Fractional carbon dioxide laser versus fractional Microneedle Radiofrequency in the Treatment of Post Burn Scars: a comparative randomized split scar study

Fractional Co2 laser resurfacing produces columns of thermal damage at specific depths (Manstein and Herron, 2004). The thermal effect stimulates a therapeutic wound healing response with heat – shock proteins, myofibroblasts, and an increased collagen III production, and therapy raises a potential for texture remodeling so that the appearance of burn scar will be improved (Luabach and tannous, 2006). Fractional microneedle radiofrequency (FMR) devices deliver energy to the deep dermis through insulated microneedles without destroying the epidermis (Kim et al., 2014). Fractional thermal injury of deep dermal collagen induced a vigorous wound healing process leading to dermal remodeling and the generation of new collagen and elastin (Alexiades-Armenakas et al., 2008).TGFβ1 stimulates growth and collagen secretion and is thought to be intergral to keloid formation (Peltonenet et al., 1991). It induces an increase in fibronectin bio synthesis, a link glycoprotein that binds to integrins and other matrix molecules, forming an early component of granulation tissue more rapidly in keloid fibroblasts, suggesting modification of this regulatory pathway (Ashcroft et al., 1999). Our current study aims at assessing the efficacy of fractional CO2 laser compared to fractional microneedle radiofrequency in the treatment of post burn scars, and the implications of both treatment modalities on TGFβ1 level. By this study, we hope to pave the way for optimum treatment strategies for patients with this disfiguring condition.