Effect of Extracorporeal Shock Wave Therapy for Burn Scar Regeneration: A Prospective, randomized, double-blinded study

Abstract Purpose This study aimed to investigate the regeneration effect of extracorporeal shock wave therapy (ESWT) on hypertrophic scar regeneration using objective measurements. Methods This was a double-blinded, randomized, controlled trial of 48 participants who had undergone autologous split-thickness skin grafting (STSG) with same artificial dermis. The ESWT group (n = 25) received shock waves with low-energy flux density (0.05-0.30 mJ/mm2). The interval between treatments is a 1-week. The ESWT group also received recommended treatment. The control group (n = 23) only received recommended treatment. We measured skin characteristics before treatment and after 6 weeks for both groups. Results No significant intergroup difference was noted at the initial evaluations (p > 0.05). The pre- to post-treatment change in the scar thickness (p = 0.03) and erythema (p = 0.03), more reductions were found in the ESWT group than control group. The pre- to post-treatment change in the sebum level (p = 0.02), more increase was found in the ESWT group. There were no significant differences in the change measurements between the two groups for melanin levels (p = 0.62) and transepidermal water loss (TEWL) (p = 0.94). The changes (skin distensibility, biological skin elasticity, gross skin elasticity, and skin viscoelasticity) measured with the Cutometer showed no significant differences between the two groups (p = 0.87, p = 0.32, p = 0.37, and p = 0.29, respectively). Conclusion This is the first report of ESWT effectiveness on hypertrophic scar regeneration caused by burn using objective tools (melanin, erythema, sebum, TEWL, elasticity and thickness). ESWT is effective for significantly improving burn-associated scar characteristics and may be used for managing burn patients.