the study

• The subject has participated in a study of another device or drug within three months prior to enrollment or during the study.

• As per the Investigator's discretion, any physical or mental condition which might make it unsafe for the subject to participate in this study

Related Conditions & MeSH terms

• Burns
• Early Medical Intervention
• Laser Therapy
• Scar
• Trauma Injury
• Wound Heal
• Wounds and Injuries

Intervention

Device:
• Fractional ablative CO2 laser
Three treatments with a fractional ablative CO2 laser 8 weeks apart

Locations

Country	Name	City	State
n/a

Sponsors (2)

Lead Sponsor	Collaborator
Miami Dermatology and Laser Institute	LUTRONIC Corporation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Manchester Scar Scale	The sum total of the Manchester Scar Scale to assess the change in scar characteristics. The scale includes the following categories: Color, matte vs shiny, contour, distortion, and texture. Scales for color, contour, distortion, and texture are rated on a 1-4 scale with 1 being most normal and 4 being most abnormal. Matte vs shiny is rated on a 1 to 2 scale with 1 being matte and 2 being shiny. Assessments completed by blinded evaluators. A decrease in score indicates improvement in scar characteristics.	From the day of the first treatment prior to intervention and at 6 months following the final treatment
Primary	Digital photography	Visual improvement as demonstrated in digital photography. Before and after photos identified by blinded evaluators	From the day of the first treatment prior to intervention and at 6 months following the final treatment
Primary	Changes in scar characteristics such as dermal and epidermal character as well as vascular structure and organization assessed through histology.	Some patients elected to do optional biopsies for deeper evaluation of changes in skin structure. Biopsies were taken prior to treatment and 6 months following treatment to assess dermal and epidermal character as well as the size and organization of vasculature. Evaluation was done qualitatively.	From the day of the first treatment prior to intervention and at 6 months following the final treatment
Secondary	Optical Coherence Tomography	Patients were scanned using OCT for noninvasive skin imaging of both control and treatment areas	From the day of the first treatment prior to intervention and at 6 months following the final treatment
Secondary	Treatment Time	The total duration of each treatment was measured in minutes to assess treatment characteristics for large surface areas	Treatment time was measured at each of the three treatments conducted on day 0, day 60, and day 120
Secondary	Severity of post treatment cutaneous responses as evaluated by the investigator	Cutaneous responses including purpura, edema, erythema, hyperpigmentation, hypopigmentation, blistering and scarring were assessed following each treatment. Areas were rated on a 1-4 scale where 1 = none, 2 = mild, 3 = moderate, and 4 = severe.	Post treatment response was assessed immediately post treatment at each of the three treatments conducted on day 0, day 60, and day 120