A six -year experience of Laser Treatments for Burn Scars in a regional Burn Center - safety, efficacy and quality improvement.

Laser treatments have long been used as a treatment method for burn scars. Since 2012, over 1,800 laser treatments were performed at Lehigh Valley Health Network Burn Center, far exceeding any previous cohort in studies exploring laser treatments for Burn scars. Although previous research has looked at improving scar appearance and physiology with laser treatments, very few have focused on safety. The purpose of the study was to determine if laser treatments are a safe treatment option for burn scars.414 patients who had undergone at least one laser treatment in the outpatient burn center since 2012 were analyzed. Electronic medical records ( EPIC ©) were reviewed. The data was entered in REDCap© and later exported to Microsoft Excel© and R Studio© for statistical analysis.Most of the complications found were related to the moderate sedation during the procedures and were mild, i.e. nausea. The most common adverse effect was prolonged recovery time, which can impact practice flow. The overall post-operative complication rate for laser treatments with and without moderate sedation was minimal at 2.2% and 1.4% respectively. Pain during and after the procedure averaged 3.9 and 1.7 respectively on a 1-10 scale. The Vancouver Scar Scale (VSS) showed modest improvement in scar appearance over time with an average improvement of 1.4. The high variability of the VSS observed in this series underlines its lack of sensitivity. The study results show that laser treatments for Burn scars in the outpatient setting generally are safe for patients in need for Burn scar intervention. Some practice flow adjustments need to be taken into consideration when offering these procedures in an outpatient setting.