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Oral Presentation - 158
Morphological changes in scar tissue during fractional CO2 laser ablations of extensive post-burn scars in children
Alina Roshchupkina 1, Oksana Bychkova 1, Saidkhasan Bataev 2, Ilya Zyabkin 3, Ali Ferzauli 4, Olga Shcherbakovа 1, Maxim Tsatsa 1
1 Federal Scientific and Clinical Center for Children and Adolescents of the FMBA of Russia
2 Federal Scientific and Clinical Center for Children and Adolescents of the FMBA of Russia, Burnazyan Scientific Research Center, Pirogov Russian National Research Medical University. Kh. Ibragimov Complex Institute of the Russian Academy of Sciences
3 Federal Scientific and Clinical Center for Children and Adolescents of the FMBA of Russia, Burnazyan Scientific Research Center,
4 Kadyrov Chechen State University
Introduction. Recently, there have been reports of successful application of fractional methods of laser exposure of CO2 laser, in which a large number of viable cells remain along the periphery of destruction zones, providing complete regeneration of damaged areas.
Methods.
A histological study was conducted with the collection of material from patients with post-burn scars in the face and neck area 20 hours and 4 days after CO2 laser ablation (staining with hematoxylin and eosin, magnification x 300).
Morphological picture in a patient who received 2 sessions of fractional CO2 laser ablation with an interval of 6 months, and a control untreated area of scar tissue of the same patient. It was found that in the area treated with fractional CO2 laser ablation, stratification of the epidermis is preserved.
Results. During a large-scale study of histological preparations of scar tissue before and after fractional CO2 laser ablation over the next 6 months, a decrease in the amount of coarse collagen type 1 with a predominance of structurally organized collagen type 3 was noted. The appearance of islands of cellular element clusters, which form skin appendages in intact skin, was also noted.
According to immunohistochemical studies, after fractional CO2 laser exposure, against the background of photothermal damage to scar tissue, the production of heat shock proteins increases. In parallel, due to the release of growth factors, the migration of inflammatory cells to the destruction zone is stimulated with the development of a moderate inflammatory reaction, triggering the processes of regeneration and synthesis of new collagen.
Conclusions. Clinically, the changes that occurred with the post-burn scar area after 2 fractional CO2 laser ablations are characterized by smoothing of the scar surface, leveling of skin tone, reduction of pigmentation and injected vessels, disappearance of excess skin flap, reduction of scar tissue thickness.